Root canal treatment is needed when the nerve inside a tooth is irreversibly inflamed or has died. Symptoms point toward it; tests and X-rays decide it.
Not brief sensitivity — pain that stays after the stimulus is gone.
Spontaneous pain
Especially waking you at night.
Pain on biting with a dull ache
Can indicate inflammation reaching the root tip.
A darkening front tooth
Sometimes follows an old injury.
Swelling or a gum bump near the tooth
Suggests infection at the root.
No symptoms at all
Some teeth are diagnosed from X-ray findings alone.
What happens if it is left
An inflamed nerve does not recover once it passes a certain point. It typically progresses to death of the nerve and then infection at the root tip, which is what produces swelling and abscess. The tooth does not repair itself, and pain stopping is not evidence that it did.
The alternatives are treatment or extraction. There is no third option that keeps the tooth and leaves the nerve untreated.
What we can explain here — and what needs an exam
A page can inform you. It cannot examine you.
We can explain online
What symptoms typically indicate
Why pain stopping is not reassurance
That the realistic options are treatment or extraction
Determined after an exam
Whether your nerve is involved
Whether the tooth is restorable afterwards
Whether treatment here or an endodontist referral is right
What to do next
Testing takes minutes and settles the question. If a tooth has hurt badly and gone quiet, it is still worth checking.