Could I have a tooth cavity that I can’t see? I don’t have any problems with the tooth either. My dentist is referring me to an endodontist for a root canal. But my dentist is good friends with the endodontist, so I am skeptical about getting an honest evaluation. My x-rays from last year don’t show any issues with the tooth. Could I have a cavity and not know or see it? I am concerned because the tooth is a top left incisor, and I was planning on getting porcelain veneers this year before summer ends. Thanks for your help. Deon

Hi, Deon,

Thank you for contacting Beverly Hills Institute of Dental Esthetics.

Could You Have a Tooth Cavity that You Can’t See?

You cannot have a tooth cavity that you cannot see. As the American Dental Association confirms, cavities begin in tooth enamel and progressively spread inside a tooth. However, your dentist may have referred to internal root resorption as a cavity.

What Is Internal Resorption in a Tooth?

Internal resorption is the progressive loss of structure inside a tooth. Although the exact cause of internal resorption is unknown, it may begin with pulp irritation from infection or trauma. Irritated tooth pulp begins to break down dentin (the layer beneath the enamel) and cementum (material covering tooth roots).

The 2011 article, Internal resorption: an unusual form of tooth resorption, notes the following about the condition:

• It is relatively rare
• It may go unnoticed for many years
• The patient often has no symptoms unless the tooth pulp is inflamed
• Root canal treatment can stop the progression of internal resorption

Do You Need an Endodontist?

You may need an endodontist if your dentist’s diagnosis of internal tooth resorption is accurate, but you see the endodontist of your choice. Alternatively, you get a second opinion from a skilled cosmetic dentist without sharing your dentist’s diagnosis. The dentist would need to examine a current x-ray for an accurate diagnosis. If you choose a cosmetic dentist, you can explain your plans for porcelain veneers and ask about a treatment plan if you need root canal therapy first.

Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.