Question:
I had a root canal done on a rear molar about 6 weeks ago, the dentist that
did the RC said that I should now have a crown put on that tooth. My
regular dentist also recommends a crown, but tells me the tooth is sound and
doesn't appear to be in any kind of "distress"?
My question is, rather than grinding down this tooth for a crown, can I
simply have the temporary from the root canal removed and go with a
permanent filling? My dentist said there is always the possibility that the
tooth can become a problem in the future, but I would prefer not to go the
crown route if at all possible, especially since I just shelled out 1150.00
for the root canal. The permanent filling can be put in for around a
hundred bucks where the crown will cost me another 650.00
My question is, is there any reason I could not safely go the permanent
filling route for now? I mean, if it does become a problem in the future, I
can always go the crown route then instead of now (and it will help that
I'll have a fresh balance on my dental plan which I have used up for this
year).
Answer:
When root canal therapy has been done on a posterior tooth, not only is there a large restoration, but the pulpal floor has been
removed to access the canal space. These leaves a large, deep hole in the tooth. Such teeth are more vulnerable to deep, significant
fractures. Far more so than a tooth with just a large filling. Resin cores, that bond the teeth, and therefore "hold" them together
a bit, are somewhat beneficial, but the teeth are still significantly weakened by the root canal.
I do not recommend crowns for the sake of crowns, but in the vast majority of cases, a crown on a posterior tooth that has been
endodontically treated it the best option.
is right on the money with his advice. Having been in practice for
over 20 years, I've seen thousands of endodontically treated teeth. For
the posterior teeth, crowns are insurance against the tooth actually
splitting apart through the roots.
Over the years, I've seen lots of cases where the patient opted to
postpone the crown. Most of the time, this has not led to a
catastrophe. However, quite a few times, patients have come in with a
root-canaled tooth split through the roots and my only option is to
extract the tooth.
One patient came in yesterday with a 'broken tooth'. Looking at the
chart, I had done a root canal and build-up in 1981! It didn't fracture
through the roots, so I just did another build-up. I probably won't
crown this one since the patient is close to 80 and suffering from alzheimers.
I've seen other teeth split in a matter a few weeks. They are not
predictable (IME). If it were my tooth, I wouldn't chance it.
I had one patient who splint a tooth right down to the tip of the root 6
seeks after the root canal treatment was done. I have seen others go many
years, as well. It is a factor of predictability. Cover the tooth with
either a crown or an onlay if it is a "back" tooth. Some front teeth (with
minimal fillings) can hold up well without the crown.
I just had a root canal done this morning to solve an inflamed nerve
problem. I always opt for a crown post-root canal. It's insurance against
exactly what you wrote about. It can quickly be a case of pay me now or pay
me more later, and I prefer the former, particularly when involving a tooth
that is responsible for grinding food and other hard things. :-)
The only thing I hate about all this is paying $595 for the root canal and
$725 for the upcoming crown. All for a little toothie. :-)
