Temporary Crowns and Root Canal Treatment: Common Concerns Explained

Q: Temporary Crowns and Root Canal Treatment: Common Concerns Explained

Hello： The physician's approach is indeed standard procedure. <br>*Since the tooth has already undergone root canal treatment, the access cavity will be preserved and does not need to be redrilled. <br>*Removing the old material and replacing it with new material ensures that the

Questions about temporary dentures and root canals?

I had four front teeth that underwent root canal treatment over 20 years ago, and they have visibly changed color with small chips and a lot of filling material.
Today, I went to a medical center's general dentistry department, and they said that all four teeth need to have the root canals redone and posts placed because the previous root canal treatment was not done properly; the nerves were not completely removed, and the filling was inadequate.
All four teeth visibly have cracks.
The doctor mentioned that the filling material is likely about to come loose.
Since the root canal treatment requires an uncertain amount of time, the doctor suggested that I first get temporary crowns.
I asked the doctor about the steps involved: first, the filling material would be removed, and if there are cavities, they would be drilled out and filled.
Then, the teeth would be reduced in size, and impressions would be taken.
After that, I could wear the temporary crowns once they are ready.
The doctor said that no root canal treatment would be performed before this.
I asked the doctor what would happen with the root canal treatment afterward, and the doctor explained that the temporary crowns would be attached using a temporary adhesive.
Each time I undergo root canal treatment, the temporary crown would be removed and then reattached after the procedure, repeating this process until the root canal treatment is fully completed.
Is this the correct procedure? Since the filling material needs to be completely removed and cavities drilled out before the root canal, wouldn’t that mean that the filling would have to be done again? Wouldn’t the teeth be too small after being reduced before drilling for the root canal, risking fracture or excessive drilling? Previously, for my molars, the root canal was completed first, and then the filling was done before starting the crowns.
This time, the doctor said to reduce the size first and then do the root canal.
I understand that reducing the size is to prepare for the temporary crowns to protect the remaining tooth structure, especially since I have noticeable discoloration, chips, and cracks.
However, is it correct to reduce the size first and then drill for the root canal? I am very confused and starting to overthink this.
I hope the doctor can provide some advice.
Thank you.

Li Qiuqiu, 30~39 year old female. Ask Date: 2021/03/23

Dr. Lin Jiayong reply Dentistry

Hello: The physician's approach is indeed standard procedure.
*Since the tooth has already undergone root canal treatment, the access cavity will be preserved and does not need to be redrilled.
*Removing the old material and replacing it with new material ensures that the interface between the filling and the tooth is complete without any gaps.
*There is no need to drill a new hole, so the risk of tooth fracture is minimal.
*The condition of each tooth being treated is inherently different, so it cannot be arbitrarily compared.
Respectfully, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/03/23

More Info

When dealing with dental issues such as root canal treatments and temporary crowns, it's essential to understand the rationale behind the procedures and the sequence in which they are performed. Your situation involves a complex history of root canal treatments and the need for temporary crowns, which can understandably lead to confusion and concern.

Understanding the Process
1. Initial Assessment: Your dentist has identified that the previous root canal treatments were not adequately performed, leading to potential complications such as infection or structural weakness in the teeth. The presence of visible cracks and discoloration indicates that the teeth may be at risk of further damage.

2. Temporary Crowns: The purpose of a temporary crown is to protect the tooth while the definitive treatment is planned and executed. In your case, the dentist suggested placing temporary crowns before completing the root canal treatment. This is a common practice, especially when the teeth are structurally compromised. The temporary crown helps to maintain the tooth's integrity and function while preventing further decay or damage.

3. Procedure Steps: The steps outlined by your dentist involve:
- Removing Existing Fillings: This is necessary to assess the condition of the tooth and to remove any decay that may be present.

- Preparing the Tooth: The tooth will be shaped to accommodate the temporary crown. This involves reducing the size of the tooth to ensure that the crown fits properly.

- Temporary Crown Placement: After the tooth is prepared, a temporary crown is placed using a temporary adhesive. This allows for easy removal during subsequent visits for root canal treatment.

Concerns About the Sequence
Your concerns about the sequence of procedures are valid. Here are some clarifications:
- Why Temporary First?: Placing a temporary crown before completing the root canal can be beneficial in protecting the tooth from further damage and providing a functional solution while the root canal is completed. It is not uncommon for dentists to use this approach, especially if the tooth is at risk of breaking or if there is significant decay.

- Root Canal Treatment: During the root canal procedure, the dentist will need to access the inner part of the tooth, which may involve drilling through the temporary crown. This is a standard practice, and the temporary crown is designed to be easily removed and replaced. The dentist will ensure that the integrity of the tooth is maintained as much as possible during this process.

- Risk of Tooth Fracture: While there is a risk of fracturing the tooth during these procedures, dentists take precautions to minimize this risk. The temporary crown provides some structural support, but the dentist will also evaluate the tooth's condition closely before proceeding with the root canal.

Future Considerations
1. Follow-Up Care: After the root canal treatment is completed, a permanent crown will be placed. This is crucial for restoring the tooth's function and preventing future issues.

2. Monitoring: It’s essential to monitor the tooth for any signs of pain or discomfort after the procedures. If you experience any unusual symptoms, communicate with your dentist promptly.

3. Long-Term Outlook: If the root canal treatment is successful, the tooth can remain functional for many years. However, if complications arise, further interventions may be necessary, including potential extraction and replacement options.

Conclusion
In summary, while the approach of placing a temporary crown before completing the root canal treatment may seem counterintuitive, it is a strategy employed to protect the tooth and manage decay effectively. Your dentist is following a protocol that aims to preserve your dental health while addressing the underlying issues. If you have further concerns or uncertainties, it is always best to discuss them directly with your dentist, who can provide personalized insights based on your specific dental condition.

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