Need crown after root canal?

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.

  1. Is the tooth a front or back tooth?
  2. Do you clench or grind your teeth?
  3. What is your history? Have you broken teeth in the past?
  4. How bad is the crack, break or decay that is causing you to have a root canal?
  5. How much of your tooth is actually left? This one is very similar to the one above.
  6. 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.

Is a dental crown after root canal necessary?

The vast majority of back teeth with a root canal need a crown, just like this one will.

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.

Do you need crown after root canal

Decay under the margin or edge of the crown. This tooth will need both a root canal AND a new dental crown.

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.

Tags: , ,

128 Responses to “Need crown after root canal?”

  1. George RoushasJanuary 30, 2018 at 8:48 pm #

    I have had a root canal done on L R 6……still sensitive after a year….residing gums and bone loss I am told is the reason.
    A gold onlay to be fitted…..would this be sufficient protection….or is a full crown better or advicable………
    Your answer would be greatly appreciated
    Thanks

    • Bauer BryanJanuary 30, 2018 at 9:13 pm #

      If a tooth is in pain still a year after a root canal then it is not advisable to put anything on it. Extraction is likely your best option. Bone loss and receding gums are not treated with crowns so even if it is true that those are the reasons why your tooth hurts (I don’t think it is), the crown won’t help. However, there is a pretty decent chance that there is some confusion on which tooth had a root canal and which one is currently in pain. This happens on a fairly regular basis.

  2. SusanFebruary 3, 2018 at 3:58 pm #

    Hello. I had a root canal done 5. Years ago and had a crown put on. Yesterday the crown and the tooth under it has follen out,. It looks like i still have bone in my gums that is a loverly brown yellow color. Would you suggest having all the bone removed in my gums and then capped again?

    • Bauer BryanFebruary 6, 2018 at 4:29 am #

      Sounds like you may need an extraction. Go see your dentist before it gets infected.

      • vinceApril 16, 2018 at 11:05 pm #

        Not a Dentist a Oral surgeon.

  3. KateFebruary 6, 2018 at 7:30 pm #

    I had a root canal 6 years ago . I recently went to the dentist and the Dr. was surprised that I never had it crowned (I was never told) but she says everything looks really great. My tooth doesn’t both me nor has it cracked. She is insisting I get it crowned. After this many years is it really necessary?

    Thanks !

    • Bauer BryanFebruary 6, 2018 at 7:40 pm #

      I always recommend doing it. Statistically back teeth with root canals that do not get crowns do not last as long. The kind of cracks that cause you to lose the tooth are more like hairline fractures and are cumulative. You don’t see or feel them until the tooth is past the point of saving and needs to be extracted. If you are under 60 I would def do it since you have so many years left that you want to keep it.

  4. AnonymousFebruary 8, 2018 at 8:56 pm #

    I had all my front 4 teeth hit while playing ice hockey, one tooth was mostly gone from the incident but the other 3 were also affected. I have had a root canal on 3 of the teeth, 1 is still holding its colour and may be alright. Two of the teeth went dark. Originally the dentist had planned on doing 4 crowns across all 4 of the teeth to insure stability (provided the 4th tooth needs a root canal). However, recently he suggested bleaching the two teeth that have changed colour and not putting a crown on them. He then would put a brace behind the teeth to hold the structure together to prevent any movement. My hockey club is paying for all the work, wouldn’t it be better to just get the crowns done anyways? Is it bad in any case to have the front teeth crowned after a root canal?

    • Bauer BryanFebruary 8, 2018 at 9:52 pm #

      I like the new plan much better. The bleaching gets the result you want and saves your own tooth structure. It is also very difficult to make perfect front teeth.

  5. AnonymousFebruary 9, 2018 at 9:41 pm #

    So even after the root canal treatment it is okay to just bleach and fill them instead of the crown? Will they have enough strength in the long run? Thank you for your feedback!

    • Bauer BryanFebruary 10, 2018 at 11:42 pm #

      Yes. Front teeth that is usually the best treatment unless there is a lot of decay or huge fillings. I like you dentists thoughts. Listen to him or her.

  6. AllieFebruary 13, 2018 at 9:19 pm #

    My dentist suggested a porcelain onlay (costing $1200) and when she started drilling realized I would need a root canal (costing another $1100). Is there alternative treatment post root canal where I can save money?

    • Bauer BryanFebruary 13, 2018 at 10:20 pm #

      That happens sometimes. Sorry it has happened to your tooth. Unfortunately the answer to your question is no. Dentists that do onlays tend to be very careful and conservative with their recommendations so my bet would be you are in very good hands. That’s of course a broad generalization but it has been my experience.

  7. PrashantFebruary 19, 2018 at 6:04 am #

    Hi Bauer Bryan,

    Thanks for your prompt reply for question. Recently we been to doc for my wife and found that she require the root canal for tooth. Doctor is also recommending the crown over that, Is crown require or can be it avoided for sometime? Crown is costling expensive and we are thinking if we can get crowned after 1yr in India?

    • Bauer BryanFebruary 19, 2018 at 3:18 pm #

      Back teeth almost always required. You can likely wait one year if you need to.

  8. akshay parmarFebruary 21, 2018 at 12:36 pm #

    sir ,
    i went to the dentst last week for routine checkup . he found some decay under my 1st maxillary premolar. he suugsted x ray of tooth and after seeing x ray he told that i need root canal since the decay has reached the tip of my pulp . so i want to know that if there is a chance for pulp capping or not

    • Bauer BryanFebruary 22, 2018 at 6:25 am #

      You need a second opinion from someone that can see and test the tooth.

