

Does #18 really need a root canal?
Hello! I had an exam/cleaning yesterday and I'm hoping to get some insight from you guys on whether or not #18 really needs a root canal and crown or if I should go get a second opinion.
Some facts:
- Pano was taken September 2024. Bitewing was taken yesterday 5/13/26.
- I previously had an amalgam filling in that tooth which was removed and replaced with a composite filling in Sept 2024. Occlusal surface filling only.
- I have no pain in #18 or any of the surrounding teeth.
- I drink occasionally (like 1 drink a week), non-smoker. Floss 1x a day at night and use an electric toothbrush. No history of periodontal disease and have never had a root canal.
The dentist did not mention seeing decay or infection on the xrays. He only saw some decay upon visual exam. The hygienist initially thought the discoloration was just a little staining from the previous amalgam filling that I had for 10+ years prior. When I started asking questions about the urgency of having a root canal since the tooth is asymptomatic and if there were any less invasive methods we could try first he seemed pretty put-out that I was not immediately accepting his assessment and reluctantly said he could try to remove the filling and see how extensive the decay is first but that a root canal would be the likely outcome. No pulp vitality test was done.
Thanks in advance!