Do you always need crown after root canal?
Need crown after root canal from your dentist? Are you being told that you have to have a dental crown after completing a root canal? Find out when you do need one and when you may not. Also find out what your crown options are.
Which teeth need dental crowns after a root canal?
Typically the easiest way to think about whether you need a crown after a root canal is to determine where the tooth is in the mouth. Back grinding teeth, molars and premolars, typically need a dental crown after a root canal. Front teeth that we use for tearing, canines and incisors, may not need a dental crown.
What are some of the factors that determine whether you need a dental crown after a root canal?
As I mentioned above, whether the tooth is a front tooth or back tooth is one of the most important factors. However, there are several other factors to consider as well.
- Is the tooth a front or back tooth?
- Do you clench or grind your teeth?
- What is your history? Have you broken teeth in the past?
- How bad is the crack, break or decay that is causing you to have a root canal?
- How much of your tooth is actually left? This one is very similar to the one above.
- Is there a tooth opposite, above or below, the tooth getting a root canal.
How do these factors impact the need for a crown after a root canal?
If you clench or grind your teeth you are far more likely to need the protection that a dental crown will provide you. If you have broken teeth in the past then you need the dental crown. Teeth that get root canals because they are badly decayed or broken have less tooth structure and therefore need a dental crown. Basically unless the tooth died of trauma, like a hit to the face, and does not have any fillings you likely need a crown.
Is a dental crown after a root canal necessary?
Studies show that a dental crown after a root canal increases the chance of the tooth surviving. There was a 6x higher survival rate in this study. Another study shows that only about 1/3 of the molars survive without a crown at 5 years.
Back tooth = Need crown after root canal almost always. AAE says always and is the authority on the subject. The exception may be for a premolar that has a tooth both in front and behind it and has only a 1 or 2 surface filling.
Front tooth with lots of decay or broken = Need crown after root canal.
Front tooth with very little decay and not broken = Does not need crown after root canal.
Do I need a crown on front tooth after a root canal?
This is the one place that you typically do not need a crown after a root canal. However, if the tooth has a lot of decay or is missing a large portion then you do need a crown.
Tooth already has a dental crown, does it need a new dental crown after the root canal?
That is a very good question and can be hard if not impossible to give you a great answer even if the same doctor did all the work on you. If there is decay around the edge or margin of the crown then yes you need a new crown. An example of that type of situation is right below this paragraph. However, many cases there is not decay apparent and this causes a problem. The problem is the dentist will not know what is under the crown. In fact, no one knows how much of your actual tooth is left. Therefore recommending a new crown can be a bit of a guessing game.
Ultimately you will probably hear whatever the dentists prefers instead of what you actually need because no one can tell you that. The “best” option is to get a new crown. However, a dental crown is an expensive procedure. Add that to the fact that most people do not need a new crown and you can see why we rarely offer this best option.
Personally, I never replace the crown when doing this unless I see tons of decay under the edge of a crown. One can make the argument that my protocol is under-treating, but I am comfortable with my method.
What are your options for dental crowns after a root canal?
Dental crowns come in a variety of materials today. Gold crowns are still available but are more expensive and wear down more. They are excellent for gum tissue and we can slightly modify gold in the mouth to have an excellent fit. However, we make very few gold crowns today. Porcelain fused to metal crowns were once very popular and are still in use today by some dentists but their use is disappearing and may not be around in a few more decades due to better options.
Ceramic crowns are what many doctors are going to and what future crowns will likely be made of. Emax and zirconia crowns are the two most popular. Both are strong and white in color. They both have some minor pluses and minuses and what you get is highly dependent on the dentist who does it. Emax on average is better looking but weaker, however, zirconia is caching up in the esthetics department.