  9. mario georgesFebruary 27, 2018 at 4:31 pm #

    hi Dr , i went to the dentist today to check a pain in molar 30 which already had a root canal and crown done as well , but we found that the roots has not been taken out all the way to the bottom, causing this infection and pain , so Dr recommend to do again the root canal procedure , so in this point what do you recommend me, it is worth to spend time and money or pull the molar,what are the chances to get it done again to save the molar? thank you Dr.

    • Bauer BryanFebruary 27, 2018 at 9:24 pm #

      Root canal retreats are tough in the best circumstances. Sometimes they fail because the infection is really bad, sometimes they fail because the tooth root is cracked, sometimes they fail because the root canal needs to be done better, sometimes they fail because the anatomy of your tooth is impossible to clean out very well. Of those only one of those things can we fix. If we can see that the root canal is not very good then it’s probably worth trying again. The decision is yours. What is your risk tolerance for failure knowing that is a possibility?

  10. JoshMarch 3, 2018 at 3:44 am #

    Hi, my tooth nepenthe to the front one suffered trauma 3 months ago (I got attacked) and it has recently changed colour to a very light grey that’s not overly noticeable but I know it’s there.
    I visited a new dentist as I’ve recently emigrated and he told me that I need a root canal and then a crown due to the tooth having a very small crack in the back (that I can’t see nor feel)
    The tooth is still a bit sensitive to cold drinks etc.
    What i’m wondering is, do I go ahead and do what he has suggested, get a second opinion or is there still a chance of my tooth healing and returning to its ‘normal’ colour?
    Thanks for any advice you may have 😊

    • Bauer BryanMarch 4, 2018 at 4:58 pm #

      Front teeth usually do not need a crown. The color will not return. I recommend a root canal and internal bleaching to bring the color back.

  11. JanaMarch 4, 2018 at 12:25 pm #

    hi DR. i have done RCT 4 years ago but i didn’t crown the tooth then some of composite fallen down i went back to the doctor and he put a crown but i feel pain
    what could be the reason behind the pain?

    • Bauer BryanMarch 4, 2018 at 4:57 pm #

      The bite could be off or it could be too late and the tooth got reinfected.

  12. PrashantMarch 10, 2018 at 6:18 pm #

    Hi Doctor, today dentist did the permanent filling for tooth number 14 after root canal two weeks ago. Is it necessary to have crown for tooth 14 or can wait until one year? Crown seems to be too expensive and my insurance covers only 50%. Kindly advise.

  13. TonyaMarch 15, 2018 at 4:44 am #

    Hi, I had a root canal done on #10 five months ago and it’s healing nicely, because 8 yrs. ago I got head-butted. Do I need a crown put on it.

    • Bauer BryanMarch 15, 2018 at 4:25 pm #

      Usually no. If the tooth is badly broken down then maybe.

  14. Sanja BroerMarch 15, 2018 at 5:02 pm #

    Hello! Just got back from having a root canal completed on #5. This tooth had a crown placed on it ~13 years ago. About two weeks ago, the tooth broke off just above the gum line (per my husband, I have been grinding my teeth in sleep, and I personally recall being woken up in the middle of the night by a loud noise in my mouth, which is when I think the final crack on #5 happened). My dentist’s initial plan was to do the root canal on the tooth and put a new crown, but today she said she’d want to hold off of a crown (as it would be a waste of money) and just see how the tooth does with current buildup. I am nervous about the buildup breaking and feel like the crown would be a better option in the long run. What do you think? I am hesitant to challenge her decision making process (she is pretty awesome at what she does) but all the research I am reading online states that crowned root canal teeth (especially the ones towards the back) have higher success rates. I really don’t want to lose this tooth. Any advice – much appreciated!

    • Bauer BryanMarch 15, 2018 at 10:39 pm #

      I’ve sure she is trying not to waste your money. Depending on how much money you have to spend and your tolerance level for risk then you can get the crown and just be aware that it could break again soon. If a dentist thinks getting a crown on a tooth is a waste of money, then it almost certainly is. My guess is she is thinking it’s going to break again soon and will need a dental implant.

  15. KimMarch 27, 2018 at 8:05 pm #

    Just got back from my dentist. Having a lot of pain in my 1st left bicuspid. No decay, no fractures. Had a first molar pulled several years ago on same side due to fracture of root aT gum line. Had a bone graft. Bite has never seemed right since. I could not afford the $3000 implant for that tooth. Dentist put me on antibiotic and wants to do a root canal and Zirconia crown on bicuspid. Is it necessary to crown a bicuspid? Can I get away with just a root canal? What are the risks of not doing a crown? It didn’t even look abscessed on x-ray. Could it just be bruised? My top cuspid bangs into it quite frequently since the large first molar was removed. Would appreciate your thoughts.

    • Bauer BryanMarch 27, 2018 at 8:16 pm #

      It’s pretty necessary to crown a bicuspid, especially if you missing the molar on that side. If you do the root canal without the crown you will likely only get a few more years out of the tooth until it breaks and we can’t save it. The abscess usually doesn’t show up until after the tooth has been dead for quiet some time. So when it is still alive but about to die – it is very sensitive, specially to cold, but nothing shows up on x-ray yet.

  16. TomMarch 28, 2018 at 2:11 pm #

    Recently my dentist recommended doing a crown on a top front tooth.Had a root canal maybe 35 years ago and tooth has held up with no problems other than discoloration near the top.Not sure a crown at this point would be a good idea.Im afraid maybe getting a crown now will be tough to match and stand out more .Your thoughts?

