Tag Archives: Dental Implant

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

How to Decide?

Answer the following questions:

  1. Is your tooth still savable?
  2. 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.

Final Thought

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

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

Choosing Between a Dental Implant or Root Canal

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

Now that you understand the benefits and risks of dental implant and root canals, it’s time to decide which is better for you. Here is a list of questions to help you decide between a dental implant or root canal. Please answer each question with either a “yes” or “no“:

  1. Did you break your tooth very badly? Essentially there is hardly any visible tooth structure left above your gum lines?
  2. Is your tooth very badly infected?
  3. Is your tooth loose, shaking or it’s roots are separating?
  4. Does your dentist sound doubtful about the 5-year prognosis of your tooth?
  5. Is the cost of a dental implant relatively comparable to that of a root canal and crown?
  6. Are you okay paying extra for the reassurance that you won’t have to worry about your problem again in the future?
  7. Are you physically healthy enough to perform surgeries?
  8. Have you already had a failed root canal or crown on the tooth in question?
  9. Have you had other root canals which have failed in the past?
  10. Do you already have one or more successful dental implants in your mouth?

Better candidate for dental implants

If you answered “yes” to most of the above questions then you consider a dental implant over root canal. Here is why:

Questions 1 through 4: Condition of your tooth

Performing a root canal only makes sense if your tooth is expected to last at least 5 years. For this to happen, there needs to be enough tooth structure left to comfortably support a crown. Very badly infected teeth are also not likely to last much longer, with or without a root canal. You’re better off going with a dental implant instead of a root canal in these cases.

Questions 5 and 6: Affording the implant

Dental implants almost always cost more than root canals do. If money is tight, you might have to take a gamble on root canal to see if it works. Still, don’t push your luck too much here. Root canals aren’t cheap neither so you should still expect your tooth to last for a while.

There are occasions where your dental insurance pays substantially towards a root canal but not as much, or sometimes nothing, towards dental implants. Again, it might be worth trying the root canal first to see what happens. However, if you’re okay paying extra for the peace of mind, then a dental implants is still a better choice in these boarder-line situations.

Questions 7: Your medical status

You have to be healthy enough to perform oral surgeries in order to receive dental implants. The good new is that there are actually very few conditions that preclude you from having oral surgeries. Aggressive cancer therapy affecting the jawbones is one of these conditions. There are also certain bone conditions in addition to localized bone loss within the jawbones that can complicate matters. Talk to your dentist to see if you’re healthy enough to receive dental implants or if you require additional preparation in advance.

Question 8: Previous tooth history

The more a tooth is worked upon, the weaker and more fragile it becomes. Teeth with a history of a failed root canal treatment don’t have very good 5-year prognosis. Similarly, teeth which have had their crown break or fall off repeatedly are most likely too weak to support a crown. These teeth are both better candidates for dental implants than root canals. A root canal or crown is most likely going to fail again sooner than later.

Questions 9 through 10: Previous success rates

We’re not going to discount factors such as age, luck and your dentist’s skills when it comes to deciding between a dental implant or root canal. If you’ve already had lots of successful root canal treatments and are happy with them, then go ahead and try another root canal and see how it ends up. On the other hand, if you’ve had one or two failed root canals then maybe you should go with an implant instead. Or vice versa, if you’ve had a dental implant or two fail then maybe it’s best to stick with root canals.

Better candidate for root canal treatment

If you  answered “no” to most of the above questions then you should consider a root canal first.

Final thought on deciding between a dental implant or root canal

It’s always preferable to keep your own tooth, but only when the tooth is expected to last for a good while. You want to make sure your tooth has a good chance of lasting 5 or more years if it was to receive a root canal. Generally speaking, successful treatment is considered one lasts at least 5 years, which is also referred to as 5-year prognosis. If your 5-year prognosis for a root canal treatment is good, then you should proceed with having the root canal done.

However, whenever your 5-year prognosis is looking bleak then you should bypass the root canal. Go straight to a dental implant instead. Receiving a root canal should not be considered as a temporary fix just to get you through for a short while. Receiving a root canal is not worth it if you’re going to lose the tooth this soon. Talk to your dentist to reassure you that they expect good long-term prognosis whenever dealing with a compromised tooth.

Keep in mind that there is no guarantee of longevity or success rate of any dental treatment, including a dental implant or root canal. However, an experienced dentist should be able to provide you with some idea to the condition of your tooth. This can assist you in making the right decision regarding which route to take. So take some time to discuss with your dentist and choose the treatment that’s more suitable for your needs.

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

What are the benefits of root canal over dental implants?