Do I definitely need a root canal?

[Rachel_W]

A few weeks ago I bit hard down on a date with a pit in it! It was a very hard impact and both my bottom and top molars at the site of impact were sensitive to cold and pressure. I also had throbbing pain after anything caused slight movement around that area of the mouth.
There was no large injury -no broken pieces or visible cracks. Everyone told me to give it time as the mouth is very sensitive but after a week I went to the dentist. He took x-rays (no obvious damage) and tapping the teeth caused pain.  Biting down on them was painful, but pain was caused no matter what angle my tooth was pressed from, and the top tooth seemed to have swelling underneath as it was the only tooth that would touch other teeth. The dentist said that it was possible for it to just be trauma, such as torn ligaments, and he could not tell if there was a hairline fracture.  He had me come back almost two weeks later (just under 3 weeks after the initial trauma).
The throbbing pain had continued, with feeling of pressure after touching the tooth, sometimes painful or just a sensation of pressure and pulse. The bottom tooth is only slightly sore and achy as far as I can tell. Pressing on the gum seemed to relieve the pain somewhat. When I went back yesterday he said that as I am no longer sensitive to cold (or heat) with pain then I have an abscess and will also need a root canal done.  
He put me on antibiotics. How does he know the abscess is in the root and not the gum (I don't have any visible or tactile swelling except for the feeling of a raised tooth which I have had for 2.5 weeks), and couldn't the lack of sensitivity be because the dynamics of the injury has changed?  If these antibiotics clear it up, should further testing be done before a root canal is performed?  I don't want to lose the tooth, but if he finds a root fracture during the procedure the tooth will have to be extracted. Also, would antibiotics sooner have helped as he said that they were not needed at that time.

[scottma]

Seeing an endodontist to evaluate pulpal vitality is advised.

[Rachel_W]

The throbbing pain stopped, but the tooth is still sensitive to pressure after 6 weeks, and I called to see if they thought that a root canal was needed.  All the symptoms of still needing a root canal are there, such as percussion pain etc, and my tooth has a smell about it.

So I have decided to have the root canal which I am having tomorrow.

The issue is the tooth is sensitive when i push on the inside of the cusps, and I worry about a crack.  After doing this if i push the other way I hear a slight crackling noise, as if there is a crack and the tow sides of the tooth are pushing back together.

I am so worried that I have a split tooth.

I know I will find out tomorrow but I am really worried and would like to know if it is possible for the cusps on either side of the tooth to actually move if there is a crack rather than a actual split throughout the whole tooth.  My gut is telling me that movement, even though it is only slight, would only happen if there was an actual split and the two sides of the teeth were actually separated.

Please help.

[Rachel_W]

Please can someone reply to this!!!

I went to the dentist and when he removed the filling the tooth was actually split down the middle from front to back, and the pieces would move apart when pushed.  He told me that it was completely split into two pieces.  

He told me that there was no way of saving it due to where the crack was and offered to extract it there.  I did not want to so went home, but after calling another clinic to ask their opinion, they also told me that a tooth that is completely in two pieces is pretty much unsalvageable and recommended that I get the tooth pulled.  As the only time they could fit me in was today, or at the end of November right before a university field trip, I had my tooth pulled.

Most dentist websites I have seen have said that once a tooth is completely in half (it was not a one-sided crack) then it should be extracted.

Now I read of a case where a dentist glued the tooth back together and now I am wondering if I should have sought a third opinion.

I am currently in the UK and usually in the US and am worried that my own dentist would have saved it.

[scottma]

Your descriptions suggest extraction is indicated.

[Rachel_W]

thank you.  This makes me feel better about my decision.  I had done searches online where a number of people had had part of their split tooth left in and crowned, but I have read that it depends on where the crack was and I assume that perhaps this would only work if over half the tooth was left, rather than two halves.  I did have one part with the two roots, but the width of the piece was still half.