Teeth that require a root canal treatment are in a weakened state due to the destruction caused by decay or trauma. Following the completion of the root canal treatment it is important to seal the access to the canals and reinforce the tooth with a restoration. The common restoration previously used to seal the tooth and protect it was either a porcelain or a metal cap, known as a crown. If a larger portion of the tooth was missing an anchoring post had to be inserted into the root canal as well. But with the development of new composite materials in use at our practice, that are able to bond and reinforce the tooth, a crown may not be needed. These new composites which have fibre glass reinforcements that support the tooth and allow me to reinforce the teeth. Before I use these materials I have to take into account 3 factors:
1. Is the tooth cracked? Unlike a broken bone, the fracture in a cracked tooth does not heal and can allow bacteria to re-invade the tooth. The crack can lead to a fracture that results in an extraction. So if a tooth is cracked, it is a serious condition and usually requires a crown.
2. Is there enough tooth to allow for a filling only? To place a filling there is a need for a good portion of the tooth to be available to bond to. If there is enough tooth remaining a filling is a good option . It does not prevent you from having a crown later on and it can prevent the loss of further tooth substance needed to be removed to make room for the crown.
3. What are the risks of waiting before a crown is made? If the tooth is intact a filling can be the final restoration and a crown if needed can be placed at a later stage. But if a large part is missing, there are a strong biting forces or there are multiple cracks then leaving the tooth without a crown is not such good idea.
In conclusion there is the option open for you when restoring a tooth following a root canal treatment to have a filling only. If you have been told that you need a crown, please come see us for a second opinion.