At the beginning of January 2013, I developed a toothache (#13). Sensitive to percussion, heat and cold. Being a former hygienist, I felt strongly that the tooth need endodontic treatment. I saw my DDS and an xray was taken. She told me that there was no evidence of nerve involvement and she placed me on a 7-day course of antibiotics, which resolved the sensitivity . . . . temporarily. Fast forward to April. The sensitivity returned along with excruciating pain and a fistula just above the gumline in the area. I saw the DDS again. Lo and behold, after viewing the xray an abscess was clearly evident at the tip of #13. Endodontic treatment was now performed. A temporary filling placed, another course of antibiotics prescribed. The fistula continued, filling/emptying at least t.i.d. After another week had passed with continued excruciating pain, the antibiotics were changed from amoxicillin to clindamycin. By now it was the beginning of May and although the pain subsided the fistula continued. I saw an oral surgeon on May 5. He informed me that it may just take some time for the fistula to heal on its own and scheduled me for a followup, which is next week. The area of the fistula remain "tender," although it seemed to have disappeared. I have been careful to keep the area clean, and not eat on the left side of my mouth. Well over the past few days, the fistula has returned and is now as "angry" as ever. The tooth itself is not sensitive, although when I do bite down on it, I can definitely tell something is going on. Do you think a "tract" has now formed? Will this ever heal on its own? Does the tooth need to be extracted with the area surgically cleaned out? Tooth #12 has an DO amalgam and tooth #14 a full P/C crown following endo many many years ago. I'm thinking I should just end this and have it extracted with a three-unit bridge placed. Thoughts?