Do You Really Need a Crown After Root Canal Treatment?

Do I need braces?

I underwent root canal treatment at the end of January (for an anterior tooth, likely a first premolar or canine, but I can't quite remember).
At that time, the endodontist recommended a crown; however, due to the bone loss observed in the X-ray caused by an abscess, it was suggested to wait some time before proceeding.
Later, in early February, I visited a medical center for a dental check-up and had another X-ray taken.
The bone loss was still present, but the doctor indicated that a crown was not necessarily required as long as I avoided biting down on hard objects.
I am still a bit concerned.
Is it mandatory to place a crown on a tooth after root canal treatment?

Haoqi de ren, 20~29 year old female. Ask Date: 2016/06/17

Dr. Lin Jiayong reply Dentistry

Hello, if the bone underneath the tooth is deficient and does not heal, there may be concerns about the stability of the dental crown once it is placed.
It is recommended that you visit the endodontics department at a medical center to discuss a detailed treatment plan for that tooth with the attending physician.

Reply Date: 2016/06/17

More Info

After undergoing root canal treatment, the question of whether or not to place a crown on the treated tooth is a common concern among patients. The primary purpose of a crown is to provide structural support and protection to a tooth that has been compromised due to decay or treatment. In your case, since you had root canal therapy on a tooth that already exhibited signs of bone loss due to an abscess, the recommendation for a crown is particularly relevant.

Root canal treatment involves the removal of the tooth's pulp, which can leave the tooth more fragile and susceptible to fractures. This is especially true for posterior teeth, such as molars and premolars, which bear a significant amount of chewing force. Without a crown, the risk of the tooth cracking or breaking increases, particularly if you have habits like grinding your teeth (bruxism) or if you engage in activities that put stress on your teeth, such as heavy lifting or consuming hard foods.

Your concern about the advice given by different dentists is valid. While one dentist suggested waiting due to the existing bone loss, the other indicated that a crown might not be necessary as long as you avoid hard foods. However, this advice can be misleading. The structural integrity of a tooth that has undergone root canal treatment is compromised, and relying solely on caution may not be sufficient to prevent future damage.

In general, it is advisable to place a crown on a tooth that has had root canal treatment, especially if there is existing bone loss or if the tooth is at risk of fracture. A crown can help distribute the forces exerted on the tooth during chewing, thereby reducing the likelihood of fractures. Additionally, crowns can help seal the tooth, preventing bacteria from re-entering and causing further infection.

If you are concerned about the cost of a crown, it is worth discussing your options with your dentist. Some dental insurance plans may cover a portion of the cost, and there are various types of crowns available, including metal, porcelain-fused-to-metal, and all-ceramic crowns, each with different price points.
In conclusion, while it may seem like an additional expense, placing a crown after root canal treatment is generally a wise decision to ensure the longevity and health of the tooth. Given your history of dental issues and the current condition of your tooth, it would be prudent to follow through with the crown placement to avoid more significant problems in the future, such as tooth loss or the need for more invasive procedures like implants. Always feel free to seek a second opinion if you feel uncertain about the recommendations provided by your dentist. Your oral health is paramount, and making informed decisions is crucial for maintaining it.

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