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Root Canals

Root canal crowns

07/20/2006

Question:

I just had a root canal last week. During a pre-visit, the doctor told me that after the root canal, I would have a crown put on the tooth. When I left that day of the root canal, he said he wasn`t gonna put a crown on it, just a permanent filling. I`m kinda worried about this, cause everyone I know who has had a root canal has had a crown put on it. Do I need a crown or is filling just as good?

Answer:

Good question.  It is highly recommended that all posterior teeth (molars) get a crown placed on them after root canal therapy.  Of course there are exceptions, but this is the general rule.  The reason for this is that the crown of the tooth is weakened after a hole is put into it to do the root canal.  Also, most of these teeth usually have large or deep fillings in them already and that adds to the weakness of the natural crown.  The molars are the food grinders and they absorb a lot of pressure during chewing and need the extra protection a crown gives.
 
As you move forward to the premolars there is less pressure on chewing, but the teeth start to get smaller and sometimes are more venerable to cracking (especially if they have large fillings in them).  Not all of these teeth necessarily need crowns, but a large percentage do.  The way your teeth come together may decide the need for a crown.
 
The front teeth absorb very little energy during chewing, but they are important in biting.  These teeth usually require crowns if they have any filling in them and will also depend on the type of occlusion (bite) the patient has. Often these teeth can be restored with a simple tooth-colored composite (plastic) filling in the root canal opening.
 
Your dentist and you should discuss the potential need for a crown and the risks if you don't get one. The biggest risk is that the tooth cracks. If it cracks in a certain way, the tooth may not be able to be fixed and may have to be taken out.
 
Hope this helps.

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University