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I had a root canal treatment on a canine tooth with a previous dentist. I’ve since moved and seen my new dentist for the first time. He said that I need to have a dental crown placed on the root canaled tooth or I will end up with a dental emergency. I feel like my old dentist would have warned me about that. Do I really need a crown?
Bethany
Dear Bethany,
I am glad you wrote. While it is true that having a root canal treatment does make a tooth more brittle, I don’t agree with the common thinking that every tooth with a root canal treatment needs a dental crown. If it is a back tooth, then yes, a crown would be important. Molars and premolars have different biting stresses. They are designed for grinding. However those forces tend to push the cusps apart, which can lead to fractures.
The canines and front teeth are designed for tearing and biting. This leads to shearing, horizontal stress. The canine tooth is especially prone to this. Putting a crown on this type of tooth will actually weaken the tooth instead of protect it. A crown will reduce the structure by 30%, which will can leave it with as little as 50% of the fracture resistance it once had. The weakest part of this tooth is at the neck. Weakening it further can lead to it breaking off at the gumline. That would be a dental emergency.
A good way to strengthen a front tooth with a root canal treatment is to thoroughly clean out the inside part of the tooth. That would include all the root canal filling as well as cement in the tooth. Next, I recommend cementing in a white fiberglass post. These are more flexible and able to take on the stresses. Then, fill the remainder of the tooth with white composite filling. This will strengthen the tooth, while temporarily preventing the tooth from turning dark. Once it finally turns, you can have a porcelain veneer placed over the tooth in order to help it match your adjacent teeth.
This blog is brought to you by Baton Rouge Dentist Dr. John Theriot.