Category Archives: Root canals

Placing a Post in a Root Canal Treated Tooth: Pros of Placing a Post

An unfortunate tooth ended up with a root canal. Once you received the root canal you went in to receive the crown. The dentist explained that your tooth will also require a post to help buildup and strengthen it. As if the root canal and crown wasn’t costing you enough now you have to pay for whatever this post is supposed to be! You try to convince your dentist to proceed without a post to cut costs but since you’re not even sure what this post is you have no leg to stand on and lose the argument! So what is this dental post and when is it really necessary? Or could you ever actually fix a root canal treated tooth without using this post?

Pros of Placing a Dental Post

1. The post fills the void created by the root canal treatment. To perform a root canal your dentist or endodontist must shave off enough tooth structure to gain access to the roots and nerves. Subsequently a substantial amount of tooth is removed which needs to be replaced prior to the placement of the crown. You can’t just leave this void empty or your tooth will crack under bite pressure. There are two methods to fill this void either a core buildup or a post.

  • A core buildup is a type of filling material similar to filling that fills the void. The core buildup works well when there hasn’t been a lot of tooth structure removed.
  • dental post is a sturdy screw-like restoration which is inserted into one of the tooth canals after a root canal.

A post is usually necessary when more tooth structure has been removed. The more tooth structure is removed during the root canal treatment, the more crucial the placement of a post becomes. A core buildup alone can not hold up over time and may fall out or become loose.

2. The post retains holds everything together. The major role of a dental post is to hold in place the filling material which seals the void created after a root canal treatment. Without a post in place the buildup material could get loose and fall off along with the crown. If this happens you must redo the entire crown process or even risk losing the tooth altogether! The post plays a crucial role in ensuring that the buildup material is held securely in place. It essentially brings everything together.

  • We even run into cases where once the patient presents to pick up their permanent crown the entire core buildup is dislodged upon removing the temporary. This only happens because the dentist neglected to place a post in place and instead went with the core buildup alone. Now you are stuck redoing the entire procedure but with a post in place this time around!

3. The post provides a better foundation. You can’t build a sturdy house without laying a solid foundation first. Similarly, to place a crown on a root canal treated tooth you require a solid foundation for long-term success. The post helps improve the overall retention and durability of the tooth. Root canal treated teeth are more likely to fail over the years than your other teeth and it is not uncommon to have either the crown fall off or even worse the entire crown portion fracture off the tooth. Often times once this occurs you end up losing the tooth and will require a dental implant. A post can help in preventing these scenarios and may substantially extend the longevity of the root canal treated tooth.

NEXT >> Placing a Post in a Root Canal Treated Tooth: Pros of NOT Placing a Post

Placing a Post in a Root Canal Treated Tooth: How to Decide

What to do if You’re Experiencing Pain After a Root Canal: Go Back to the Dentist

You finally decided to go and get that one painful tooth fixed and receive a root canal. You were explained that a root canal is basically the process of removing the nerve tissues from the tooth and replacing it with a rubber like material. This gets rid of the pain and the infection will eventually go away so you get to keep the tooth at the same time. But somehow your tooth is still hurting even though there is supposedly no more nerves in it. How could this be? Should you wait to see if the pain subsides on its own? Or could something have gone wrong and it’s best to go back to the dentist right away?

Pros of Going to the Dentist

1. There may be an unsuspected nerve left behind. This usually happens with the back teeth, particularly the molar teeth which have multiple nerves.

  • All front teeth as well as lower bicuspids usually have one nerve and area easy root canals to perform.
  • Upper bicuspids usually have two nerves and are so-so difficult. Sometimes the dentist misses the lingual canal.
  • Lower molars are hard since they usually have 3 or 4 nerves and your dentist may miss one
  • Upper molars are the hardest. They may have as many as 5 different nerves in one tooth. Most dentists will refer these to an endodontist, although some very skilled ones can fix these as well.

Your dentist may have inadvertently left a nerve behind without even knowing it existed. If this is the case and there was a nerve unnoticed then you shall continue experiencing sensitivity to hot and especially cold even after the root canal is done. This can be a big problem. Your dentist may need to either go back in and find the nerve or you will have to be offered a refund and an immediate referral to the root canal specialist, an endodontist, who can find and fill this evasive nerve.

2. Your tooth nerves may have been improperly filled. Now this is not supposed to happen but unfortunately it does sometimes. To complete a root canal the tooth nerves must be properly removed and filled with a sterile material. The filling material, known as the gutta percha, needs to pretty much fill the entire nerve. If this filling material does not fit well to the nerve, such as if it is short of the end of the nerve or if it sticks out too far past the nerve, then this is a problem which needs to be addressed. You may have to be refunded for the root canal fee and referred to the endodontist to have the work redone properly.

helpful hint – It is a good idea to ask your dentist to show and discuss the final root canal X-ray as a verification of the success of the treatment whenever possible. Also, if you have dental insurance, the insurance will only pay your dentist if they submit an X-ray showing an acceptable root canal which is a nice safety net to have!

