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.

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63 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.

  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.

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