    • Bauer BryanMarch 28, 2018 at 9:53 pm #

      Nope. Front teeth rarely need a crown. If want to hide the color you can try internal bleaching or a veneer

  17. TomMarch 31, 2018 at 3:13 pm #

    I had a crown replaced and root canal with new crown was done 3.5 years ago. Tooth never felt quite right but I was told to give it more time. Yesterday I experienced severe pain and was told by the same dentist that did the work that I needed to decide extraction or another root canal from a dental specialist because of the level of infection. I am pleased that his diagnosis was the same as yours but I was very upset that he did nothing to address the extreme pain immediately. Also he charged $116 for the diagnosis.

    • Bauer BryanApril 2, 2018 at 3:35 pm #

      Unfortunately the only immediate thing we can do is take the tooth out. To save the tooth will require that you get through the pain. $116 is in line with what you would have been charged in our office. We would waive that if the work was very recent but by 3.5 years, that is a very reasonable fee. Just be aware the root canal specialist and, if they are referring you out for an extraction, the oral surgeon will also charge you for their consultation.

  18. DebApril 2, 2018 at 2:32 am #

    Hello,

    I took a hammer to the teeth about 10 years ago. None of the teeth broke, but I did end up needing root canals for both of my upper front teeth. Now they say I need root canals on the bottom two. One of the bottom teeth is discolored and has been for years. I have no pain in either tooth. My dentist says I need crowns on all 4. My biggest question is do I need crowns on all four teeth? I know sometimes you don’t on front teeth, but because its a bunch of them I am not sure. Thank you for your time!

    • Bauer BryanApril 2, 2018 at 3:36 pm #

      That is highly unlikely. I would get another opinion.

      • Bauer BryanApril 2, 2018 at 3:37 pm #

        By that I mean another in person opinion with another dentist.

  19. AwenApril 3, 2018 at 5:31 am #

    Dr Bryan, I am going to have a root canal on tooth 29, for some unknown reason, the nerve died and had an infection. My dentist told me I need a crown after root canal. I am wondering, since the tooth has no decays or cavities, will a filling be good enough? Thank you.

    • Bauer BryanApril 3, 2018 at 6:50 pm #

      Are you sure it has no fillings existing? Maybe one along gumline? If there is no decay and no existing fillings then you could probably get by without a crown. The thing I would be concerned about in a situation like that is that perhaps the tooth died due to some microscopic crack and if there is a crack you definitely want a crown. Sorry probably not as direct of an answer as you are looking for. You probably could skip the crown but you are taking a chance. There is no research I am aware that shows that if a tooth has no other work that then the odds are in favor of not getting a crown. The research simply shows that back teeth are more likely to last longer if get a crown. A dentist will always say get one because if we don’t and you break it then patients tend to blame us, but if we recommend and you never do it then it’s one you if breaks.

      • AwenApril 4, 2018 at 6:29 am #

        Thank you very much for your reply. Well, since you asked, yes, there is a small filling along the gum line. There was a little gum recession before, so my dentist did a small filling, but the filling came off a few months later, and she did the filling again. 8 months after that, I notice the lump growing near that tooth, my dentist told me I need a root canal, but she said the tooth’s death is not related to the filling. It seems like you think the death might be caused by the gumline filling? thank you.

  20. KATIEApril 4, 2018 at 7:57 pm #

    HELLO,

    IN 2017 I WENT TO A DENTIST BECAUSE I HAD A SMALL CAVITY AND I GOT IT FILLED. MY TOOTH STILL HURT. SO I GOT ADJUSTMENTS AND MY TOOTH STILL HURT. SO I GOT THE FILLING REPLACE. ONCE IT THE PAIN NEVER STOP. SO I FOUND ANOTHER DENTIST AND HE REPLACE THE FILLING AND GOT ADJUSTMENTS AND IT STILL HURTS. JUST WENT BACK TO THAT DENTIST AND I WAS TOLD I WOULD NEED A ROOT CANAL AND A CROWN.
    I BEEN GETTING THE FILLING ON MY 12 UPPER LEFT TOOTH. THE DENTIST DID NOT EXPLAIN WHY MY TOOTH BEEN HURTING . HE JUST SAID I NEED A ROOT CANAL AND A CROWN. DO YOU THINK THAT WILL STOP THE PAIN? WOULD I NEED THE CROWN?I CAN CHEW MOST FOOD ON MY LEFT SIDE. I AM JUST HOPING IT NOT MORE SERIOUS. HOW WOULD I KNOW IF MY ROOT OF THE TOOTH IS CRACKED ?

    • Bauer BryanApril 5, 2018 at 3:05 am #

      Get the root canal and crown like the second dentist told you. BTW maybe consider going back to first since it clearly wasn’t him but the situation.

  21. SreeApril 6, 2018 at 5:52 am #

    Hello Doctor,
    Recently I got RCT for 7 teeth, doctor asked to put cap for those 7 teeth, If I’m putting cap for those teeth it will looking different from my old teeth or looking as usual normal after the cap works. And what is the validity time for cap covering of RCT teeths.

    • Bauer BryanApril 6, 2018 at 7:15 pm #

      Crowns look similar but they are different.

  22. VeronicaApril 6, 2018 at 11:31 am #

    Hello,

    I am 29 and had a root canal on LL2 but she couldn’t get to the bottom due to a curved canal, so today I am having one with the rotary tool. She said even that may not get to the bottom of it!

    She said the lifespan of a root canal is only 5-10 years… is this accurate? Is there anything I can do to extend the life of my tooth?

    I’m concerned I will eventually lose the tooth as I still have many more years to live with it!

