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Writer's pictureDavid Chen, DDS

Do I Need A Crown After A Root Canal?

Updated: Jul 8

After seeing the root canal specialist, you will return to your general dentist for a permanent crown because the specialist only left a temporary filling in the tooth. It needs to be replaced with something permanent because the temporary slowly melts away.


completed root canal tooth with no crown
completed root canal tooth with no crown

When do you need a crown after a root canal?

There are 4 situations where you need to have a crown after a root canal because they need one or all of the benefits of a crown. A dental crown will increase the stability, integrity, strength, and aesthetics of the tooth underneath.


The integrity of the tooth is weakened

The tooth becomes weakened after a root canal because the nerve and blood supply is removed during the procedure. Without any more blood supplying nutrients to the tooth, it will start to weaken and become brittle over time. In order to address the weakened tooth, a crown is placed over it to protect it from being damaged.


It is important to protect a weak tooth with a dental crown and you don't want to delay getting a crown either because you can bite into something hard the wrong way and crack the tooth in half.


cracked root canal tooth
cracked root canal tooth

A cracked tooth will look like it has a line running through it. It cannot be saved due to the severely weakened structure and we call this non-restorable. Once a tooth cracks in half, you can no longer put a crown on it but instead you need to have the tooth removed.


This means that you just spent all that time and money on a wasted procedure. Hopefully this convinces you of why a crown is a good idea after a root canal because it protects a weakened tooth.


Does a crown also prevent sensitivity after a root canal?

A crown will not prevent a tooth from being sensitive after a root canal because the tooth should not be sensitive to temperature after the root canal. The root canal procedure removes the nerve from the tooth so it is no longer able to sense heat, cold, acidity, or sugary substances. It is still possible to feel pressure through the tooth but it comes from the pressure sensors of the bone surrounding the tooth.


If you are still feeling sensitivity to cold or other temperatures, you should revisit the root canal specialist before getting your crown because tooth may need additional treatment. There might've been an additional nerve that is still hiding within the tooth somewhere and that will need to be removed before a crown can be placed over it.


To improve the aesthetics of a discolored grey tooth

After a root canal, your tooth will begin to discolor and look grey in appearance. A dental crown is needed to cover up the grey tooth and improve the aesthetics by changing the color. The reason why a root canal tooth turns grey is similar to how people that are alive are pink in color but once they die, they start turning grey.


grey tooth

The color of it can be changed by placing a crown to cover up the color. Our dentists in long island city will improve the cosmetics of it by giving you an all porcelain crown or veneer.


If the tooth already has a crown or old fillings

Another situation where you need a crown after a root canal is if it already has an existing crown or a large filling on it. The crown will get damaged from the root canal because the specialist has to drill a hole through the top of it to remove the nerve.


Since the crown is damaged, you should replace it with another one afterwards. Sometimes we can find tooth decay underneath old crowns so while we replace we can also check for cavities.


If your tooth already has a large filling on it before the root canal, you will need a crown because after the nerve is removed, the tooth will have an even bigger hole in it. In order to protect the tooth from getting fractured, placing a crown over it will protect it's integrity.


If you grind your teeth at night

If you grind your teeth at night, you should definitely get a dental crown after the root canal because teeth grinding drastically increases the chances fracturing the tooth. A tooth is weakened after the root canal and if you continually grind on it throughout the night, it will eventually crack.


For teeth grinders, our LIC dentists recommend a special type of porcelain crown made of zirconia. This type of crown is very strong and highly resistant to external forces.



This is the only type of porcelain crown that can withstand teeth grinding throughout the night. If you use a veneer type of porcelain, it will crack before the night is even over.



When can you get the root canal without a crown?

The only situation where you don't need a crown after a root canal is if it is on a virgin tooth without any fillings on it and the root canal specialist made a small hole. If the hole is small enough, the tooth structure won't be as weakened, which makes it eligible for a filling instead of a crown. This is the only time where you can leave a root canal tooth with just a filling. Although over time, the tooth will start to turn grey so you may still want to get a crown to improve the aesthetics.


Takeaway

Every situation is different so when you need a crown after a root canal will depend but if you have any of the conditions listed above, you may want to move forward with the procedure sooner rather than later. Although there are two exceptions.


Exceptions:

  • It was a virgin tooth and there was no cavity or prior restorations on it. This means that the root canal access hole will have been very small. If you have enough tooth structure remaining, you may be able to avoid the tooth cap and just get a small filling.

  • If you just had a crown placed within the last year and you ended up needing the nerve removed. Since the tooth cap is pretty new, you should just put a cavity filling on top instead of replacing the whole crown. You can replace it a few years later after you've put some mileage on the crown!


We hope that helps in answering your question of if you need a crown after a root canal. If you are ever unsure you can always make an appointment for a consultation with one of our long island city dentists at 1311 Jackson Ave Dental! We're conveniently located in Queens, right across from midtown.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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