What Is The Best Option For A Dead Front Tooth?

My dentist sent me to a specialist who performs root canals. This dentist told me that my tooth has calcified and he cannot perform a root canal. All of my other teeth are healthy and straight. Should I consider a veneer or crown for this front, top tooth? Will it be possible to match it to my other teeth?

Doctor Answers 21

Calcified Tooth

A good root canal specialist (endodontist) isn't going to do a root canal unless you need one. This may depend on whether or not you have symptoms and what the x-rays show. If a tooth is too calcified to treat with a normal root canal, then a surgical procedure called an apicoectomy would usually be the next step.

While it can be more difficult to match a single front tooth to it's neighbors color wise, it's certainly possible to do and do well. Once endodontic treatment is complete, you should have a veneer or crown placed to protect the tooth long term.

If for some reason the tooth can't be saved, then the next best option would be an implant.

Cleveland Dentist
5.0 out of 5 stars 17 reviews

Porcelain Veneers: What's the best option?

Based on what you are saying, a crown seem s like the best possible option, however, a full comprehensive exam would have to be performed to fully substantiate that.

Best of luck. James Asaf, DDS

James Asaf, DDS
Beverly Hills Dentist
5.0 out of 5 stars 1 review

Dead front tooth

Often times it is required to place a crown on a root canal treated tooth because once the tooth dies, it becomes brittle and it loses its color. Even though this tooth has not had a root canal done to it, it may be dead. I actually think you should consider seeing another root canal specialist to evaluate the possiblility of treating it even though it may be calcified. Many root canal specialists are able to penetrate through the calcified portion depending on how severe it is. 
A veneer is an option too, which is more conservative, but it depends on how much stress you're putting on that tooth to determine if that's a good option for you.
I think the best thing, if you do end up getting a root canal is to try to bleach the tooth internally after the root canal and see if you can get it back to its original color. 

Anjali Rajpal, DMD
Beverly Hills Dentist
5.0 out of 5 stars 1 review

What Is The Best Option For A Dead Front Tooth?

So we have had patients that come in with a dead front tooth or a tooth that has had root canal or has died and has calcified and is practically the same type thing where the tooth is no longer vital, doesn’t have the elasticity that a normal tooth would have if it were still alive. In that case if the tooth is dead the better option would be to do a full coverage porcelain crown, so that it helps protect the tooth against fractures and protect the tooth against a bite that might cause it to break and chip.

Dead (Dark) Tooth Options

When a tooth is considered "dead" this means the nerve has died and the supply to that tooth has been cut off. Over time this tooth will most likely turn dark. I highly recommend covering your front tooth with a porcelain restoration to avoid having to see a dark front tooth. Your options to restore this tooth would be a Porcelain veneer or a Porcelain crown. If the existing tooth has a good deal of tooth decay that needs to be removed, the best option may be a crown. However, if the tooth itself is in good condition, the best option may be something more conservative like a porcelain veneer. You need to have the tooth evaluated by a general dentist to determine the best treatment option for this tooth.

Parnaz Aurasteh, DDS
Beverly Hills Dentist
5.0 out of 5 stars 1 review

How to treat a dead front tooth

Two things you didn't make clear, has the tooth changed color (gotten darker) than the adjacent teeth and does any infection at the root tip show up on the dental x-ray?

If the tooth has discolored, but no infection is apparent, then you might just consider first trying to bleach the tooth.  Although bleaching will lighten almost any tooth, the dentist cannot guarantee that bleaching will effectively match the adjacent teeth perfectly.

If that is the case, then a porcelain veneer commonly the best solution, today oftentimes replacing the need for full crowns on front teeth.  Your dentist may have you go to the dental ceramist at the dental lab to have the color matched more accurately.

In cases where the patient has very high expectations, many cosmetic dentists will recommend veneering both front teeth.  This insures that both teeth will look more optimum, same length, shape, color, etc. (i.e. both will be mirror images of each other). This is especially true when the other tooth also doesn't look as good (i.e. chips, discoloration, rotations or misalignment, etc.).

Norman Huefner, DDS
Laguna Niguel Dentist

Dead front tooth

To treat a tooth that is dead but has no canal for root canal treatment means that only  the front surface can be treated.

if you are happy with the colour of the other teeth, then a simple opaque veneer bonded to the enamel will be fine.

If the shape is fine then do not get it trimmed too much.

Dark Front Tooth

The single dark front tooth is the most difficult cosmetic procedure that a dentist can perform. It is tough enough to match a single porcelain crown to a natural tooth, having a dark base makes this even more difficult. 

Masking a dark tooth with a single porcelain veneers is challenging because porcelain veneers are thin and do allow some light to pass through. This will result in a tooth that looks gray or "off" compared to the others. Some dentists try to block out the darkness with filling material or an opaque cement, sometimes this works and sometimes it doesn't.

A crown can mask the darkness better that a veneer. The disadvantage is that more tooth need to be removed. 

A would recommend going to a dentist that has a ceramist/lab in the office or going to the lab yourself (if the dentist uses a local lab) to ensure that best possible match.

Sylvan Fain, DDS
Miami Dentist
5.0 out of 5 stars 1 review

Dead front tooth

If there is no infection in your tooth and it is simply calcified, you will probably be fine without a root canal.  If the tooth is cosmetically unacceptable, then a single veneer should be a possibility.  Make sure you find a good cosmetic dentist who has the ability to correctly match a single tooth because this can be a difficult case.

Porcelain Crown or Veneer for a Dead Tooth

I am assuming that this tooth has discolored and that is your reason for your restorative options.  I would say that after your evaluation by an endodontist it is probably not necessary for a root canal.  An all porcelain crown would be a great option for this situation for two reasons.  Aesthetically, your crown can be matched exactly to the other teeth around it.  Also, the crown will help protect your tooth against fracturing since the canal is calcified and there is no longer any blood supply to the tooth. Good luck.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.