Do You Need A Crown After A Root Canal?

Dr. Christopher Li Etobicoke - Li Family Dental

By Dr. Christopher Li

April 29, 2024

crown after root canal, dental crown, root canal

If your dentist has just told you that you need a root canal, you’re probably a little nervous and have quite a few questions. Along with unnecessary worries about pain, many patients fear the cost of a root canal will be sky-high because they’ll need a crown. But do you, though?

Let’s look at the question of getting a dental crown after a root canal, when you do need one and when you don’t, as well as some information about root canals and crowns in general.

What Is A Root Canal, And When Would I Need One?

what-is-a-root-canal-and-when-would-i-need-one

A root canal is also known as an endodontic treatment. It is used when the inner area of your tooth, called the pulp, is infected. This layer is beneath the dentin where it is in direct contact with the blood vessels and nerves of your teeth, making infection very painful. As a result, a root canal offers sweet relief, by removing the infected pulp and all signs of decay.

So, when will your dentist recommend a root canal? When decay and bacteria make their way into the soft tissue of your tooth’s centre, it causes something called “pulpitis,” which allows bacteria to reach the pulp. This causes infection, pain and swelling that, if left untreated, can lead to an abscess. Whether your dentist diagnoses the infection or the situation progresses to an abscess where a sore appears on the gums above or below the tooth, your dentist will recommend a root canal.

What Causes Pulp Infections?

what-causes-tooth-pulp-infections - Close-up of a person's open mouth showing several teeth with visible dental issues, including decay and discoloration.

Pulp infection occurs when the enamel and dentin layers are damaged, which includes:

  • Cavities
  • Tooth decay
  • Tooth injury, such as cracks and breaks that expose the pulp
  • Impact to the tooth without any obvious cracks or chips
  • Decay beneath an existing filling

Do Root Canals Hurt?

Root canals have gotten a bad reputation for pain, when in fact, they are the solution that eliminates your pain. Once the infected tissue and decay are removed, that pulsing pain from swelling that impacts your blood vessels and nerves goes away. Although there might be some minor discomfort for a day or so after a root canal, that terrible pain from the infection is gone. 

Is A Crown Always Required After A Root Canal?

is-a-crown-always-required-after-a-root-canal-not-if-tooth-structure-is-still-intact

No! There are several “root canal, no crown” scenarios, including:

  • The tooth in question is not a molar that needs a sturdy structure to do a lot of chewing
  • The tooth is in good condition and mostly intact, so a straight filling will do
  • This is the first time for a root canal on this particular tooth so it can maintain its appearance and function on its own 

Are There Some Cases When A Patient Isn’t A Good Candidate For A Root Canal Crown?

Yes! There are a few things your dentist will consider, including:

  • Tooth location: If the tooth is either a canine or incisor, with little “excavation” required, you aren’t really a candidate for a root canal crown.
  • Tooth condition: If your tooth is not damaged beyond repair, including teeth that require a lot of structure to manage chewing like molars, then you won’t be considered for a crown and instead will just need a filling.
  • Tooth history: If your tooth hasn’t undergone several restoration procedures already, and the structural integrity is still intact, then you likely won’t be a candidate for a crown. 

When Do I Need A Crown After A Root Canal?

when-do-i-need-a-crown-after-a-root-canal - Close-up view of a dental mirror reflecting a decayed tooth inside a patient's mouth.

In general terms, although root canals are designed to save the tooth and keep the tooth roots in place, the procedure makes it difficult for the tooth to maintain its strength. As a result, we use crowns to provide the protection and reinforcement required to restore that strength.

Common scenarios where your dentist might decide you need a crown after a root canal include:

  • The tooth has had previous restorations that have left it too fragile for a simple filling
  • There was previous trauma to the tooth that impacted the root and tooth structure
  • Tissue was removed from the area
  • The drilling process made the tooth more fragile
  • You are at higher risk for future infections and require added protection to avoid tooth loss
  • The root canal has left your tooth overly sensitive to hot and cold
  • Your tooth now appears grayish, misshapen or deeply stained 

When Is The Crown Placed?

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A root canal treatment involves these steps:

  • The area is numbed using a local anesthetic to keep you comfortable during the procedure.
  • A small hole is drilled in the tooth so that the pulp can be accessed.
  • The infected tissue is removed, along with any signs of decay.
  • The canal is filled and sealed to protect it from further infection.
  • The tooth is shaped to accommodate your new crown.
  • If your dental office offers CEREC Crowns like ours, you won’t require a second appointment.
  • We craft your crown at our office so it can be inserted directly following your root canal.
  • The dentist will check your bite and the fit of the crown, making adjustments if necessary.
  • The crown is bonded to your existing tooth using strong dental cement. 

Is There Ever A ‘Crown, No Root Canal’ Situation?

Two dental crowns on metal posts, one ceramic and one metallic, displayed against a blurred light background.

Yes! Dental crowns are both a restorative and cosmetic treatment that can be used to resolve issues beyond a root canal. This might include the following:

  • Your tooth has been severely broken or cracked, and a simple filling won’t do the trick
  • You have a missing tooth or teeth and want a natural-looking tooth replacement using a bridge
  • You are having tooth implants as a permanent tooth replacement solution with porcelain crowns
  • You have a weak tooth that needs to be protected from breaking
  • You want to resolve cosmetic issues such as staining, discolouration, misshapen teeth, etc.
  • You have large gaps between your teeth but want an alternative cosmetic solution to avoid orthodontics

So, there you have it. Although a crown might be recommended following a root canal, there are several scenarios where you’re either not a good candidate or have retained enough tooth structure to get away with having a simple filling.

Give us a call at 416-232-2033 or request an appointment by clicking here.

Dr. Christopher Li

About the author

Doctor Christopher Li, DDS
Dr. Chris, as he is affectionately known, is a licensed dentist with over 20 years experience. His caring personality makes even the most tentative person at ease. Patients are constantly commenting about how Dr. Chris is incredible at delivering pain-free freezing, and how he has an amazing chair-side manner.  Dr. Chris loves sharing information with his patients and everyone who has teeth about how to care for their teeth, avoid tooth decay, and the treatments available to help them overcome their tooth pain or other dental issues so they can enjoy life and food to its fullest!

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