    • Bauer BryanApril 6, 2018 at 7:12 pm #

      If someone can not get to the bottom with hand files the rotary will definitely not get there. If you don’t get to the bottom the lifespan might only be 5-10 years. I would consider another opinion, it’s pretty important to get to the bottom.

  23. Christine HinderliterApril 10, 2018 at 4:01 pm #

    Hello. I just finished root canal on #3 molar, upper right. They put temp filling In and said to have post crown done within 2-6 weeks. Is it possible to wait longer? It’s just not financially feasible at this time. I have all of my teeth surrounding, and only part of the tooth was broken off. Or any other procedure that is less expensive? Thank you

    • Bauer BryanApril 10, 2018 at 8:39 pm #

      Yes you can often wait, but there is a small risk of it breaking. If someone approaches me and is humble and honest and says, “listen doc I know I need a crown but I just can not afford right now. Can we do it next fall or year?” I say fine if I think that too bad or if I think the tooth is at severe risk of breaking I will offer to put a temp crown on now with permanent cement. That can buy a year or so. Good luck!

  24. Chelsea NApril 12, 2018 at 9:53 pm #

    There was only a small piece of my 31 molar removed for a root canal, just a corner of the part touching number 30. Do i need a crown or can it be fixed with just a permanent fill? Cost is the issue… Thank you!

    • Bauer BryanApril 13, 2018 at 3:50 am #

      Only if you want a much higher statistical chance to keep the tooth. If you are willing to take a chance, about 1/3 do survive for 5 years. Those are pretty terrible odds if you ask me.

  25. TrentApril 14, 2018 at 2:14 am #

    Dr. Bauer, appreciate your online presence. Endodontist completed root canals on 19 and 20 finding six canals in 19 and four in 20, and placing permanent filling. Due to cost prefer to wait on the crowns. Is the temp crown with permanent cement for now viable? Permanent crowns can be placed in about 8 – 9 months. Is just waiting viable?

    • Bauer BryanApril 18, 2018 at 4:27 am #

      Yes

  26. Carol DixonApril 14, 2018 at 11:24 pm #

    Six years ago I had my fillings replace, thought it would be the silver again, wrong a new veneer or whatever was the new filling. Anyway two to three years later I was eating a meal and I heard a crack on the right upper side of my mouth. Seems the filling cracked and went into my gums. No pain and has taken me two more years to to see about it as I cannot eat on that side. Will three hours later walked out, had xrays and cleaning, owing about $2200. Seems I need a crown. No choice given to me and I was unprepared for this diagnosis. No reason given or whether the tooth is worth saving. My choice pull it. I am 71 how concern should I be having this done?

    • Bauer BryanApril 18, 2018 at 4:29 am #

      If uncomfortable with choices given get a second opinion.

  27. JustinApril 16, 2018 at 7:28 am #

    I got a temporary filling in April and am told I will need a root canal. I have no pain or discomfort whatsoever. I have no insurance now, but will have insurance in July to cover most of the cost of the root canal. Do you think I can wait until July to do the root canal? Also, can I wait one year after the root canal for the crown (there is a one year waiting period on insurance coverage for crowns).

    • Bauer BryanApril 18, 2018 at 4:30 am #

      The tooth will decide if you can wait. If it blows up and starts hurting a lot you won’t be able to wait. My money would be on you can wait.

  28. MariaApril 19, 2018 at 8:53 pm #

    Hi doctor,

    I just had a root canal on my #36 tooth ,it was too painful and nerves were dead ,The endodontist will have me back after a month to have another root canal on same tooth,is that normal? I thought only once is enough. And also he said I get a crowm 6-8 months after the root canal.Is that normal to wait that long?Thank you so much

    • Bauer BryanApril 22, 2018 at 2:42 am #

      Sounds like it badly infected had the doctor has concerns about it’s success. That is not abnormal for a badly infected tooth. And the second step is just them rinsing out the medicine they put in the first time, that is also normal.

  29. ChelseaApril 20, 2018 at 1:34 am #

    I got a root canal today on #5, but cannot get the crown until after my braces come off (per orthodontist and dentist orders) I’m really scared of cracking this tooth as I still have 6 or so months left of braces. Am I pretty much stuck with only eating on my left side for 6 months? Only eating mushy food?

    • Bauer BryanApril 22, 2018 at 2:43 am #

      You’ll be fine. The diet restrictions that come with braces will keep you away from anything that would break the tooth.

      • ChelseaApril 22, 2018 at 2:56 pm #

        Good to hear. Does this also mean cleanings, tightenings, bands, and taking the brackets off will also be safe?

  30. Lynda P.April 20, 2018 at 5:03 pm #

    Had a root canal #5 last week ($1195) Went to reg dentist this week to get crown. About 3 minutes into the exam he said no crown because my tooth was too cracked. The root canal was a waste of time and $. He re-filled it. Now he wants me to get it extracted and get implant- 2-3 thousand more. Can I wait?

    • Bauer BryanApril 22, 2018 at 2:44 am #

      Yes you can wait. Everything in dentistry is elective to some degree.

  31. VaibhavApril 25, 2018 at 4:07 pm #

    Hi
    I had root canal last Thursday on my 7th molar RHS, then my doc said the height of my teeth is short so normal crowning is not possible and she asked for Crown lengthening but i am not ready for crown lengthening so i visited another doc. he suggested that crown lengthening is also not possible as just after the root canal treated tooth i am having a wisdom teeth which is horizontal. He suggested to put a Cap in the gap from where the root canal treatment is done. Is is safe doing so? Thank you in advance

    • Bauer BryanApril 29, 2018 at 4:06 pm #

      There is no perfect answer to this one. Risks with all options.

