How infection reaches the nerve
Inside every tooth is the pulp: the nerve and blood vessels. While enamel and dentine protect it, all is well. Decay left for years eats through the dentine to the pulp; a crack or a blow can open the way faster. Bacteria enter the pulp, it becomes inflamed (pulpitis), then dies, and the infection travels down the canal into the bone at the root tip (periodontitis, a "cyst"). Each stage hurts differently, and that tells you how far it has gone.
7 signs you need root canal treatment
- Throbbing pain at night. Lying down increases blood flow to the pulp and pressure inside the tooth; that is why pulpitis "wakes up" at night.
- Lingering pain after heat. A healthy tooth's reaction to heat fades in seconds; an inflamed one aches for minutes. If cold water relieves it, the nerve is already partly dead.
- Pain on biting. The inflammation has gone beyond the root; the tooth feels "taller".
- Swelling. The gum or cheek next to the tooth puffs up; pus is looking for a way out.
- The tooth has darkened. Breakdown products of the dead pulp stain the dentine from inside.
- A pimple on the gum. A fistula that periodically drains pus. Often painless, which is exactly why it is dangerous: the infection keeps eating bone.
- The pain "went away by itself". After days of severe pain, silence. That is not recovery; the nerve has died. The infection stays and sooner or later returns as swelling.
What to do before your visit
- Book: for acute pain Laurus Dent plus offers the earliest available slot, +371 22428688. We treat in English.
- A painkiller as directed (ibuprofen works better than paracetamol here, if you have no contraindications).
- Do not warm the cheek; heat increases pus formation. A cold compress on the outside is fine.
- Do not put tablets on the tooth or gum; that burns the tissue and treats nothing.
- Do not chew on the tooth; avoid very hot or sweet food.
What happens if you wait
Pulpitis does not resolve on its own. The nerve dying reduces the pain for a while, but the infection in the bone at the root grows: a granuloma or cyst forms, bone loss increases, and eventually the tooth loosens or cracks. Treated early it is two visits and 120–320 EUR; treated late it is the same procedure with lower odds, or extraction and an implant (1,600 EUR). A pus-filled infection in the jaw can become a general health problem, especially with diabetes or heart disease.
How it is treated and what it costs
Two visits under anaesthesia: the first cleans the canals and places medication, the second, 1–2 weeks later, seals the canals and closes the tooth. 120–320 EUR depending on the number of canals, both visits included. Full procedure and prices on the root canal treatment page.