Root canal/crown questions - Dental Health Message Board

jlh2605 · 05-01-2006, 06:21 AM

If I need to get a root canal in my tooth, do I automatically have to get a crown as well? And would I need to get a crown immediately after a root canal or could I wait a while, because I can't afford both just now, I can barely afford a root canal.

And does a root canal hurt? I've had lots of fillings before, most of which were OK, but I've had some which were deep and they were really painful.

I've also been considering just getting the tooth pulled, because it's so much cheaper. I've lost three premolars, one due to severe decay when I was younger, and two for orthodontic treatment. And my wisdom teeth have cavities and need to be pulled as well sometime in the future when I can afford it. So I'll be down 7 teeth......would another one make much difference, or should I try to save this tooth?

JenniferE · 05-01-2006, 11:53 AM

If possible, try and save the tooth. The last thing you really want to do is lose another tooth. Once it is gone, it is gone. As much of a pain and expense as your natural teeth can sometimes be, it is still better to keep them for as long as possible.

A crown is not always necessary after you have had a root canal on the tooth. It really depends on the tooth, how much pressure you apply to that tooth, and how fragile the tooth already is before the root canal.

The reason why crowns are applied to a tooth after a root canal is because the tooth will become fragile over time. A root canal is simply a procedure where they remove the nerve of the tooth, sterilize the inside of the tooth, and then fill the inside of the tooth where the nerve once was. The nerve supplies moisture to the tooth. Since that nerve is now gone, the tooth will dry out and become fragile over time. The crown is then placed on the tooth as a protective measure.

Now, if the tooth has had a lot of work on it in the past and there is 50% or less of the natural tooth structure left, a crown is needed to protect the remaining tooth structure and allow for the tooth to function properly.

After the root canal procedure is finished, a temporary filling will be placed in the tooth. In a few weeks after the procedure, either a permanent filling will be placed and/or a crown. If you do not have to have a crown placed right away, wait at least 6 months or more before having a crown placed. This will give time for the tooth to heal as well as to make sure their was no re-infection of the tooth. Make sure to get the permanent filling placed and not just leave the temporary filling in. It is much easier to re-treat the root canal tooth if there is only a filling there and not a crown. Also, it is not uncommon for some people to experience sensitivity in a root canal tooth after the procedure even though there is no nerve in the tooth. The sensitivity is from the ligaments that hold the tooth in the socket and just from general dental work. The sensitivity should subside with time after the procedure. This is another reason why if you can wait to have a crown placed, it is best to do so. If a crown is placed too soon, the tooth can become all that more irritated and be sore for quite some time.

Some people experience some pain before and some sensitivity after the root canal treatment. During the procedure, you will be numb. When the root canal procedure is completed, you will have no nerve left in the tooth. The tooth will be essentially dead. The sensitivity, sometimes pain, that people feel after they have had root canal treatment is from the ligaments that hold the tooth in the socket. They can be sore due to the procedure itself and if the tooth was already sore before the root canal. The sensitivity will ease with time. Many times, people can take Advil or Tylenol for relief.

There are also people where the root canal tooth was only sore and/or painful before the procedure was started. Once the procedure was completed, they had no pain or sensitivity in the tooth. It's really different for each person.

Thelma-Louise · 05-01-2006, 11:59 AM

Most dentists will tell you that you need a crown but I had a root canal done on a front tooth with no crown for many,many years. I thinks it depends on what tooth it is and its condition (fractured, cracked, etc.). I even had a root canal on a tooth already crowned and did not replace it although they kept insisting it should be. I just made sure the filling never came out and when it did went promptly back to the dentist and had it put back. I have had 6 root canals and never had pain during the procedure. A good endontist is a must. The tooth will ache afterwards but I always took aleve (around 4-6 per day) for 1-3 days afterwards. It usually takes 2 appts to complete a root canal. Maybe I was lucky - not sure - but I never had any complications afterwards. I am down several teeth as well due to braces and perio and now have severe tmj - do what you can to save it. Good Luck!

jlh2605 · 05-01-2006, 02:38 PM

Thanks both of you for your advice.

Just an extra bit of information, the tooth in question is a back top molar, the one just in front of the wisdom tooth. It hasn't had any work done on it in the past, and as far as I'm aware it's not cracked or anything like that, but it does have quite a large cavity in it, I checked with a mirror and it's pretty extensive unfortunately.

It's not horribly painful at the minute, but I have a dullish ache in it which is getting more persistent now.

Thelma-Louise · 05-01-2006, 08:24 PM

I would still get the root canal & tell the dr you can't afford the crown (even if he insists) right now and to put a really good filling in for now. At least you can save the tooth. Most dentists would rather do that than risk losing a tooth.