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Do You Need a Crown After a Root Canal?

So you need a root canal. You're probably exploring your options and wondering, "Can I get a root canal without a crown?" A crown might supply the finishing touch you need to protect your tooth and keep it strong for years to come. However, a crown isn't necessary in every case. Ultimately, your dentist or endodontist will let you know what's best for your tooth, but you can explore in which situations you might get a root canal without a crown.

Is a Crown Necessary After a Root Canal?

During a root canal procedure, the small, threadlike tissue in the tooth's centre — the damaged pulp — is removed. The remaining space is then cleaned, shaped, and filled. Though root canals save teeth from decay, they cannot restore teeth to their former strength. Sometimes a tooth needs a little reinforcement.

A dentist or endodontist might choose to place a dental crown after a root canal for several reasons. These include:

  • To strengthen a fragile tooth. A previous injury, the removed tissue, or the trauma of drilling can all leave a tooth more fragile after a root canal. Placing a dental crown can provide the strength it needs to last and prevent any future damage.
  • To prevent recontamination. A problematic or injured tooth is automatically at higher risk for recontamination. A dental crown provides an extra layer of protection so you can avoid an extraction.
  • To protect from sensitivity. A root canal can leave some nerves feeling extra sensitive to temperature. Get a dental crown to tolerate the heat or chill better.
  • To provide a natural-looking appearance. Without the pulp, a tooth might appear grey or deeply stained. Restore the whiter shade and match the surrounding teeth with a dental crown.

When Can You Get a Root Canal With No Crown?

Dental crowns provide some fantastic benefits. In fact, a study in the Journal of Endodontics (the official journal of the American Association of Endodontists) found a 90% survival rate for teeth placed with crowns after a root canal procedure. However, a dental crown isn’t always necessary. Ask yourself some of these questions to see if you would benefit from a crown:

  • Where is the tooth located? If the tooth receiving a root canal is in the back of your mouth (your molars or premolars), there's a greater chance that you’ll need a dental crown. This is because these teeth must withstand all the pressure of chewing and grinding, so they might require the extra strength a crown can provide. On the other hand, the front teeth (your canines and incisors) might be perfectly fine without a crown, depending on the level of excavation.
  • What is the condition of the tooth? The more injured or problematic the tooth, the more likely you are to need a dental crown. If the dentist or endodontist must excavate a large amount of the tooth during the root canal procedure, you will probably need a crown to reinforce the tooth. Molars and premolars that maintain a large amount of tooth and are at low risk for fracture might still be suitable for filling-only restorations after a root canal.
  • Has this tooth been restored before? Similarly, if the tooth has undergone several restoration procedures — including a root canal — it will most likely need a crown to maintain its appearance and function.

In the end, your dental professional will help you determine the best option for restoring a tooth after a root canal. If you’re worried about the cost or appearance of a crown, bring those concerns to your dental professional so you can work together to find the best solution for your smile.

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