Crown Necessary after Canine Root Canal?

[Post bimax]

I had a root canal back in January of this year (lower right-side canine) that went smoothly.  Had the canal done by an endo and then filled by my old dentist.  At the time, endo/dentist told me a crown wasn't necessary.

I just switched dentists and the new guy really wants me to get a crown on that tooth.  I'm going to call the endo who did the canal in the first place to ask about this, but do you guys know if crowns are recommended/necessary for canals done on canines?  I know they're definitely recommended for molars due to the forces applied during chewing, but most sources I'm seeing basically say they're optional for other teeth.

Only asking because it'll be about $500 after insurance.  He also did debridement and also wants to me to do a graft to build up my gums (they really are recessed though), which will also be expensive.  Just not sure if this guy is trying to swindle me.

[ArtVandelay]

The cynic in me says be extremely skeptical about elective medical advice post coronavirus recession hit. Lot of missed revenue that offices need to catch up on.

What's the downside to not getting a crown? I feel there's no downside to waiting besides maybe dealing with pain for a weak if you wear it out/crack it. Cracked tooth or a crown, one way or another it's destroyed right?

[kavan]

Crowns are what they usually do after a root canal. The reasoning is that the tooth is DEAD. The living material, (like blood supply, nerves) in the root canal is GONE. The tooth can get brittle and dark. So, they want to put a crown over it. The main issue is that they don't tell you that's part of the whole ordeal in the first place.

[GJ]

Crowns are what they usually do after a root canal. The reasoning is that the tooth is DEAD. The living material, (like blood supply, nerves) in the root canal is GONE. The tooth can get brittle and dark. So, they want to put a crown over it. The main issue is that they don't tell you that's part of the whole ordeal in the first place.

Yep.
I'd do it, but I can see why on a canine it would be more optional.

[Gadwins]

I don't know if you would wear braces again? I have really filled up first molars and asked many orthodontists if I should wear crown before I get braces. They suggested I should wait with the crowns, because they could be damaged by the braces or have problems with the glue.

[Post bimax]

Thanks for the feedback guys.  Seems like I probably should get a crown either now or some point down the line to just to be on the safer side.

Only issue is my ortho has already taken and submitted scans to get my new aligners made, so I don't know if putting a crown on now would interfere with that.  I'll have to call his office as well on Monday to ask.

[GJ]

I don't know if you would wear braces again? I have really filled up first molars and asked many orthodontists if I should wear crown before I get braces. They suggested I should wait with the crowns, because they could be damaged by the braces or have problems with the glue.

Yeah, they'd have to rough up the crown with an abrasive to get the glue to stick to it.
It will still stick otherwise, but likely keep popping off after continued force from chewing. So he's right; if possible it's best to wait.

BiMax, do you have any greying of the tooth?

[kavan]

Thanks for the feedback guys.  Seems like I probably should get a crown either now or some point down the line to just to be on the safer side.

Only issue is my ortho has already taken and submitted scans to get my new aligners made, so I don't know if putting a crown on now would interfere with that.  I'll have to call his office as well on Monday to ask.

They suggest the crowns because the tooth can get brittle and eventually crack and there are some kinds of cracks (like vertical) that are hopeless and would have to be extracted. With a crack, the bacteria pathogens get in there and cause inflammation and eventually infection.

I guess the question would be how long after a tooth is DEAD (remember, once the pulp chamber dies or is removed the tooth is dead) does it get brittle enough to crack.

[kavan]

The cynic in me says be extremely skeptical about elective medical advice post coronavirus recession hit. Lot of missed revenue that offices need to catch up on.

What's the downside to not getting a crown? I feel there's no downside to waiting besides maybe dealing with pain for a weak if you wear it out/crack it. Cracked tooth or a crown, one way or another it's destroyed right?

No. Not really. A cracked tooth dead (from prior root canal treatment) or alive is insidious situation because the crack can't be seen on an X ray and one only finds out the crack is there after a gradual period when bacteria get in and cause constant periodontal inflammation and/or infection.  Worse ones are vertical cracks that propagate to the root of the tooth and that type becomes a GONNER if infection sets in and has to be extracted.

