A patient walks into your clinic with a tooth that looks like this. The pulp is not exposed and other than being discolored, the tooth is sound.
Why not just monitor? This tooth received significant trauma at some time in its life as evidenced by the discoloration. Studies show that over 92% of intrinsically stained teeth are non-vital. Dead teeth abscess and become painful. Our patients cannot tell us when a tooth such as this one is causing pain, so a wait-and-see approach is not recommended in this case.
More often than not you will be correct if you assume the worst, that the tooth is dead. When a tooth is discolored, root canal therapy or extraction are the two treatment options.
Root canal therapy can save a strategic tooth, can often be performed in less time, is less painful, and has fewer post-operative complications than extraction.