Why Can't My Daughter Get a Crown After Root Canal Treatment?

A fifth-grade girl is facing issues with a single dental crown?

My daughter, who is in fifth grade, just completed root canal treatment on her second molar (which is a permanent tooth) today.
However, the dentist advised against making a crown immediately, stating that her tooth crown is relatively low and that we should wait until her oral development is complete, which would be around the time she enters junior high school.
I'm concerned because teeth that have undergone root canal treatment are generally more fragile.
I'm worried that during this waiting period, my daughter might accidentally bite down on something hard and fracture the tooth! Could you please explain why we can't make a protective crown right away? Is it because her crown is low and not suitable for her age?

Xiao J, 40~49 year old female. Ask Date: 2019/10/03

Dr. Zeng Guanghui reply Dentistry

Hello, Xiao J.
As a fifth-grade student, you are still in the growth and development stage, and your teeth and gums have not fully matured.
Clinically, the dental crowns are low, and there is still a chance for growth in the future, which would allow the crowns to become taller and facilitate the fabrication of braces.
Therefore, it is recommended to wait until middle school when growth and development stabilize before getting braces.
In the meantime, you can use hard resin or silver powder to fill in the defects of the dental crowns and try to avoid chewing on excessively hard foods.
Thank you.

Reply Date: 2019/10/03

More Info

After a root canal treatment, it is indeed common for patients to be concerned about the structural integrity of the treated tooth, especially in children and adolescents whose teeth are still developing. In your daughter's case, the dentist has recommended waiting until her mouth has fully developed before placing a crown on her second molar. This recommendation is based on several important factors.

Reasons for Delaying Crown Placement
1. Tooth Development: In children and adolescents, the roots of the teeth are still forming. Placing a crown too early can interfere with the natural growth and development of the tooth and its roots. If the crown is placed prematurely, it may not fit properly once the tooth fully matures, leading to complications down the line.

2. Risk of Fracture: While it is true that a tooth that has undergone root canal treatment is more susceptible to fracture, the dentist may have assessed that the risk of immediate fracture is manageable. If your daughter is careful and avoids biting down on hard objects, the tooth may remain intact until it is time for the crown.

3. Crown Fit and Aesthetics: A crown needs to fit well and look natural. If the tooth is still developing, the crown may not fit properly once the tooth reaches its final size and shape. This could lead to the need for additional dental work in the future, which could be more complicated and costly.

Concerns About Tooth Fragility
It is understandable to be concerned about the fragility of a tooth after root canal treatment. The tooth can indeed be more brittle, especially if it has lost a significant amount of structure due to decay or previous treatments. However, dentists often recommend temporary measures to protect the tooth until a permanent crown can be placed. These may include:
- Temporary Filling: After a root canal, a temporary filling can be placed to protect the tooth until the crown is ready. This can help maintain the tooth's integrity while waiting for the crown.

- Avoiding Hard Foods: As you mentioned, avoiding hard foods is crucial. Educating your daughter about the importance of being cautious with her tooth can help prevent accidental fractures.

What to Do in the Meantime
While waiting for the appropriate time to place the crown, here are some steps you can take to help protect your daughter's tooth:
1. Regular Dental Check-ups: Ensure that your daughter continues to see her dentist regularly. This will allow the dentist to monitor the tooth and address any issues that may arise.

2. Oral Hygiene: Encourage good oral hygiene practices. Brushing and flossing can help prevent decay around the treated tooth, which is essential for its longevity.

3. Dietary Adjustments: Encourage a diet that avoids hard, crunchy, or sticky foods that could put undue stress on the tooth.

Conclusion
In summary, while it may seem counterintuitive to delay the placement of a crown after a root canal treatment, the dentist's recommendation is based on the need for proper tooth development and fit. By following the dentist's advice and taking precautions, you can help ensure that your daughter's tooth remains healthy until it is time for the crown. If you have ongoing concerns, it is always a good idea to discuss them with the dentist, who can provide personalized advice based on your daughter's specific situation.

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