Shadow in tooth x-ray

[kv1204]

My dentist was concerned about a shadow on a x-ray of a lateral incisor, which currently has a crown. About two years ago, I had pain in it that went a way in a couple days. The dentist coincidentally asked if I ever had any pain in that tooth, and suspected the nerve might be dead. He did a test with endo-ice/freeze spray and I didn't feel anything, so he said the nerve is most likely dead and he's gonna do a root canal. If so, and it has been dead for years, is it possible to go that long without an infection? What would the shadow represent? (It was either in the pulp/dentin era or root canal tip...can't remember if the x-ray image was upsidedown or not)

 

[honestdoc]

When you had the crown on the lateral incisor, there were a lot of drilling (prep) prior to crown placement. This drilling along with the reasons for needing a crown such as cavities, fracture, damage, etc led to trauma of the root canal (pulp). With so much trauma, the pulp tissue dies and no vital nerves are present (not feel any temperature/colds). With dead tissue present, it poses as a source for infection. The infection then organizes as an abscess which is acidic and eats through the bone to situate under the root tip (shadow on the x-ray). You may not feel any pain and there may not be any swelling yet. We cannot predict when the infection will spread. Your dentist is correct that the tooth needs a root canal treatment to rid the source of infection.

 

[Sonia Salamuri]

I've seen some patients like you. Some people don't have any kind of pain, but the problem is there and keeps growing silently. The coment made by Honestdoc is what I hear many times from the Endodontist.