Do Root Canals and Dental Crowns Always Go Hand in Hand?
Just because a tooth is a candidate for a dental crown that doesn't automatically mean that it will also require a root canal procedure. A dental crown, whether metal and ceramic, zirconia, or porcelain is a dental restoration and so as long as conditions are ideal, no root canal should be necessary either before or after crown placement.
However, in some circumstances a dentist may need to perform a root canal either before or after crown placement.
When There Isn't Enough Tooth Structure
Even when the nerve inside a badly damaged tooth is healthy and intact, if there isn't enough enamel remaining to place the crown then a root canal will be necessary. This is because your dentist will need to place a post into one of the root canals of the tooth. The post will provide your dental crown with a stable foundation that might not otherwise be possible.
In this case, your dentist may need to work with an endodontist who will perform the root canal before crown placement.
If Your Dentist Anticipates a Problem
Before placing a dental crown over a damaged tooth, a dentist needs to assess the tooth to determine the likelihood of the nerve becoming irritated by the procedure. If there is very little tooth structure between the crown and the nerve, the chance of the nerve being affected is high. Therefore, a dentist may recommend a root canal prior to crown placement.
While dentists are not fortune tellers, they are well-placed to judge how likely a tooth is to need a root canal after crown placement--and because of crown placement.
Heavily Filled Teeth May Need a Root Canal
Teeth that have had several fillings over the years might be better off having root canal treatment prior to crown placement. Repeated fillings traumatize the nerve and drastically reduce available tooth structure. Because of these two factors, a dentist will suggest that the nerve be removed before the crown is placed.
Some Teeth May Later Need Endodontic Treatment
A small percentage of teeth; 9% according to one recent study, may need root canal treatment after crown placement. This is likely because the pulp was already traumatized to begin with. Placing a dental crown on a badly damaged tooth then can sometimes lead to the need for a root canal after the crown has been placed. However, this might not be for months or even years.
If you are considering having a tooth restored with a dental crown, remember that badly damaged teeth may be better off having a root canal performed on them prior to crown placement.