Xray showed dead tooth - do I definitely need root canal treatment or can I start my Invisalign treatment without it?

Dear Skarlet,Thank you for posting your question on Real Self. I recommend scheduling a general exam and prophylaxis with your general dentist before starting any type of orthodontic treatment. Regarding your 'dead' tooth, it is possible to start treatment but you will need to monitor it very closely. It wouldn't hurt to schedule a consult with an endodontist for a second opinion. Best,Dr. Jenn

Sometimes there could be a dead tooth in the mouth that died out because of trauma.  If the tooth is asymptomatic and there is no infection, you can choose to wait and see what happens.  The problem is that these teeth could get infected some time in the future necessitating root canal treatment even if you don't do Invisalign and move your teeth.  Also a dead tooth frequently gets discolored with/or without Invisalign, but only time will tell if that will be a fate for your tooth. I have a similar case, and we decided to wait with the patient and just monitor the tooth rather than jumping to do a root canal, but it needs to be closely monitored. You can get an Invisalign, and if it flares up then, you can do a root canal while on Invisalign and put a filling on top, not a veneer or a crown until Invisalign is finished.  If your treatment with Invisalign is long, and you don't want to take any chances, your best bet would be do a root before the treatment.  Discuss that with your doctor again because if there are any signs of invection or symptoms, root canal is a better option. 

You can start treatment anytime with invisalign.  The question is "When do you want your abscess to flare up?"You can have the root canal therapy anytime.  Save the crown or new filling until after or before you have a refinement or retainer made.