Do You Need a Root Canal Before Getting a Dental Crown?

Does getting dentures require a root canal treatment?

Hello Doctor: I had a root canal treatment on my lower left second molar many years ago, and after filling it with silver amalgam, it was fine until last week when I bit into something hard and broke a piece off.
During the New Year holiday, I went to the emergency room, where the doctor could only remove the broken part and suggested that I get a crown.
Yesterday, I went to a dental clinic for an X-ray, and the dentist said it appears the root canal treatment was not completed properly.
He recommended reopening the tooth to complete the root canal before placing the crown, otherwise, if there are issues inside later, the crown would need to be removed and redone.
He also mentioned that if completing the treatment is difficult, I might need to see an endodontist.
However, based on the X-ray and comparison with adjacent teeth, the root appears short, which may indicate that it was already difficult to treat previously.
He allowed me to choose not to redo the root canal and go directly for the crown.
Since I have no symptoms of discomfort at all, I would like to ask if you would recommend that the root canal treatment needs to be redone? I am concerned, as I have seen your previous responses to other patients indicating that redoing a root canal could disrupt the original balance and lead to inflammation and pain.
Furthermore, the clinic dentist mentioned that if not done properly, I would need to see an endodontist, so if I decide to redo the root canal, would it be better for me to go directly to a larger hospital?

Ms. Li, 20~29 year old female. Ask Date: 2016/02/17

Dr. Huang Zhicheng reply Dentistry

Hello, before getting dentures, the dentist will use X-rays to check if there are any periodontal or root canal issues with the tooth roots.
Since crowns are not inexpensive, there can be no mistakes.
If the root canal treatment is incomplete, this is a good opportunity to redo the treatment.
There are now many endodontists available, so there's no need to go to a large hospital.
Wishing you peace, health, and well-being.
Sincerely, Dr.
Huang Chih-Cheng, Director of Dentistry, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/02/17

More Info

When considering whether a root canal treatment (RCT) is necessary before getting a dental crown, the answer is not straightforward and depends on various factors related to the condition of the tooth in question. In your case, since you have a history of root canal treatment on your lower left second molar, and it has recently been compromised due to a fracture, there are several aspects to consider.

Firstly, the primary purpose of a root canal treatment is to remove infected or damaged pulp tissue from inside the tooth, which can prevent further complications such as abscess formation. If your dentist has indicated that the previous root canal treatment may not have been completed properly, it is crucial to address this issue before placing a crown. A crown is designed to protect and restore the function of a tooth, but if the underlying tooth structure is compromised (due to incomplete RCT or other issues), the crown may not be effective or could lead to further complications down the line.

In your situation, the dentist's recommendation to redo the root canal treatment before placing the crown is based on the principle of ensuring that the tooth is healthy and stable. If there are remnants of infection or if the root canal was not adequately cleaned and sealed, placing a crown could trap bacteria and lead to further decay or infection, necessitating additional procedures in the future.

You mentioned that you have no symptoms of discomfort, which is a positive sign. However, the absence of symptoms does not always correlate with the health of the tooth. Some issues can be asymptomatic, and the only way to ensure the tooth's health is through proper diagnostic imaging and treatment. If the X-ray indicates that the root canal treatment did not reach the apex of the root, it is advisable to consider redoing the treatment.
Regarding your concern about the potential risks of redoing the root canal treatment, it is true that there can be complications, such as the possibility of damaging the tooth further or causing inflammation. However, these risks are generally outweighed by the benefits of ensuring that the tooth is free from infection before placing a crown. If your current dentist is not confident in performing the retreatment, seeking a specialist, such as an endodontist, may be a wise decision. Endodontists are trained specifically in root canal treatments and can provide a higher level of expertise in managing complex cases.

In summary, while it may be tempting to skip the root canal retreatment due to the absence of symptoms, it is generally recommended to address any underlying issues before proceeding with a crown. This approach will help ensure the longevity and success of the dental restoration. If you feel uncertain about your current treatment plan, seeking a second opinion from another dental professional or an endodontist could provide you with more clarity and confidence in your decision. Ultimately, the goal is to preserve your natural tooth structure as much as possible while ensuring that any restorations placed are built on a solid foundation.

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