  32. JenniferApril 27, 2018 at 3:21 pm #

    Hello,
    I damaged my two front teeth in sixth grade, and two years later they did root canals on both. When I was 30, I got crowns placed due to the fact they had started to turn grey— and they are perfect. I am now 46, they have not been bothering me at all , and I just saw my dentist who did my exam and said everything looked good. However, I had a 3D panoramic X-ray done, and today she called to say she reviewed the images and there are signs of a vertical root fracture on the left. I am so bummed, because I haven’t seen many front teeth that look real and I dont want to lose my crown! Is it inevitable?

    • Bauer BryanApril 29, 2018 at 4:15 pm #

      Yes. A great dentist can make it exactly the same. But it is hard to do. BTW with a vertical fracture you will be getting a dental implant. here are some of mine.

  33. AyushMay 3, 2018 at 11:04 am #

    Hello,

    I am currently having a root canal treatment on my 2 molar (tooth number 18) . Now, after taking X Rays and examining my tooth, the doctor has told me to get my wisdom tooth (number 17) removed before he puts in a crown. He says that the wisdom tooth is locked in my 2 molar and needs to be extracted otherwise the crown won’t fit.
    Is it necessary to get a crowning done there? Or shall I not get my wisdom tooth extracted and get the crowning done anyways?

    Thank You

    • Bauer BryanMay 3, 2018 at 8:32 pm #

      Yes you need the crown and yes you need the wisdom tooth pulled. That is a fairly common situation we run in to so I am very confident in saying you should trust the dentist on this one.

  34. Paige CloudMay 6, 2018 at 11:00 pm #

    I recently fell off a long board and chipped my #10 tooth and it needs a root canal. I went to 2 different dentists and one said I shouldn’t get a root canal (GraceMed that doesn’t take my insurance) and then another dentist said that I should get a crown? It’s my left tooth next to my front tooth. It’s sensitive and hurts whenever I bite down or drink something . Also my #11 front tooth got a little chipped but not bad and is intacted so it doesn’t need a root canal. He wanted to shave it but I said to put filling instead. He said it’ll fall off is this slightly true? I’m just scared cause there my front teeth and I want them to go back to normal as much as possible.

    • Bauer BryanMay 8, 2018 at 4:42 am #

      The ones that don’t take your insurance are on average giving better advice. If they said no crown I would go with that.

  35. Paige CloudMay 6, 2018 at 11:02 pm #

    One dentist said I shouldn’t get a crown and then the other dentist said I should get a crown**** is what I meant to say sorry!

  36. Paige CloudMay 6, 2018 at 11:05 pm #

    Also my root canal tooth is already starting to discolor a little and I don’t have a root canal scheduled till 2 1/2 months away. If it gets more darker when they do the root canal will they bleach my tooth? Or will the RC make the darkness go away. Afterwards they said after the RC and crown they’d do the filling for my chipped part at bottom.

    • Bauer BryanMay 8, 2018 at 4:43 am #

      See if they can do sooner. If gets dark they can whiten from the inside.

  37. cjMay 7, 2018 at 3:27 pm #

    Hi,
    I had a crown put on a tooth 20 years ago because of sensitivity. Dentist could not find a cause… so I got a crown. Fast forward 20 years…had some decay on same crowned tooth, had decay resolved and got a new crown. Now 2 weeks later I have some slight throbbing I notice only at night while in bed. If I now need a root canal, can my new $1000.00 plus crown I just paid (out of pocket) for be used again??? Just can not afford to pay for another a new crown at the moment if I do, so will just have live with the throbbing! I know you are going to say go visit the dentist again, and find out, but that mean more $$$$ again!!!

    • Bauer BryanMay 8, 2018 at 4:44 am #

      We cut through the center of crowns all the time to do root canals and they hold up just fine. Should not be an issue.

  38. HillaryMay 9, 2018 at 7:46 pm #

    I just had a root canal down yesterday doctor never talk about no crown only the nurse said let us know when you can afford it. Which I called today and ask how much for crown she said 1000. Why didn’t doctor talk to me about any crown its one of my back tooth. Do I really need a crown??

    • Bauer BryanMay 9, 2018 at 11:08 pm #

      Yes.

  39. BernieMay 9, 2018 at 8:50 pm #

    Recently got a root canal on my front tooth (number 9 i think). After it is done i am then told by the dentist that i need a crown and build up which is about $800. My front tooth is not decayed, or broken. Is a crown necessary or can i just do a filling? i really do not want to file down my front tooth.

    • Bauer BryanMay 9, 2018 at 11:09 pm #

      Unlikely. get another opinion.

    • Bauer BryanMay 9, 2018 at 11:10 pm #

      Is $800 all it costs for the crown and buildup or is that just your out of pocket?

  40. ElizaMay 27, 2018 at 7:54 pm #

    Hello- I got a root canal about 4 years ago (#7 upper left side) due to a deep cavity and was told I should get a crown. At the time the dentist also shaved away some of the tooth between 6 and 7 because my teeth are very close together (dentists always complain if I need a filling). At any rate, I didn’t want to get the crown right away because I was still having a lot of lingering pain. In hindsight, what I think happened is that there was a natural period of several months for the inflammation to go away… and then the larger space between the teeth ended up being a huge problem for food getting stuck in there- so maybe it turned into a gum issue. So in the end, I’ve had pain with that tooth off and on for 4 years. My current dentist just did the crown prep and together we were hoping a properly constructed crown would fill in that gap again and hopefully solve my issues. So the question is this- 5 days after the crown prep, should it be so painful that I need to take ibuprofen every few hours? I usually have a high pain tolerance, but this is pretty bad.

