The most common sign of pulp infection is severe, persistent pain in the affected tooth. This pain is often described as:

• • Throbbing or pulsating: Pain that feels like it's beating in rhythm with your heartbeat
• • Sharp and shooting: Sudden stabbing sensations that come and go
• • Constant ache: Dull, unrelenting pain that doesn't respond to over-the-counter pain relievers
• • Worse at night: Pain that intensifies when lying down due to increased blood flow

If your tooth has extreme sensitivity to hot or cold drinks and foods—or if the pain from temperature extremes lingers long after the stimulus is removed—this is a red flag for pulp inflammation or infection.

Normal tooth sensitivity (from exposed dentin) typically resolves within seconds after the stimulus is removed. If sensitivity lingers or is extreme, the pulp is likely affected.

When a tooth's pulp becomes infected, the body's immune system responds with inflammation. This often results in localized swelling and tenderness of the gums around the affected tooth.

When the pulp dies or begins to die from infection, the tooth often changes color. A tooth needing root canal therapy may appear:

• • Greyish or yellowish: Darker than surrounding teeth
• • Blackened or brown: Especially in advanced cases with pulp necrosis
• • Noticeably dull: Lacking the shine of healthy teeth

Dr. Nguyen will use X-rays and examination to confirm whether discoloration indicates pulp infection or is cosmetic staining.

If a tooth is extremely painful when you bite down or chew on it, this often indicates pulp inflammation or infection. The pain may be:

• • Sharp and immediate: Triggered by biting or chewing pressure
• • Lingering: Pain that continues after you stop chewing
• • Severe enough to avoid chewing: You favor the other side of your mouth