Post-Root Canal Treatment: Do I Need a Crown for My Tooth?

After root canal treatment

I recently visited a doctor because I had an abscess on my gums.
One doctor said that my tooth root was infected and that I needed to have it extracted for an implant.
For another slightly recessed premolar, he suggested that I could get a crown.
However, when I went to a different clinic, the doctor said that my tooth root was not infected and that the abscess was due to inadequate cleaning.
After draining the abscess and applying medication, I was sent home without any mention of needing to refill the recessed tooth or get a crown.
I was only advised to maintain proper oral hygiene.
I had a root canal treatment two years ago on the upper left and right premolars.
Do I need to go back for a crown? My teeth are generally large and in good condition, but one of my premolars is more recessed in the middle compared to the other side.
Could this be because the filling has fallen out? Why did neither of the two doctors I saw suggest refilling it? Is it because it’s not necessary yet? Should I see a dentist again to have it refilled?

Ling, 20~29 year old female. Ask Date: 2016/07/27

Dr. Huang Tingfang reply Dentistry

Dear Ling,
Hello! Basically, after root canal treatment, it is best to have a crown placed.
If there is a pus pocket, it is important to determine whether it is a periodontal abscess or an apical abscess, as different treatments are required.
Cavities must be filled; otherwise, they will worsen and expand! Please communicate more with your dentist.
Thank you! Wishing you safety!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2016/07/27

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. In your case, it seems you have undergone root canal treatment on both upper small molars two years ago, and you are now experiencing some issues with one of them, including a cavity that may need to be filled again.
To address your primary question: Yes, it is generally advisable to place a crown on a tooth that has undergone root canal treatment, especially if it is a molar. The reason for this recommendation is that root canal treatment often leaves the tooth more vulnerable to fractures. The process involves removing the pulp from the tooth, which can weaken its structure. A crown serves to protect the tooth from further damage, particularly from the forces exerted during chewing.

In your situation, the fact that you have a cavity in one of your small molars is concerning. If the filling has fallen out or if the tooth is significantly decayed, it is crucial to have it assessed by a dentist. If the cavity is deep and close to the root, it may require additional treatment, such as a new filling or possibly even a new root canal if the tooth has become reinfected.
Regarding the differing opinions from the two dentists you visited, it is not uncommon for dental professionals to have varying approaches to treatment. The first dentist suggested extraction and implant placement due to perceived root inflammation, while the second dentist believed that the issue was related to inadequate cleaning. This discrepancy highlights the importance of thorough diagnostic procedures, including X-rays, to evaluate the health of the tooth and surrounding structures accurately.

If you are experiencing a "dimple" or depression in the tooth, it could be due to the loss of the previous filling, which may have allowed bacteria to enter and cause further decay. It is essential to address this issue promptly to prevent further complications. If the cavity is not treated, it could lead to more severe problems, including the need for extraction.

In summary, it is advisable to return to your dentist to have the cavity evaluated and filled if necessary. Additionally, considering the history of root canal treatment, discussing the placement of a crown on the treated tooth is essential. This will help ensure the longevity of the tooth and prevent future complications. If you have concerns about the recommendations given by your dentists, seeking a third opinion or consulting a specialist, such as an endodontist or prosthodontist, may provide you with further clarity and options for treatment.
Maintaining good oral hygiene is crucial, especially after root canal treatment, to prevent infections and ensure the health of your remaining teeth. Regular dental check-ups and cleanings will help monitor the condition of your teeth and address any issues before they escalate.

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