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Does A Root Canal Need A Crown?



When you have a severely damaged or infected tooth, and you are at risk of losing your natural tooth, root canal treatment can help to prevent further damage and restore the function of the tooth. Many dentists recommend a crown to seal the tooth and strengthen its structure after a successful root canal. But you can skip this final step without serious repercussions, especially if the restored tooth is at the front of the mouth where it is not subjected to brutal chewing forces.

Reasons To Get A Crown After Root Canal Treatment

That said, the root canal procedure involves drilling into your tooth to remove the infected or damaged area, following a deep cavity or cracked tooth. The pulp, which contains the nerves and blood vessels, is removed, and the remaining tooth cavity cleaned and disinfected before it can be filled and sealed. Before treatment, the tooth is usually in a vulnerable state.

Reasons to Add a Crown
Although root canal treatment saves your natural tooth, prevents tooth extraction, and eliminates the cost of tooth replacements—implants or bridges—the procedure itself can further weaken the tooth. Even with filling material, teeth with large cavities are still weak, and may need additional strengthening with a crown.

The tooth may need strengthening with a crown if:

  • It was damaged during treatment – Removing the pulp to create a cavity often causes the tooth to weaken. The situation is worsened if the tooth’s individual root canals are deep in the root, forcing the dentist to drill further and remove more of the root structure.
  • It has been previously damaged – Root canal treatment is usually recommended for severe tooth damage. Issues such as large fractures and cavities may cause the tooth to be in a weakened state, and be likely to come apart when subjected to chewing or biting forces.
  • Changes in tooth dentin – The chemicals used to clean the cavity may diminish the flexural strength of tooth dentin, increasing the risk of fracture after restoration.

To address these issues, your dentist may recommend that a crown be placed to strengthen the tooth and create a proper seal to prevent contaminates in the mouth from seeping past the filling material and into the root structure, causing the treatment to fail.

So, When Can You Skip Crown Placement?

Crown placement is mostly recommended for restored premolars and molars, where strength is needed to withstand the bulk of chewing forces. However, back teeth with sufficient natural tooth structure can be sufficiently strong with silver fillings and no crowning. Incisors and canines can also last for decades following root canal treatment without crown placement.

Discuss your options with your dentist to ensure a successful root canal procedure.

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Dr. Tali Waksman
A graduate from the Faculty of Dentistry at the University of Toronto, Dr. Tali Waksman went on to work as the only dentist on a Native reserve, serving 2000 people after completing a residency at Sunnybrook Health Sciences Centre. With a warm and friendly personality and close attention to detail, she treats every patient like family.