Do I really need a root canal procedure?

Recently, over a period of 48 hours, I experienced increasing mild discomfort in a bicuspid tooth. When my dentist percussed the tooth, the pain was much sharper. An X-Ray showed some clouding around the root of the tooth. I already was taking PenVK 500 mg BID to treat a mild case of gingivitis that had been elevating my C-reactive protein. My dentist told me to up the dosage to 500 mg QID. I never needed pain relief except of some tylenol, and I felt much better within 24 hours. A few days later, I was examined by an endodontist. There was only slight pain when the tooth was percussed and no particular sensitivity to hot or cold. Nevertheless, he told me that I needed a root canal procedure. That was over a week ago. I still am taking PenVK, and now I have NO SYMPTOMS AT ALL except for some very very minimal awareness of discomfort (only 0.5 on a 1 to 10 scale) when I bang on the tooth with my finger. I still am taking PenVK 500 mg TID and plan to stay on this regimen for another few months to see if I can lower my C reactive protein. I am wondering if the antibiotic might help me avoid a root canal procedure. I believe that the conventional wisdom is that pulp infections can't be treated by antibiotics. But does it make sense to go ahead with surgery when I feel fine? What if I waited another month or two and had another X-Ray? Could this tell us anything? What if the X-Ray were normal and all of symptoms were gone, including sensitivity to palpation? Would it make sense to go ahead with surgery anyway? If a follow up X-Ray were normal, couldn't I just repeat the X-Ray two or three times over the course of the next 12 months and see what happens?

[Jordy]

I don't think it would hurt to wait this one out.  Every single time I've gotten a root canal (six), my dentist or endodontist (depending on which situation; I've had both) have had me wait out for at least several weeks to see what course the pain in my tooth took.  I've been prescribed both antiobiotics and anti-inflammatories to help clear the irritation.  You definitely should ask about anti-inflammatories.

However, there is the possibility that the diminishing pain is the result of the nerve in your tooth actually dying, rather than healing, in which case a root canal would be required.  Perhaps that is what your endondist expects.  You need for him to explain to you why he knows for sure that you need a root canal when you are sure you are experiencing an easing of your symptoms.