I need a root canal on my tooth #7. I expressed my concern about having a crown in the front (fear that the dark line would show after time, etc.) a while back. So this past visit he said that he does not need to crown it after the root canal. He will fill it because it is deep but narrow.
I hear that teeth become brittle and can break off after a root canal, so is it wise to not crown it? I just dont’ know which way is the smarter way to go. is it just a matter of time before the tooth discolors and break, or is there a good chance it will be fine?
– Rachel from New Jersey
Rachel,
Let me explain about root canal treatments on front teeth and crowns. There aren’t a lot of dentists who fully understand this, but I’m hoping that your dentist does.
Yes, teeth do become more brittle after a root canal treatment. Besides, teeth that need root canals usually have extensive fillings or decay. When that tooth is a back tooth, the danger is that the chewing force will split the tooth, which can make the tooth unsavable. So, it’s fairly routine to just put a crown on the tooth and protect it.
However, on front teeth, there are no strong forces that tend to split a tooth vertically. That is because there is only one cusp or a biting edge. But there is a possibility for a front tooth, especially an incisor, to shear off horizontally – that does happen.
So then, what is the best thing to do if you have a root canal treatment on your upper lateral incisor as you are going to have? If there is not extensive loss of tooth structure, a crown could actually weaken the tooth in the critical neck area – that’s where an incisor would be most susceptible to horizontal fracture. If a crown IS placed, it is probably best to reinforce the inside of the tooth with a flexible fiber post.
So this means that yes, you can get along without a crown on this tooth, and as long as the filling isn’t extensive, that will leave your tooth less likely to fracture, not more. But then you have the discoloration problem. Root canal teeth tend to turn quite dark.
But here is what your dentist can do, and maybe he doesn’t understand this. It turns out that almost all of the darkening, at least in the first couple of years, comes from root canal filling material and sealer cement that is left inside the tooth. If your dentist will clean all of these root canal materials out of the crown of your tooth – the part that shows – you may have no discoloration at all for a good ten years. He can instead fill the tooth with a composite or a core material and bond it to the inside of the tooth. After ten or twenty years, the tooth may become noticeably darker, and you can deal with that problem at that time.
Dr. Hall
Other links:
Read about root canal treatment on a front tooth.
Read about porcelain fused to metal crowns and the dark line at the gumline that they tend to develop.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.