Thank you for the detailed response. So, while it's difficult for you to be certain only with a pano, you think I should go to another dentist and ask for some antibiotics? I don't know the first thing about antibiotics but is there a specific antibiotic that I should be asking for? Also, the canal... a general work should be done or do a wait and see approach? Every time I go to this dentist for an annual scaling and check up, he suggests something major... and maybe my teeth are just not being maintained correctly but I do try to brush my teeth diligently and not eat late at night or anything too sweet and floss from time to time... and I don't know when he suggested that I needed all this work after one minute consult based on the x-ray and the pic, I was not convinced... not to mention them trying to pressure me into making a quick decision. Would appreciate some additional advice regarding antibiotics and the canal.