Crowns and root canals

Crowns & Root Canals

Why Does a Tooth with a Root Canal also Need a Crown?

This question sometimes follows surprise expressed by patients who have recently undergone root canal treatment on a tooth.  This is especially common when one doctor, a specialist called an endodontist, performs the root canal, and the patient returns to the general dentist for follow-up treatment.  This week’s blog will explain why crowns are usually necessary to cover teeth with root canal treatments.

What Does a Root Canal Treatment Do?

A root canal treatment is the dental procedure required to remove an infected, irreversibly inflamed or dead pulp from the hollow space inside a tooth.  The pulp is the collection of soft tissue containing nerves and blood vessels within every tooth.  This tissue does not have the ability to heal itself from infections or injuries, so when those occur, removal of the tissue is the only way to keep the tooth in the mouth. (The alternative treatment is extracting the tooth.)

After diagnostic testing to determine the state of the pulp, a dentist or endodontist will access the pulp through an opening in the biting surface of the tooth.  Then the doctor removes the pulp tissue, cleaning and disinfecting the internal chamber of the tooth.  Once clean, the doctor seals and fills the space with a biocompatible filling material from the tip of the root to the level of the gum tissues.  This means that the root canal filling exists only within the root of the tooth.  Then the doctor closes the access opening with a sealed filling material.

What Does a Crown Do?

A dental crown is a restoration that covers the entire exposed (visible) portion of the tooth.  Dentists use crowns to rebuild severely broken down teeth and to hold together teeth with cracks.  When a tooth is too weak to withstand normal chewing forces, a crown can restore that chewing ability by covering and strengthening the underlying tooth.

When your dentist prepares a tooth for restoration with a dental crown, he or she must remove the outer layer of enamel to make room for the material replacing it and forming a new, stronger coating for the tooth.  Crowns are made from a variety of materials, depending on cosmetic and functional needs, including gold, porcelain, a combination of porcelain and metal, among others.

Why Does a Tooth with a Root Canal Need a Crown?

The pulp tissue inside a tooth contains the blood supply which nourishes the tooth from the inside, maintaining a level of hydration.  When there is no pulp inside a tooth (which is the state of a tooth after it has a root canal treatment), the tooth often becomes dry and brittle, cracking or breaking more easily.  This is due to dehydration of the tooth.

In order to protect the tooth from breaking and restore it to normal chewing function, a dehydrated tooth should have full coverage by a dental crown.

Do All Teeth with Root Canals Need Crowns?

The broad answer is YES.

There are some rare cases in which a tooth has a significant amount of healthy hard tooth structure and needs a root canal treatment.  If your dentist predicts that the tooth can remain strong despite dehydration, then he or she may allow you to forego the dental crown.  Again, these cases are rare because most teeth requiring root canal treatment have undergone significant damage already.

More Questions about Root Canal Treatments and Crowns?

Call Empire Dental Specialty Group today to schedule a consultation with our root canal experts.  We can answer any question you have and assess your specific situation and create an endodontic care plan.