Persistent pain is one of the first signs you may need a root canal, the pain may be consistent or it may come and go, but it always returns. With tooth pain, however, it may be another issue besides needing a root canal like: • Gum disease • Cavity • Pain from a sinus infection • Damaged filling • An impacted tooth that has become infected Another symptom is sensitivity to hot and cold items which can often cause sharp or dull pain. Tooth discoloration can occur when the pulp of your tooth is breaking down damaging the roots and giving the tooth a grayish-black appearance. Swollen gums are another factor, as the swelling occurs near the area that is having issues, and can feel tender to the touch. Here Dr. Divya Nagaraj DDS and the dental staff will take note of anything that may need to be watched over the next few months, and take X-rays to keep on file. This is the best indicator that you have a root canal than just going off of a few common symptoms that may or may not indicate you may need a root canal.