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Could I Have a Tooth Cavity Without Signs or Symptoms?

Posted by AllSmiles

I’ve seen two different dentists at the dental practice I go to. Last week, I had my routine cleaning and exam. It was time for my yearly X-ray, and the dentist found a cavity inside my upper left lateral incisor. She referred me to a root canal specialist. The dentist and the specialist have the same last name. The previous dentist I saw didn’t mention anything about tooth decay. Anyway, the tooth has been healthy until now, and I don’t feel any pain. However, the tooth protrudes at an angle and doesn’t touch my lower teeth when I chew. Could I have a cavity inside the tooth without any outward signs or symptoms? – Thanks. Erik from Colorado


If you think your dentist and the specialist are relatives and there might be a conflict of interest, you can see another root canal specialist (endodontist) for a second opinion.

Can You Have a Tooth Cavity Without Signs or Symptoms?

Six-step root canal diagram: infection, opening the tooth, removing infection, filling and sealing, post, dental crown
Root canal therapy removes infected tooth pulp

A tooth cavity must have an entry point outside the tooth. Decay begins on a tooth’s surface and works through the tooth. Untreated decay can infect the tooth, requiring root canal treatment.

However, your dentist may be referring to internal resorption—a rare occurrence of the tooth pulp destroying the tooth from the inside. Although the cause of internal resorption is unknown, it is an inflammatory reaction that signals tooth irritation. On the other hand, external root resorption occurs outside the tooth. Taking X-rays at different angles helps determine where resorption is occurring.

If the tooth has no history of decay, it may have experienced some trauma since it sticks out farther than your other teeth. Still, trauma is unlikely and rare. We advise you to see an endodontist for a second opinion on whether your tooth is at risk and needs root canal treatment.

  • Ask your current dentist for a copy of your X-rays.
  • Don’t mention your dentist’s name to the second-opinion dentist.
  • Avoid sharing the diagnosis with your dentist and endodontist.


Chandler, Arizona, dentists Dr. William Walden and Dr. Tyrel Beavers sponsor this post. Read how they strive to give patients some of the best dental care in Chandler.

2425 S Stearman Dr.
Suite 111
Chandler, AZ 85286
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