    • Bauer BryanMay 28, 2018 at 11:08 pm #

      Possible, because after 4 years I am almost certain you have decay in between the teeth and the doctor probably had to remove both gum tissue and maybe even bone.

  41. Ida r gutierrezMay 29, 2018 at 4:16 am #

    Hello

    I had a crown placed 2 yrs ago.
    I have a lot if pain which is radiating to my ear,
    i seeked advise from 2 different dentist last week 1st dentist office said i have an infection and i need a new crown /root canal . cost is approx $700.00
    2nd dentist did not state anything about an infection but he could drill in the middle of my crown and perform the root canal without replacing a whole new crown, cost $300.00
    im confused and worried, please advise, both offices did a xray.

    • Bauer BryanMay 29, 2018 at 1:32 pm #

      Second one is right. Just do the root canal through the crown. The crown will be fine even with a hole through it. You do not need to replace the entire crown.

      • Ida r gutierrezMay 29, 2018 at 2:07 pm #

        Thank you! Can I take a 800 ibuprofen before. The root canal I’m schedule for this morning at 11:00 am
        And if so how long before can I take the pill

        • Bauer BryanMay 29, 2018 at 8:29 pm #

          yes about an hour before is ideal

  42. SUYOG CHETTRIJune 1, 2018 at 11:07 am #

    I had a root canal treatment on my front teeth.
    My dentist told me that I don’t need crown.
    He said let it be for one year and we will see it.
    Does leaving it without crown will harm it?

    • Bauer BryanJune 1, 2018 at 1:10 pm #

      Unless the tooth is really badly broken down you can go without. Usually fine without but the dentist is the only one that saw it so….

  43. KathyJune 22, 2018 at 10:38 pm #

    I had a filling and after several months it still hurt (apparently the filling was too close to the nerve) so it was recommended that I have a root canal. I had the root canal today but dentist told me she didn’t get to the “end” of the root (was about 1mm away). What does this mean and what are the possible implications? Thank you

    • Bauer BryanJune 25, 2018 at 8:15 pm #

      It means the dentist could not completely clean out the tooth from top to bottom due to either your anatomy being difficult or the dentist ability or a combination. If the tooth was still alive (most likely) then it will probably not have any impact on your outcome. If the tooth was dead it is unlikely but possible to have the root get reinfected later. The reality is that teeth root anatomy is so variable and complex that most of the problems arise from individuals with anatomy that our technology can not clean, you may be one of those people.

  44. YogeshJune 24, 2018 at 5:33 pm #

    Hi Mr. Bryan.
    I just got my root canal done in Dubai. The dentist said that he will call me in 3 months again to put the crown on it. Is it okay to wait that long ? I got the root canal of the tooth at the back not the front. Also , it’s been 2 days since my root canal, I feel very less pain , is it normal to have little pain after the root canal? What food should I eat or drink ?
    Thanks.

    • Bauer BryanJune 25, 2018 at 8:16 pm #

      Yes it’s ok just don’t bite down on anything too hard, like nuts. Other than that normal bite is fine.

  45. YadiraJune 29, 2018 at 2:51 pm #

    Hello I have a lump inside my gums that is causing my front teeth nerves are dead is visible on xrays. I have orthodontic treatment many years ago and my dentist told me that because of my orthodontic, I have that lump. 10 years ago, My dentist told me that I need a root canal in teeth 6,7 and 8. I don’t have cavities, pain, nothing. I only have a not perfect appearance on my teeth because of a lot of fillings (resin). And my dentist told me If I want to improve the appearance of my teeth then I will need the root canal. Now I have an outside abscess behind my nose where the nerve of my teeth #7 is. I am currently taking Clindamycin. Do I need the root canal anyway?

    • Bauer BryanJuly 3, 2018 at 6:37 pm #

      Yes you need a root canal

  46. heather mackJuly 2, 2018 at 5:44 pm #

    I had a root canal on tooth 29. I was having pain on my right side of my mouth and 2 dentist told me all my teeth were fine after Xrays. One finally referred me to a endodontics office. I went there, they did an xray and also said it showed nothing. Finally they did a sensitivity test and one hurt more than all the others so he did a closer xray of one tooth and noticed a small amount of tooth decay under the filling and said if it’s bothering me that bad we can do the root canal. Had the root canal done and the endodontic told me it could probably go with a permanent filling instead of a crown. When I called the dentist that referred me to the endodontics the secretary told me they wanted to schedule a crown. I explained to her that the endodontic told me I could probably go with just a permanent filling and she said I could make an appointment to see the doctor and then discuss it with her. I have a feeling they are really going to push the crown down my throat because it’s obviously more money for them. It will cost me a lot out of pocket after paying the root cancel (1100) & probably $800 if I need the crown. My insurance covers the permanent filling. Should I get a second opinion if she pushes the crown.. do you think I could go without the crown or should I just pay the money to be safe? I really don’t even think I needed the root canal to begin with. I’m pretty sure the pain I was experiencing was from my jaw because I still get the pain but I was willing to try anything at that point in time. Now I’ve accepted the pain and don’t really want any more unnecessary work or money blown.

    • Bauer BryanJuly 3, 2018 at 6:41 pm #

      It’s very unlikely that you can just have a filling and not the crown. You can do whatever you want but statistically speaking how long the tooth will last you decreases without the crown on that tooth. If you do not clench or grind at all then maybe you would be ok but that is a risk you take. No dentist will say it’s fine because then when it breaks people come back and say why didn’t you make me get a crown.

