Is it possible to have a tooth infection for years and not know it? one that causes symptoms but isn't glaringly obvious. tooth nerve is probably dead

A chronic abscess: May be painless, with symptoms of its presence even as it continues to grow inside the jawbone. Or the area of infection may be walled off by a fibrous membrane, forming a granuloma. Since granulomas are painless and slow-growing, they are discovered only by dental x-ray examinations. The tooth can be saved by root canal therapy and/or surgery. Rec.: see your dentist for evaluation and x-rays.

Absolutely: Since the jaw bone has medullary spaces, and is not a solid mass, it is possible that a tooth can have a low grade dormant infection, w/o having any symptoms for a very long time. It is only if the infection becomes active and expands that a patient may feel symptoms. If a 2-d x-ray radiograph is taken, the lucency around the tooth may look small. If one takes a 3-d scan it may very well look big.

Yes: The inside of a tooth can "die" without infection or be contained to the tooth. Later a more aggressive bacteria lands on the tooth and causes symptoms. Once a tooth abscesses it takes time for the infection to show on an x-ray. Also gums disease often goes unnoticed. Another possible cause is a sinus infection or seasonal alleriies.

Yes: 50% of all infected teeth i treat are chronic, asymptomatic abscesses. These can become symptomatic ( acute) at anytime. Hence, get them treated when diagnosed, regardless of the presence of pain!