When the problem is inside the tooth, saving it starts with the right diagnosis.
Endodontic care focuses on problems affecting the pulp and roots inside your tooth. When deep decay, a crack, injury or infection reaches those tissues, the goal is to understand what’s happening and preserve the natural tooth whenever treatment can do so predictably.
Tooth pain tells you something is wrong. Endodontics helps determine what — and whether the tooth can be saved.
Six clues the inside of a tooth may need attention.
Pulp and root problems don’t always feel the same. The pattern of pain, temperature response, swelling and the history of the tooth all help us understand what may be happening.
Hot or cold pain lingers
Sensitivity that continues after the hot or cold stimulus is gone can be a sign that the pulp inside the tooth needs evaluation.
It hurts when you bite
Persistent pain or pressure during chewing can occur when the pulp, root or surrounding tissues are inflamed or damaged.
The gum is swollen or tender
Swelling, tenderness or a small pimple-like area on the gum can accompany infection associated with a tooth.
The tooth is cracked or chipped
A crack can give bacteria a pathway toward the pulp, and the treatment depends heavily on the location and extent of the fracture.
The tooth was injured
Trauma can damage the pulp even when the outside of the tooth doesn’t initially look severely damaged. Bethesda Dental Group includes trauma among causes of pulp problems.
An old root canal is hurting again
A previously treated tooth can develop new problems years later because of new decay, a damaged restoration, fracture or persistent infection.
A tooth doesn’t have to hurt constantly for something inside it to need attention.
Root canal: the procedure.
Endodontics: diagnosing and treating problems involving the pulp and roots of the tooth.
A root canal is a treatment. Endodontics is the care around the diagnosis.
Inside every tooth is soft tissue called the pulp, containing nerves, blood vessels and connective tissue. Deep decay, cracks, trauma or repeated dental procedures can inflame or infect this tissue.
Root canal treatment is one way to save a tooth when that pulp can no longer recover: the damaged tissue is removed, the canals are cleaned and shaped, and the internal space is sealed.
Endodontic care starts one step earlier — determining which tooth is causing the problem, whether its pulp can recover and what treatment offers the best chance of keeping the natural tooth.
First-time pain, an injured tooth or symptoms that came back.
Different endodontic problems can feel surprisingly similar. The treatment depends on what has happened inside the tooth — and whether that tooth has been treated before.
Root Canal Treatment
When the pulp is irreversibly inflamed or infected, root canal treatment removes the affected tissue, cleans the canal system and seals the space so the tooth can remain in function.
- For selected teeth affected by deep decay, cracks, trauma or other pulp damage that can still be predictably preserved.
- For patients with renewed pain, swelling or other symptoms in a tooth that has already undergone root canal treatment.
Previously Treated Tooth Evaluation
If a root canal-treated tooth becomes painful again, we evaluate the restoration, roots and surrounding tissues to understand why symptoms have returned.
Cracked or Injured Tooth Evaluation
Cracks and dental trauma can damage the pulp in different ways, so preserving the tooth starts with determining the depth of injury and whether the root remains treatable.
- For teeth affected by fractures, sports injuries, falls or other trauma where the health of the pulp or root is uncertain.
Find the tooth. Understand the pulp. Save what can be saved.
- Diagnose where the pain is coming from
We review your symptoms and tooth history, examine the area and use appropriate testing and imaging to identify which tooth and tissues are involved.
- Treat the inside when needed
If root canal treatment is appropriate, the area is numbed, the damaged pulp is removed and the canal system is cleaned, shaped and sealed.
- Protect the tooth afterward
After endodontic treatment, the tooth needs an appropriate final restoration to seal and protect it. The exact restoration depends on the tooth and how much healthy structure remains.
200 reasons to choose us.
We don't ask you to trust us. We let our patients do the talking.
I hadn’t been to the dentist in longer than I wanted to admit, so I was expecting a lecture. Instead, the whole visit felt easy. My cleaning was gentle, everything was explained clearly, and I left knowing exactly what to keep an eye on and when to come back.
Melissa R.
Teeth Cleaning & Exam
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had a small chip on my front tooth that bothered me in every photo. I expected a much bigger treatment, but bonding was enough. The shade matches beautifully and the tooth still looks completely natural.
Laura M.
Cosmetic Dental Bonding
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I drink coffee every day and felt like my teeth had gradually become much darker than they used to be. I wanted them brighter, but I definitely didn’t want that artificial super-white look. They helped me choose a shade that still looked like me, and the difference was exactly what I wanted. My smile looks fresher without looking “done.”
Emily S.
Professional Teeth Whitening
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I avoided the dentist for years because of a terrible experience when I was younger. By the time I finally booked, I was embarrassed about both my teeth and how anxious I was. Nobody made me feel judged. They talked through the sedation options with me beforehand, explained exactly what to expect and made the appointment feel completely manageable. It was the first time I left a dental office thinking, “I can actually do this again.”
Lauren D.
Sedation Dentistry
Kensington, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I used to think preventive dentistry just meant getting my teeth cleaned and coming back six months later. They actually took the time to explain why I kept getting cavities in the same areas and helped me change a few things at home. We also added extra protection to a couple of teeth that needed it. My visits feel much more proactive now instead of waiting for the next problem.
Nicole B.
Preventive Dentistry
Kensington, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had been dealing with jaw soreness and painful clicking for months and wasn’t even sure whether I should see a dentist about it. The appointment was very thorough. They asked when the pain happened, checked how my jaw was moving and explained the difference between the joint and the surrounding muscles. I appreciated that the plan felt conservative and specific to what I was actually experiencing.
Sarah L.
TMJ Evaluation & Treatment
Chevy Chase, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had already been diagnosed with sleep apnea but struggled with my CPAP enough that I wasn’t using it consistently. I talked with my sleep doctor about alternatives and then came to Bethesda Dental Group for an oral appliance. The fitting process was easy, the adjustments were explained clearly, and traveling is much simpler now. My wife is also very happy that the snoring has improved.
James R.
Sleep Apnea Oral Appliance Therapy
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I had a badly broken molar and kept putting the appointment off because I was nervous about having it removed. They showed me why the tooth couldn’t really be saved, talked me through everything before starting, and the actual extraction was much more manageable than I had built it up to be. I also appreciated that we talked about what to do with the space afterward instead of just stopping there.
Rachel P.
Tooth Extraction
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I went in with a toothache that had kept me up the night before and was honestly dreading hearing “root canal.” The team explained exactly what they were seeing and what would happen next. Once I was numb, the appointment was much easier than I expected, and the relief afterward made me wish I had come in sooner.
Michael T.
Root Canal Treatment
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
I chipped an old filling and was convinced it was going to turn into a much bigger procedure. Dr. Shawn showed me exactly what was happening, explained my options clearly, and repaired the tooth without making the visit stressful. My bite feels completely normal again, and the new filling blends in so well I can barely see it.
Daniel M
Composite Filling Replacement
Bethesda, MD
5.0 ★ · Over 200 reviews on Google · Read all reviews →
Saving your natural tooth can be worth addressing before the problem gets more complicated.
Endodontic treatment may receive insurance benefits depending on the procedure and your individual PPO plan. Bethesda Dental Group accepts PPO insurance, and Cherry, Sunbit, Proceed and Care Credit financing is available for eligible care with no hard credit check · approval in seconds · and plans from 3 to 24 months.
Before you give up on the tooth, find out what’s happening inside it.
Whether the pain is new, the tooth was injured or symptoms have returned after previous treatment, we’ll evaluate the pulp and roots and determine the appropriate next step.