  47. KenJuly 10, 2018 at 3:16 pm #

    I just had a retreat root canal of #30. Previous work had been done maybe 8 or 10 years ago, and there was infection showing up below the roots. There was a gold onlay placed on the tooth, on the forward portion of the tooth, and the endodontist was able to drill right through it without it being dislodged. The remaining “divot” in the tooth after the RC is about 4mm across, and margins of the gold onlay remain, as well as the forward “body” portion of the only (i.e., where the bulk of the gold lies.

    Now, based on the report received from the endodontist but without yet having seen the tooth, my regular dentist (restorative) says that the whole original crown of the tooth needs to be replaced. That to me seems excessive. The onlay replaced the portion of the tooth that had been decayed and damaged by the original root canal; the rear 2/3 of the tooth is actual tooth.

    Your thoughts are appreciated.

    • Bauer BryanJuly 14, 2018 at 6:19 pm #

      Tough call. Based solely on the data I have, which of course can never be very much in this format, I would lean towards what your restorative doc says. Gold onlays are pretty small and even though the margins are intact visually and the onlay seems fine, the chattering of the bur going through gold often either dislodges the onlay or slightly dislodges it (which is actually worse as it creates a space for bacteria to get under). Unless you really need to save the money I would not take the chance that the onlay has issues under it at this point. I’ll also add I am pretty damn conservative as a dentist and often will take the leave well enough along route, just so you know what my bias is.

  48. DedeJuly 12, 2018 at 1:06 am #

    Hello doctor
    So my front upper left tooth was very very very sensitive after a doctor removed some decay from it and I rarely used it, and I grind my teeth all the time , also this tooth was a bit loose , and so
    7 years later this tooth got infected and i thought it was pain from grinding but since it lasted 2 weeks I went to see a doctor he told me that the root is dead and I needed a root canal, After getting it I noticed that my tooth is way more loose and that there is a fracture going across it (not sure if it was there before the root canal) and I’m still in excruciating pain similar to the pain I felt before getting root canal.
    Does this mean that the doctor botched my root canal and that i have to get it removed and put a fake one in ?
    It’s been 2 days since I got the root canal

    Thank you
    And sorry for my bad English

    • Bauer BryanJuly 14, 2018 at 4:42 pm #

      2 days is not long enough. Wait longer. I always say at least 3 days. Also some teeth do to anatomy can never be done perfectly.

  49. NicoleJuly 17, 2018 at 1:34 am #

    Hi, I got a retreatment today (tooth 2). My endo said to get a crown right away and my dentist says that I have to heal for at least 2 weeks. Who do I listen to? Thanks!

    • Bauer BryanJuly 17, 2018 at 5:20 pm #

      2 weeks is pretty much “right away”. They’re both right.

  50. ConnieJuly 22, 2018 at 4:38 pm #

    I am getting physical therapy for my TMJ disorder and they used a tens-like unit on my jaws that causes a lot of vibration and now my crowned back tooth is killing me! Could this have loosened my crown?

    • Bauer BryanJuly 23, 2018 at 7:56 pm #

      Possible but unlikley

  51. NanAugust 6, 2018 at 9:56 pm #

    Hi Doc,
    My upper maxillary first molar, tooth #26, underwent root canal treatment and crown prep. The dentist placed a temporary crown, and I met the technician in order to take my tooth shade.
    The only non metal crowns my technician provides are Zirconia, but I am very concerned about the toughness of Zirconia and the abrasive effects it may have on healthy dentition. I want to be able to chew comfortably without worrying about my teeth ruining or my crown breaking. I normally don’t grind or clench my teeth.
    Is Emax (lithium disilicate) preferred over Zirconia?
    What is the most recommended type of non metal crown for an endodontically treated molar?

  52. NanAugust 7, 2018 at 9:10 am #

    Would you still recommend the Zirconia considering I am 24 years old and this would be my first crown?
    As well, the core buildup my dentist chose was glass ionomer filling without a post/pin/screw – would you advise differently re crown material in such a case?

    Also are you familiar with Ceramtec Zirconia – are they a reliable company in terms of quality?

    • Bauer BryanAugust 7, 2018 at 9:18 am #

      All those things sound very appropriate.

  53. NanAugust 7, 2018 at 11:19 am #

    Thank you so much for your response.
    One more question: I might want to straighten my teeth with Invisalign in the near future – would there be an issue doing so after permanent crown placement?
    Would you recommend getting them straightened beforehand? (I am wearing a temporary crown at the moment)

    • Bauer BryanAugust 7, 2018 at 2:20 pm #

      Tooth #26 will not move much if at all during ortho so no worries. Do the crown now.

  54. NanAugust 9, 2018 at 1:58 pm #

    Hi again,
    I was just reading your Zirconia dental crown blog post that you referred me to, where you state from CR research regarding wear of Zirconia crowns – concluding that the crown itself “appears to be wearing more heavily”. You write that you are concerned this wear will accelerate.
    You advised that Zirconia is better than Emax for posterior teeth and that it wears better, but how is that so considering the CR research?

    • Bauer BryanAugust 9, 2018 at 2:14 pm #

      It wears the opposing better. Something will wear eventually, so you want to look at the total wear – both teeth. They haven’t updated their research yet but based on other research I have seen since 2014 their data would be the outlier to not have zirconia preform better. They may never update as they may not have enough data to follow up anymore. I test for CR and am going to shoot them an email to see if they plan to follow up again.

  55. NanAugust 9, 2018 at 2:40 pm #

    I appreciate your response.
    You’re saying the CR data would be an exception?
    How would their data re Zirconia wearing heavily explain the fact that Zirconia withstands even the extreme impact of a hammer test?

