When Is A Root Canal Without Crown Protection Wise?
Dr. Tanya Reiter, DDS, is a board-certified endodontist and an endodontic surgery specialist in Charlotte, NC.
September 24, 2018A crown may supply the finishing touch after a root canal – sealing the tooth and strengthening it for the long term – but a crown isn’t necessary in every case. Teeth at the front of the mouth and those that are reasonably strong, in particular, may not need them at all. Weighing the following pros and cons can help you decide if a root canal without crown placement is the best and most cost-effective option for you.
Strong but Delicate
Root canals save teeth from decay, but they can also weaken them. When the pulp inside a tooth is infected or no longer living, dentists can treat the tooth through a root canal by removing the pulp and apply filling to replace it. When performing routine root canals, however, dentists drill through the tooth and then remove infected and decayed enamel, dentin and pulp. For this reason, teeth with large cavities are weak even when the cavities are filled.
Because root canals also remove the pulp, the teeth involved can no longer function as living things. Over time, this deficit causes them to lose strength and become likely to fracture.
Why Crowns Are Added
After performing root canal work, dentists apply permanent fillings to protect the treated teeth from bacteria and to strengthen them in the process. For many root canal procedures, however, fitting crowns over the filled teeth is necessary because of the high risk of fracture without the extra protection crowns provide. Another advantage of crowns is that they restore the natural appearance of your teeth.
When to Do Without
For incisor and canine teeth that are relatively intact, a root canal without crown placement may be perfectly fine. Teeth at the front of the mouth, for example, experience less physical stress than premolars and molars because they are not used for chewing. In fact, the effectiveness of crowning front teeth after root canals, as explained by the National Institutes of Health, includes only incisors or canines that have been extensively excavated during the procedure. In these cases, you may need the strength crowns provide.
Premolars and molars that are at low risk of fracture may also be suitable for filling-only restorations after root canals. Silver or composite fillings alone can provide a strong, permanent seal and chewing surface when a large amount of tooth remains.
Whether teeth are covered by crowns or filled without them, keep in mind they are still vulnerable to tooth decay. Brush your restored teeth twice daily.
Your dentist can ultimately help you determine the best option for restoring a tooth after a root canal. Front teeth may not need a crown for strength, but you might still refer the improved appearance a crown offers. Then again, if the tooth is a premolar or molar that is not at high risk of fracturing, a filling-only restoration may be the most cost-effective choice.