Visiting the dentist’s office still remains one of the most daunting things when it comes to general health routines in modern society. The discomfort of having a medical professional work inside your mouth combined with the possibility of going through pain has most people cringing in the waiting room even before they sit in that chair.
Part of the challenge is not knowing what’s to come. So let’s shed some light on at least one aspect of dentistry: Crowns and root canals.
Is it Possible to Have a Crown With No Root Canal?
There’s a common belief that crowns and root canals always go hand in hand. But, much like coffee and milk, where adding one to the other makes perfect sense, it is not always necessary.
If your dentist has scheduled you for a root canal procedure and insists on doing a crown instead of a regular filling, you need to find out why.
The facts below will give you some insight on the matter.
A root canal is a procedure that prevents further deterioration and even rotting by:
- Cleaning the inside of the tooth (the canals)
- Removing the pulp
- Add a filling to keep the different parts together and seal the tooth
There’s no reason to do a root canal if the structure of the tooth and the interior—the pulp—aren’t compromised. Therefore if there is only minor damage and no sign of decay or inflammation a dentist probably won’t feel it’s necessary to do a root canal.
Any tooth that obviously has minimal damage may simply be crowned to:
- Improve strength
- Restore it to its original shape after chipping
- Make it appear natural after slight damage
This relates to Molars and incisors.
But dentists will also think long term and this will influence what they advise you to have done. Your molars experience much more pressure and friction than your incisors during chewing. This stress impacts your tooth’s structure over time.
If there’s a chance that your molar has some structural damage due to decay, the crowning process or physical damage, it is wise to have a root canal done.
From this point on, the situation will only get worse as pressure affects the tooth daily. Also, the slightest fissure can lead to infection. When this happens, the likelihood of you returning to the dental office for a root canal procedure increases gradually.
But your incisors are free of this extreme stress and a crown is usually enough even as a long-term solution.
Is the tooth more likely to have a root canal after a crown was placed?
Yes, statistics show that endodontic therapy often follows a crown procedure. This usually occurs due to one of several reasons, and therefore, it is not a given in all situations:
- At the time of the crowning, the tooth was already damaged but not visible to the eye. It deteriorates over time and then a root canal is required.
- The crowning procedure weakened the tooth:
- The excessive heat created while working on the tooth can affect the structure
- As parts of the tooth are taken off during crowning the structure or the pulp tissue inside could be damaged
The most recent study was conducted in 2005 by Dr. Cheung. The study evaluated 122 teeth with no previous history of root canal issues in patients of various age, sex, and ethnicity.
The findings showed that after a period of 10 years, 16% of the studied teeth needed endodontic therapy. In the next 5 years, that number increased to 18%.
In comparison, a previous study done in 2002 by Dr. Whitworth, concluded that within 10 years of crown procedure, 4 to 8% teeth will require root canal treatment.
Why so much controversy?
The reason you don’t want a root canal unless it’s absolutely necessary is that it’s not a forever solution. Yes, it will maintain structure and prevent decay for a while.
However, without the life-giving pulp, which provides nutrients, your tooth will be more fragile than before. It could eventually crumble and its lifespan becomes unpredictable.
This is one of the reasons crowning is associated with root canals. Placing a crown after a root canal was done adds protection so the tooth can handle more pressure.
What is the Relationship Between Crowned Teeth and the Need for a Root Canal?
While a crown makes sense after a root canal, does it also work the other way around?
Looking at timelines of getting these procedures done it seems suspicious that a root canal is often necessary shortly after a crowning. Does this mean a crowning leads to a root canal? No.
As mentioned above the reason for requiring a root canal may already be present at the time of crowning, but simply not picked up by the dentist. A crowning is often done when a tooth has been damaged such as chipped. The deep-seated damaged could be because of this trauma and not be related to the crowning at all.
And now it makes sense why many dentists may prefer doing both procedures at once, no matter the circumstance. Isn’t it better to sit in the waiting room once and get it all done than returning a few months later anyway?
Cheung GS, et. al. Fate of vital pulps beneath a metal-ceramic crown or a bridge retainer. Int. Endod. J. Vol. 38, No.8. August 2005.
Whitworth, J et al. Crowns and extra-coronal restorations: Endodontic considerations: the pulp, the root-treated tooth and the crown. British Dental J. Vol. 192, No. 6. March 2002.
Author: Peter Mayhew
Peter is a dental hygienist in the city of Chicago, IL. In his free time he likes to write blogs and product reviews on anything dental health related.