After root canal treatment, your dentist will almost certainly recommend a crown. Many patients question why a crown is necessary when the tooth already had treatment. Here is the clinical reasoning.
Why the Tooth Changes After Root Canal Treatment
The pulp (the soft tissue inside the tooth) provides the tooth with moisture and nutrients. Root canal treatment removes the pulp. Over time, the dentine becomes more brittle - losing some of its resilience to the forces of biting and chewing. This makes the tooth significantly more vulnerable to fracture.
🦷 Studies show that root-treated molars without a crown are up to six times more likely to fracture than those protected by a crown. A fractured root typically results in extraction of the tooth - losing the benefit of the root canal treatment entirely.
Which Teeth Need a Crown?
The recommendation for a crown depends on the tooth's position and the amount of remaining tooth structure:
- Molars and premolars - crown is strongly recommended in almost all cases. These teeth bear the greatest chewing forces.
- Front teeth (incisors and canines) - a crown may not always be needed if sufficient tooth structure remains and the tooth is not heavily loaded. A post-retained composite restoration may be sufficient in some cases.
How Soon Should the Crown Be Placed?
The permanent crown should be placed within 4 - 6 weeks of completing root canal treatment. The temporary filling placed at the end of treatment is not designed for long-term use. Delaying the crown increases the risk of fracture and bacterial re-contamination of the root canals through the temporary filling - which can cause treatment failure.
⏰ Do not delay the crown. The root canal treatment protects the root - the crown protects the root canal treatment. Both are necessary for the tooth to survive long-term.
What Type of Crown is Recommended?
At Accord Dental Practice, we recommend zirconia crowns for root-treated back teeth - zirconia is extremely strong and provides the best protection against fracture forces. For front teeth where aesthetics are paramount, lithium disilicate (e.max) provides excellent translucency alongside good strength.
Learn more about root canal treatment at Accord Dental Practice, Camberley - performed by Dr. Gadde, who holds a Postgraduate Diploma in Endodontics from King's College London.