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.
NEXT >> Placing a Post in a Root Canal Treated Tooth: Pros of Placing a Post
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.
NEXT >> Placing a Post in a Root Canal Treated Tooth: How to Decide
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.
- A 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.
Placing a Post in a Root Canal Treated Tooth: How to Decide