Do Teeth With Root Canals Need Crowns?

In “traditional” dentistry, the back teeth (premolars and molars) almost always need crowns to hold them together after a root canal, but for front teeth it all depends on how big the cavity was; since many front teeth still have a lot of healthy tooth left after the root canal, a crown is often not needed on front teeth. However, microscope-enhanced dentistry allows us to save more healthy tooth, so even some back teeth don’t need crowns after a root canal. However, you need to make sure and ask your dentist, because if you need a crown and don’t get it, the tooth will break and become non-fixable, which ends up being a waste of time and money.

Very often after a root canal, there’s simply not a lot of healthy tooth left over, and this is why many root-canal-treated teeth do need crowns. Here’s one example of a tooth we recently fixed with a root canal and a crown. The photo on the left is how the tooth looked after all the decay was cleaned out and smoothed (90% of this was done with our Lightwalker dental laser BTW), and the photo on the right is the “After” picture, once the root canal procedure was done, and after we’d bonded in the porcelain crown made the same day.

On the flip side, when the tooth has not been badly destroyed by decay, or not broken or cracked, a dentist with a microscope can do the root canal procedure with only a very small hole. With such a small hole, and most of the tooth preserved, we can avoid doing a crown and just do a simple bonded filling, and the tooth should still be fine for decades to come. Even if the patient needs more work down the road (the patient in the following photos is only 14yo), there will be a lot more healthy tooth to work with, than if I’d drilled it down for a crown.