1. In rare occasions a root canal won’t require a crown. This only applies when three things occur.
- It’s a front tooth
- The cavity or fracture is very small
- Once the root canal is performed you still have the majority of your tooth struture intact
This only works on front tooth because they have only one nerve and the dentist or endodontist can make a very small access hole to do the root canal. This will also leave plenty of tooth structure intact. You may pass up on placing a crown on the tooth in these cases, at your own risk of course. Again, this only applies if very little tooth structure has been removed, so if there is a large cavity or a large existing filling in place then you will still require the crown.
helpful hint – The back teeth almost always require a crown after the root canal. Back teeth usually have multiple nerves and the dentist will have to create a large access hole to perform the root canal. As a result you will require a root canal. Additionally, since you chew on the back teeth, these will take the blunt of your chewing pressure and you run the risk of cracking them without a crown in place.
2. Doubling your expenses and number of appointments. Crowns are expensive and typically cost about the same or more than the root canal itself. And often times they also require a post in order to help hold the filling in place which further adds to the costs. And it takes several additional visits to perform a crown as well.
3. Your crown may have to be replaced in the future. A well done root canal will generally last you a lifetime. A crown on the other hand may require replacement over time should something go wrong with it. Crowns are made of porcelain or similar material and once they break it automatically results in a do over since crowns can not be repaired inside the mouth. Or your crown may fit well now but as you lose gum tissue around the tooth over the years, you may be forced to replace the crown as it is now trapping food, looking unattractive or no longer providing a proper seal around the tooth.
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Do I Need to Place a Crown On a Root Canal Treated Tooth: Pros of Placing a Crown
How to Decide?
Answer the following questions:
- Is your tooth still savable?
- Has the root canal destroyed a substantial amount of tooth structure?
If you answered “yes” to most of the above questions then you probably need a post to bring your tooth to its original state.
If you answered “no” to most of the above questions then you may not require a post. IF your dentist or endodontist create only a small opening access to perform the root canal treatment and preserves the majority of your original tooth structure then you will not require a post.
- This usually applies only to the front teeth which have only one nerve and are thus easier to access the tooth nerve without having to remove a whole bunch of tooth structure. And it only applies in cases where there is not a lot of decay and cavity in the tooth.
Unfortunately this is not something that you have any control over and is at the sole discretion of your dentist. If your dentist goes into the tooth and can’t find the canal and is forced to increase the size of the access hole then you will automatically require a post.
If your dentist or endodontist removes a substantial amount of your tooth structure then a post can help to better restore your tooth to its original state. It basically improves your odds of not having to redo the treatment in the future. Without the placement of a post the chances of the crown breaking off or falling out increases greatly. Should this happen you will probably either have to redo the entire post and crown procedure over or even risk losing the tooth. Keep in mind that the post placement must be performed between the root canal treatment and the crown preparation appointment, you can’t go back and place the post once the crown has been fabricated.
If you are down to less than 20% of your natural tooth structure above the gumline things are not looking good for that tooth. A post may help a little but you are still likely to lose the tooth sooner than later. Before invention of dental implants it made sense to attempt to place a large post and perform additional treatments and surgeries in attempts to salvage the tooth at all costs. But these treatments add up to as much as a dental implant would cost only with much lower success rates. So you are almost always better off receiving the dental implant instead of trying to save these very badly broken teeth.
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Placing a Post in a Root Canal Treated Tooth: Pros of NOT Placing a Post
1. Placing a post increases the likelihood of root fracture. While dental posts are helpful in many ways, they can also be harmful to the tooth. Since the post itself is a solid and rigid material it tends to concentrate a lot of stress, particularly at the spot that it terminates within the tooth root. It is not uncommon to see the tooth fracture down the line at this exact spot where the dental post terminates. If this occurs then the root is fractured and the tooth needs to be removed. Your dentist can detect this when he or she takes an X-ray and notices a defect corresponding to the exact location where the post terminates within the tooth root.
2. Additional cost. Most dentists charge you an additional fee for the placement of the post. But don’t stress yourself too much over this charge because even if you convince them not to place the post they could still technically charge you for the core buildup material. Most insurances do cover the post placement so having dental insurance will come in handy.
3. If most of the tooth structure above they gumlines is removed then the post will not make much of a difference. The longevity of a root canal treated tooth comes down to how much natural tooth structure remains above the gumlines. If your tooth is very badly damaged then it will likely not last you very long either way. Placing a post, or even two posts which some dentists do when desperate, is just delaying the inevitable loss of the tooth. You are probably better off skipping straight to a dental implant and saving yourself the aggravation and unnecessary expenses of a treatment that is not very promising. Talk to your doctor about how they feel about the longevity of your tooth and its 5-year prognosis to get a better idea of whether you should save the tooth and place the post or simply remove it and place the dental implant instead.
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Placing a Post in a Root Canal Treated Tooth: Pros of Placing a Post