3. The bite may be left too high. This is one of the most common problems that gets overlooked all too often. When your root canal has been completed the tooth is filled with a temporary filling material until the time to do the crown. Because the tooth is now traumatized and a lot of the tooth structure has been removed to do the root canal it becomes very weak and tender. If the tooth or the temporary filling is left where you are biting on it then the pressure applied can cause severe pressure pain. So it is very important to make sure the tooth has been taken out of bite after the root canal is completed for the pain to dissipate. This literally takes a minute but many times dentists or endodontists fail to do so.

helpful hint – If you feel that you are applying too much pressure to the root canal treated tooth then you need to go back to your dentist to have the bite adjusted. But the better solution is to always test your bite right after the root canal treatment has been completed to verify a correct bite and avoid this unnecessary additional visit.

NEXT >> Wait a Little First

What to do if You’re Experiencing Pain After a Root Canal: How to Decide

Benefits of Dental Implant over Root Canal

Should I get a dental implant or root canal?

You might’ve broken a tooth so badly that you’re left wondering whether it could be saved or not. Typically, when a tooth breaks below your gum lines it has very poor prognosis. There just isn’t enough tooth structure to support a crown any longer. As such, you most likely need to remove teeth which break below the gumlines. However, when teeth break above the gumline they might be salvageable. Your dentist can best determine if your tooth can be saved or not. In these cases you’re usually faced with two treatment options: A dental implant or root canal. So which is the better treatment option for your broken tooth? Is it worth saving your tooth with a root canal? Or are you better off removing the tooth and placing a dental implant over root canal?

What are the benefits of a dental implant over root canal?

A root canal is when your dentist removes and replaces the tooth nerve with a filling material. Dental implant on the other hand involves removing the entire tooth and replacing it with a screw and fake tooth. When you perform a root canal you get to keep the actual tooth, however with an implant your original tooth is completely removed. Lets review the benefits of dental implant over root canal first:

Dental implants are less likely to fail than root canals

Neither a dental implant nor root canal have a 100% success rate. There is always a risk of failure with any dental procedure, including both dental implant and root canals. Dental implants may lose their supporting bone structure, a condition referred to as peri-implantitis, and become loose and fail over time. Root canals can develop a recurring infection or break and fail as well.

A successful dental implant rarely ever creates a problem. Most well placed dental implants tend to last you a lifetime. On the other hand, many root canals run into issues and need to be removed and replaced with a dental implant years later. Root canal failure is much higher than dental implants. In fact in some cases root canals fail almost immediately and the tooth must be removed and replaced with a dental implant right away!

Dental implants are sturdier than root canals

Teeth that receive root canals usually also require a post and crown to restore the original tooth structure. However, each of these treatment come with their own risks and complications. Here are some reasons why root canal treated teeth are likely to face more problems over time:

Root canal treatment dries up teeth

Root canal treatment removes the tooth nerve along with its blood vessels. Lack of blood flow makes teeth become dry. As a result root canal treated teeth turn fragile and brittle over time.

Dental posts fracture teeth roots

Your dentist usually has to place what’s known as a dental post after completing a root canal. Dental posts help re-enforce the missing tooth structure subsequent to root canal treatment. Unfortunately, dental posts also place a lot of stress on teeth roots. This can lead up to root fracture over time.

Crowns further weaken tooth structure

Your root canal treated tooth will also require a crown to protect the tooth. This means that your dentist has to shave down substantial tooth structure to make a proper fitting crown for your tooth. This additional removal of tooth structure further weakens your tooth and makes it more likely to fail over time.

As you can see, root canal treatment makes your tooth much more likely to break and fail. A dental implant on the other hand that has a much lower failure rate. Since dental implants are fully synthetic material, they tend to hold up better over time than root canal treated teeth.

You get a more definitive outcome with implant over root canal

Root canal treated teeth may always be lost due to infection or fracture. If this happens, you most likely have to remove the tooth and replace it with a dental implant. Very seldom can anything be done to save teeth with a recurring root canal infection. You’re probably throwing good money after bad money trying to save a failing root canal treated tooth. Most likely it’s just a matter of time until your tooth fails again.

When is it best to go with an implant over root canal?

Whenever there’s very little to no tooth structure left above your gum lines, it’s better to go with a dental implant over root canal. Root canal treated teeth require sufficient tooth structure to hold up a crown over time. Badly broken teeth don’t have enough tooth structure to support a crown. Additionally, teeth with very advanced infections usually respond better to a dental implant over root canal. When a gross infection surrounds your tooth, chances or root canal failure increases significantly. It might just be a better idea to remove these teeth and go for a dental implant right away.

Some people avoid dental implants and choose to receive a risky root canal treatment for all the wrong reasons. Maybe they are scared of implants or they don’t want to spend as much on the tooth. Keep in mind that if your tooth is severely compromised, then it’s very likely to break within a few months or years. You will have no choice but to receive a dental implant sooner or later in these circumstances. Don’t let fear or price be the determining factor in these situations. After all a root canal, post, crown that fails and needs to be removed ends up costing the same, or even more, than a dental implant!

NEXT >> What are the benefits of root canal over dental implants?

10 Questions to help you decide between a dental implant or root canal