Can You Have a Cavity Inside the Tooth Without Being on the Outside?

I recently moved, which necessitated seeing another dentist. My new dentist said I have a tooth that needs a root canal treatment and referred me to an endodontist. I’m questioning this diagnosis for a couple of reasons. First, there are no outward signs of decay at all. This tooth has always been perfect and never needed any work on it. I’d just seen my old dentist six months ago and he never mentioned anything. Second, and this does show my suspicious nature, both the dentist and the endodontist share the same last name. I did some digging and it is her husband. This seems remarkably convenient to me.

Elliot

Dear Elliot,

You reticence is justified. You would have to have some decay on the outside that made its way to the pulp of the tooth in order for it to be infected. So, I’m curious. In order to give the dentist the benefit of the doubt, I wonder if it is possible that she was using the wrong terminology to describe a different problem that fewer people are familiar with.

There is a rare condition, known as internal resorption. While there is not a known cause for it, we do know that it is an inflammatory response. If you had some type of tooth trauma that could be a possibility. With this condition, the tooth eats away at the root of the tooth. That would be a reason to need a root canal treatment.

My suggestion is that you get a second opinion from a root canal specialist before moving forward— one that doesn’t share your dentist’s last name. When you go, bring a copy of your x-rays. Your dentist is required to give them to you. Two other precautions are first, not to tell them who your dentist is and second, not to tell them the diagnosis. It’s best if they come at your case with a blank slate.

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