If a lateral incisor is negative to a vitality test and is asymptomatic, what should be done?

In cases where a lateral incisor shows negative vitality test results but remains asymptomatic, the most appropriate action is often to leave the tooth alone. This approach is based on the understanding that a tooth can still be non-vital yet not exhibit any signs or symptoms indicating a need for intervention. Asymptomatic teeth may be able to remain in the arch without posing any immediate risk to the patient's oral health.

Leaving the tooth alone allows for the possibility that it may not develop issues in the future, especially if there are no clinical signs of infection or other complications. It is important to monitor the tooth over time with regular check-ups to ensure that no changes occur, as latent issues can sometimes develop without prior symptoms.

Extracting the tooth is unnecessary if it is asymptomatic, as this would involve unnecessary loss of tooth structure. Initiating root canal treatment might also be excessive without any signs of pulpal disease or symptoms of pain. Applying a fluoride varnish does not address the underlying pulp vitality issue and is more suited to preventive care rather than a necessary intervention for an asymptomatic non-vital tooth. Thus, monitoring the situation while leaving the tooth alone is the most prudent course of action.