[kavan]

I don't know if you would wear braces again? I have really filled up first molars and asked many orthodontists if I should wear crown before I get braces. They suggested I should wait with the crowns, because they could be damaged by the braces or have problems with the glue.

Ya, as GJ and your ortho say, best to wait. Even though your tooth is FILLED, it's NOT a DEAD tooth because the filling is there to protect the (living) pulp chamber.

[Post bimax]

Yeah, they'd have to rough up the crown with an abrasive to get the glue to stick to it.
It will still stick otherwise, but likely keep popping off after continued force from chewing. So he's right; if possible it's best to wait.

BiMax, do you have any greying of the tooth?

GJ,
The tooth was greying before I got the root canal, which is how Gunson identified it during my consult and recommended I see an endo.  The endo performed the canal and did some sort of bleaching to make the tooth match my others, and the dentist completed the filling.

I guess the question would be how long after a tooth is DEAD (remember, once the pulp chamber dies or is removed the tooth is dead) does it get brittle enough to crack.

Kavan,
Yes I suppose this would be the question.  Considering my endo and old dentist were comfortable with no crown on the tooth, I'd probably be okay to wait until revision/ortho is complete; which I estimate to be about 1.5-2 years post-canal.

[kavan]

GJ,
The tooth was greying before I got the root canal, which is how Gunson identified it during my consult and recommended I see an endo.  The endo performed the canal and did some sort of bleaching to make the tooth match my others, and the dentist completed the filling.

Kavan,
Yes I suppose this would be the question.  Considering my endo and old dentist were comfortable with no crown on the tooth, I'd probably be okay to wait until revision/ortho is complete; which I estimate to be about 1.5-2 years post-canal.

So, it's been dead before the root canal treatment and I think the internal bleaching can weaken it. I wonder if you could get some kind of band around it to protect it from cracking.

 However, it is the teeth with more than one CUSP that are more susceptible to cracking. I guess, always be mindful and careful not to put any cracking forces on it.

[InvisalignOnly]

I'd definitely not get a crown especially if you are still wearing braces or planning further orthodontic treatment. I have several root canal treated teeth, front and back, and one of the front ones had been bleached. And I only have one crown which I got because it was on offer at my dentist at the time . I never had a problem with the root canal treated teeth (had some of them for several years with no issues) and I regret getting the crown because it offers no advantage and that was the only tooth that my ortho had to simply leave out as the bracket would not stick to the crown no matter what he tried. Brackets stick to the root canal treated teeth without any issues (in my particular case, might be different for others).
Obviously you have to be careful with chewing but if you are wearing braces, most likely you are already being careful. Crowns on front teeth are not a great idea as they often do not look natural after a while, no matter what they tell you when they're trying to sell it. So my two cents: I'd leave it as it is and just be gentle when biting into things.

[Post bimax]

I'd definitely not get a crown especially if you are still wearing braces or planning further orthodontic treatment. I have several root canal treated teeth, front and back, and one of the front ones had been bleached. And I only have one crown which I got because it was on offer at my dentist at the time . I never had a problem with the root canal treated teeth (had some of them for several years with no issues) and I regret getting the crown because it offers no advantage and that was the only tooth that my ortho had to simply leave out as the bracket would not stick to the crown no matter what he tried. Brackets stick to the root canal treated teeth without any issues (in my particular case, might be different for others).
Obviously you have to be careful with chewing but if you are wearing braces, most likely you are already being careful. Crowns on front teeth are not a great idea as they often do not look natural after a while, no matter what they tell you when they're trying to sell it. So my two cents: I'd leave it as it is and just be gentle when biting into things.

Hmm interesting.  It did feel like the dentist was trying to sell me things.  Definitely holding off on the crown at least until after the next round of orhtodontics unless my ortho advises my otherwise.

[kavan]

Hmm interesting.  It did feel like the dentist was trying to sell me things.  Definitely holding off on the crown at least until after the next round of orhtodontics unless my ortho advises my otherwise.

That makes sense. The DEFERENCE is due to the ortho over the dentist.