White flling after root canal or crown

[Beth]

Hi

I am due to have a root filling on one of lower middle teeth and my dentist has given me the option of having a white fillng after the root canal or a crown. I am not sure which option would be better for my tooth.

I know that the crown costs a more than the white filling. I would like to know which option you would recommend for my tooth and the reasons why?

[Dr Vahid Motahar]

Hi,

Thank you for your question.

Well, as I am a dentist and like to keep busy I would say why not both!? But really there are very important and valid points behind me suggesting you should have both. Let me explain:

In a very large majority of the cases, teeth that need root canal treatment usually have had a large defect or cavity that has reached the pulp or nerve house of the tooth, causing symptoms and need for root canal. Then one has to remove even more of the tooth away in order to gain good access to the pulp to do the root canal treatment. At this stage I am sure you agree with me there is not much tooth structure left.
So once your good root canal treatment is completed what are you going to do with the tooth? In otherwords what is going to happen to the large hole that is there. You cannot just put a crown on that as crown needs foundation and a core to fit onto and support it. Thus the hole has to be filled before one can consider crowning it. We refer to this as the core of the tooth and sometimes it is necessary to place a post in one or more of the canals to support the core because there can be so little tooth tissue remaining that is not enough to adequately support the core without the post!

Whether you decide to crown the tooth or not you should have a core build up or as you put it the white filling. White fillings are a good choice for core build up as they adhere to the tooth tissue rather than filling a hole, so they are stronger.

But why should you crown the tooth? This is because even if the tooth is build up with white fillings the tooth itself is still very week and vulnerable to fracture. Also studies has shown over and over again that crowning the tooth after root canal therapy will reduce the failure rate of the root canal significantly. Therefore there are 2 reasons why one should crown the tooth after root canal treatment. First to further protect the tooth from fracture and give it strength. Second to reduce the likelihood of the root canal failure.