Reviewed by Dr. Kepa Beitia, DDS Independent dentist providing online second opinions.Reviewed by Dr. Kepa Beitia, DDS Independent dentist providing online second opinions.

Dentist Says I Need a Root Canal — What Should I Do Next?

Your dentist just told you that you need a root canal. Your mind is probably racing with questions:Your dentist just told you that you need a root canal. Your mind is probably racing with questions:

"Is this really necessary?" "Can I wait?" "Should I get a second opinion?" "What happens if I don't do it?""Is this really necessary?" "Can I wait?" "Should I get a second opinion?" "What happens if I don't do it?"

These are all completely normal questions — and you're right to ask them.These are all completely normal questions — and you're right to ask them.

Root canals are one of the most commonly recommended (and expensive) dental procedures. Many patients are told they need one even when symptoms are mild or unclear, which is why understanding the *why*, *urgency*, and *alternatives* matters.Root canals are one of the most commonly recommended (and expensive) dental procedures. Many patients are told they need one even when symptoms are mild or unclear, which is why understanding the *why*, *urgency*, and *alternatives* matters.

This guide walks you through exactly what to do when a dentist recommends a root canal, when a second opinion makes sense, and how to make an informed decision you can feel confident about.This guide walks you through exactly what to do when a dentist recommends a root canal, when a second opinion makes sense, and how to make an informed decision you can feel confident about.

Quick Answer: Don't Rush — You Usually Have Time

When a dentist recommends a root canal, here's what to do first:When a dentist recommends a root canal, here's what to do first:

1. Ask questions — Understand why it's being recommended 2. Request to see your X-rays — Visual proof matters 3. Get a second opinion if you're unsure — This is smart and common 4. Understand the urgency — Most root canals are not emergencies1. Ask questions — Understand why it's being recommended 2. Request to see your X-rays — Visual proof matters 3. Get a second opinion if you're unsure — This is smart and common 4. Understand the urgency — Most root canals are not emergencies

Unless you have facial swelling, fever, or constant severe pain, you typically have days or weeks to make a decision and seek a second opinion safely.Unless you have facial swelling, fever, or constant severe pain, you typically have days or weeks to make a decision and seek a second opinion safely.

Why Dentists Recommend Root Canals

A root canal is recommended when the pulp (nerve) inside your tooth is infected or dying. This can happen due to:A root canal is recommended when the pulp (nerve) inside your tooth is infected or dying. This can happen due to:

• Deep decay that reaches the nerve
• A crack that exposes the nerve
• Trauma to the tooth
• A large filling close to the nerve
• Repeated dental procedures on the same tooth

The goal is to remove infected tissue, clean the tooth from the inside, and prevent the spread of infection.The goal is to remove infected tissue, clean the tooth from the inside, and prevent the spread of infection.

However, not all root canal recommendations are accurate. Many patients are told they need a root canal when simpler treatments — such as fillings, bite adjustments, or monitoring — may be sufficient.However, not all root canal recommendations are accurate. Many patients are told they need a root canal when simpler treatments — such as fillings, bite adjustments, or monitoring — may be sufficient.

Is This a Dental Emergency?

A true root canal emergency usually involves:A true root canal emergency usually involves:

• Facial or gum swelling
• Fever
• Severe, constant pain
• Pus or drainage
• Pain that worsens rapidly

If you do not have these symptoms, the situation is usually not urgent, and you have time to get a second opinion.If you do not have these symptoms, the situation is usually not urgent, and you have time to get a second opinion.

Signs a Root Canal Recommendation Is More Likely Correct

Your dentist's recommendation may be accurate if you have:Your dentist's recommendation may be accurate if you have:

1. Severe, Constant Pain

• Throbbing pain that doesn't stop
• Pain that wakes you up at night

2. Swelling or a Gum Pimple

• Facial or gum swelling
• A draining pimple on the gums

3. Lingering Temperature Sensitivity

• Cold or heat pain lasting 20–30 seconds or more

4. Clear X-Ray Evidence

• A dark area at the root tip (abscess)
• Decay clearly reaching the nerve

Red Flags That Mean You Should Get a Second Opinion

You should strongly consider a second opinion if:You should strongly consider a second opinion if:

• You have **no pain or symptoms**
• Pain only occurs **when chewing**
• The diagnosis was very fast
• No tests were performed
• You weren't shown clear X-ray evidence
• You felt pressured to decide immediately
• Multiple expensive treatments were recommended at once

These situations are extremely common and frequently misdiagnosed.These situations are extremely common and frequently misdiagnosed.

What to Do Immediately After the Recommendation

Step 1: Ask the Right Questions

Ask:Ask:

• "Can you show me the problem on the X-ray?"
• "Is this urgent?"
• "What happens if I wait?"
• "Are there alternatives?"

Step 2: Get Your X-Rays

You are legally entitled to your dental records. Having them allows easy second opinions.You are legally entitled to your dental records. Having them allows easy second opinions.

Step 3: Assess Urgency

• Swelling or fever → urgent
• Constant severe pain → urgent
• Occasional pain or no symptoms → not urgent

Step 4: Get a Second Opinion

A second opinion can confirm, delay, or eliminate the need for a root canal.A second opinion can confirm, delay, or eliminate the need for a root canal.

How to Get a Second Opinion

Option 1: Online Second Opinion

Upload X-rays and symptoms for a fast, unbiased review — often within 24 hours.Upload X-rays and symptoms for a fast, unbiased review — often within 24 hours.

Option 2: Another Dentist

Bring your X-rays and request an evaluation.Bring your X-rays and request an evaluation.

Option 3: Endodontist

A specialist who focuses on root canals and diagnosis.A specialist who focuses on root canals and diagnosis.

Common Scenarios Explained

"The tooth doesn't hurt, but I need a root canal."

Often not urgent. Get a second opinion.Often not urgent. Get a second opinion.

"I have pain only when chewing."

Frequently caused by cracks or bite issues. See Tooth Hurts When Chewing — Causes Dentists Miss

"They want to do it today."

Urgent only if swelling or severe pain is present.Urgent only if swelling or severe pain is present.

The Cost of Getting It Wrong

Root canals cost $800–$2,500 in the US and are irreversible. A crown often follows, doubling the cost.Root canals cost $800–$2,500 in the US and are irreversible. A crown often follows, doubling the cost.

A second opinion can prevent unnecessary treatment and save thousands.A second opinion can prevent unnecessary treatment and save thousands.

When to Proceed

Proceed if:Proceed if:

• Symptoms are severe
• X-ray evidence is clear
• A second opinion confirms the diagnosis

When to Wait

Wait if:Wait if:

• You have no symptoms
• Evidence is unclear
• You feel unsure or pressured

FAQ

How long can I wait? Days to weeks if no swelling or severe pain.How long can I wait? Days to weeks if no swelling or severe pain.

Is a second opinion rude? No — it's responsible.Is a second opinion rude? No — it's responsible.

Can I get one online? Yes. Online reviews are fast and convenient.Can I get one online? Yes. Online reviews are fast and convenient.

Final Advice

If a root canal recommendation doesn't sit right:If a root canal recommendation doesn't sit right:

• Don't rush
• Ask questions
• Get a second opinion
• Make an informed choice

If you're unsure, an online dental second opinion can help you decide with confidence.

For deeper explanation, see Do I Really Need a Root Canal? A Dentist Explains

Last medically reviewed: January 2025Last medically reviewed: January 2025