    • Bauer BryanAugust 9, 2018 at 4:50 pm #

      If you look at CR data it wears other things less so it is kinder to teeth so you have to factor in the total wear of both surfaces. Other studies that I don’t have on there that I have seen over the years show zirconia to be the best product. They are not testing strength just abrasiveness. How something wears and how strong it is are not the same properties. Abrasiveness is not the same as strength. Sandpaper is flimsy yet very abrasive. Hope that makes sense.

  56. NanAugust 9, 2018 at 5:41 pm #

    I understand.
    As well, Is it true that it is difficult to adjust a Zirconia crown after cementation (chair side) as opposed to Emax?
    I am worried that if the crown will need an adjustment, the dentist might end up adjusting the healthy opposing tooth instead – (because of the difficulty in adjusting the Zirconia) and I would not be happy with that.

  57. JoanAugust 16, 2018 at 9:37 pm #

    Hi Doctor,
    I just had a root canal on bottom molar #18 due to decay under an old filling. The procedure went really well with no pain afterward. However, my wisdom tooth #17 is fully erupted (it has been for years) and even though it is not impacted, it is tightly pressed against the #18 tooth. My dentist told me he wants me to see an oral surgeon to have the wisdom tooth removed so he can fit a crown on the root canal molar. I was told that the wisdom tooth is very close to the nerve, which if damaged during surgery, can negatively affect some important facial functions (tasting food, etc). I am 58 years old. Are there any other options besides a crown? Should the dentist try to fit the crown on the tooth somehow? I am not worried about any pain with surgery, only nerve damage. Please advise, thanks.

    • Bauer BryanAugust 16, 2018 at 10:05 pm #

      I don’t see why couldn’t put a crown on #18 if it is fully erupted. However, I think there is likely something I am missing or was lost in communication with you. Very common situation is the wisdom is erupted but not perfectly making a crown very difficult if not impossible to do well. If I was to guess I would guess that is your situation. Maybe get another opinion of someone that can see the x-ray

  58. C PrakashAugust 21, 2018 at 12:05 pm #

    Hi Doctor

    My wife had root canal for her 5 front lower teeth 3 months back. The upper layer of the material came out from them(one by one) within a span of 15 days and the doctor filled them again. After a month, one of the upper fillings again came out & he re-filled it.

    What’s wrong? Was the material bad or some other reason.

    • Bauer BryanAugust 21, 2018 at 1:34 pm #

      That is not normal. I am guessing she had so many root canals because she ground her teeth down? If that is the case then her grinding is what likely caused the material to be lost as well. The dentist will have to try something different.

  59. C PrakashAugust 23, 2018 at 8:55 pm #

    This was first time in her life that she had RC at the age of 60. She does eat only softs ( nothing like nuts) and afterall they are mostly incisors 23 to 27, ofcourse uncrowned. As per my knowledge, the doctor didn’t grind them and they are normal shaped.

    Shall we wait for recurrence , if nothing serious.

  60. JonAugust 30, 2018 at 10:54 am #

    I went to the dentist cuz my front tooth that was bothering me. The doctor told me that it was infected and I need to get it root canal followed by a crown and I can’t really afford to spend all that money to do all the work. About 20 years ago I had chipped the corner of that tooth off and the dentist had glued it back on. So I’m wondering is a crown necessary.

    • Bauer BryanAugust 30, 2018 at 7:53 pm #

      Probably not unless you have a lot of decay that has caused the root canal. You never NEED a crown after, but many dentists may not be willing to accept the risk of doing a filling only to have it break soon and the patient showing up and blaming him/her for bad work. Basically they won’t do something that has a high likelihood of failing, but that doesn’t mean it will fail for sure.

  61. salmaSeptember 16, 2018 at 3:59 pm #

    Dear Bauer Bryan,

    As a teenager i been given some bad and cheap fillings, now on my 28 birthday i have got 4 root canals on the upper right side of my mollars, where the fillings where. The are now turning dark and my smile is getting very ugly. My question what cant of crowns would you recommend me, that will keep a lot of the teeth structure. And i have the best options to keep my tooth good for when i also older. E-Max, gold on the back, or ceramic.

    Best regards,

  62. Donna MOctober 1, 2018 at 10:19 am #

    Hello! Looking for some answers on an ongoing dental issue. I’m 39 years old and I chipped my front tooth #8 when I was 9. They had me wait until I was 13 and then they bonded the front tooth. Over the years it looks like my gums have receded back some and you can see a line on my front tooth between the bonding and my natural tooth, which has always sort of bothered me but I never got repaired. Fast forward to March 2017, I fell on my face and that tooth #8 became luxated. X-rays showed no fracture, so my dentist shaved some off to avoid contact and we watched it for several months, and it became stable. This year I’ve been noticing that tooth and the old bonding becoming more and more unsightly, and the small part of my natural tooth that shows toward the gumline was appearing darker, so I inquired to my dentist about correcting this. She examined me and based on the discoloration and history of trauma, she recommended an endodontic evaluation. I went last week and he said it definitely requires root canal therapy, and he will bleach internally to try to fix the color. I’ve done a lot of reading, and I’m aware that front teeth often don’t need crowns, but my question is, since I had trauma to that tooth 30 years ago where the lower portion was chipped and bonded, will it still be possible to restore without a crown? Another question I have is regarding my appearance after the root canal and before restoration. I’m not sure how you access front teeth for root canals, so will I leave the endodontist’s office looking the same as I do now, or will I be missing part of my front tooth? Thanks so much for sharing your knowledge about this!

    • Bauer BryanOctober 5, 2018 at 4:33 am #

      We access from behind the tooth so you will look the same. The internal bleaching will work but it needs to be redone eventually. That is likely the best solution for you.

Leave a Reply