From the X-ray, the impacted wisdom tooth appears to be in close contact with the distal aspect of the 2nd molar, and there appears to be distal caries on the 2nd molar.
The good news is that a root canal is NOT automatically required just because the decay looks deep. The dentist should first remove the caries and assess the remaining tooth structure and, importantly, the pulp status.
If the decay has not reached/infected the pulp, the 2nd molar can usually be restored with a filling (or another appropriate restoration depending on how much tooth is left).
RCT becomes necessary if the pulp is irreversibly inflamed or necrotic—for example, if there is a history of spontaneous/night pain, prolonged sensitivity to hot/cold, tenderness to biting, or abnormal pulp-testing findings.
Since the wisdom tooth is impacted and appears to be contributing to the distal caries, extracting the wisdom tooth is a reasonable part of treatment. Saving the 2nd molar is generally preferable at age 23 if it has a good long-term prognosis.
So, don’t agree to an RCT solely based on the X-ray. Ask the dentist to perform pulp vitality testing after caries removal/assessment and explain whether the pulp is actually involved. If the pulp is healthy, there is no reason to do an RCT just because the cavity is deep.
Answered2026-08-08 12:10:47
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