Is It Possible to Have a Crown Redone? Will It Mean I Need a Root Canal?

Dental crowns are a long lasting treatment. They can last over 20 years in the right circumstances. We have crowns now that are both highly aesthetic and very strong. Not that long ago we still had a lot of crowns that looked dark at the edge or for back teeth, showed silver at the edge.

A crown can be easily re-done. I does require some additional trimming to make a new crown, but if the current crown is in good condition, then you will likely not need too much treatment. You are correct in thinking that every time a crown is removed and replaced it does have some affect on the health of the tooth. Re-doing a crown multiple times does increase the chance that the tooth may ultimately need a root canal.

Some labs and dentists are fanatical about making a very natural crown. Others are not so concerned and there are many very average crowns out there. In general, a new crown ought to be able to be designed such that it IS very natural, but make sure your dentist knows exactly what you are concerned about BEFORE starting this re-crowning process.

If you have been really disappointed in the size or shape of other crowns, you may need a better dentist and a better lab. If you are REALLY concerned about this going well, the dentist may have a wax replica made before he starts so you can see and get a sense for the target results. Oftentimes, the new temporary crown can be modified to be similar to the new final result. You can test drive the plastic crown to get an idea of what the new final one will be like.

In general, this should be able to be done easily, but discuss your concerns first, and make sure you are getting a thoughtful reply from your dentist and staff. Listen for clues as to HOW they are going to address your concerns.

 

Hi:There is always an increased chance of root canal when there is work done on a existing crown.  You can definitely send the crown back to the lab prior to cementation if you are not satisfied.Best,Dr. Maddahi

Thank you for your quesion. Like any medical procedure, there are always risks. In my opinion it is minimal  though in comparison to leaving bulky crowns on. Bulkiness  can cause inflammation of the gums, which might lead to gum recession, teeth sensitivity and gum disease in the long term.
In my office, before cementing ANY permanent dental work, including crowns , we show it to the patient to make sure he/she is happy with a final result. In case, which is very rare, patient wants to change/modify something, we absolutely send it back as long as it is a reasonable request.

Not every situation is the same, but the more stress you put on the tooth the higher the chances of trauma to the tooth leading to a root canal.  Despite the procedure’s negative reputation in popular culture, there is absolutely no need to be afraid of a root canal. A root canal is performed to treat and prevent infection after decay, injury, or a tooth fracture and if done in time can actually save your tooth. In the past, a root canal procedure might have been quite painful.  The patient have to be happy with the color selected, and any changes can be made before is cemented on the tooth.

Yes, your crowns can be removed and replaced with new crowns without needing root canals, provided that there are no hidden cavities under the old crowns.  Your current crowns can be carefully removed so that there is minimal irritation to the nerve of the tooth.  As far as the appearance of the crown, my suggestion would be to have your dentist order a wax model of your new crowns from which he can also make temporary crowns so that you can preview the final result.  This gives you both an opportunity to modify the shape or size as needed.  Hope this helps.  Good luck!

Crowns can always be redone and if properly prepared, contours of the crown should be able to be created that match your adjacent teeth and feel natural, not bulky.  Anytime you work on a tooth there is the possibility of nerve damage as teeth have a limited ability to regenerate and withstand trauma.  As dentists we do everything we can to prevent the need for a root canal through our techniques, but we do not have total control over the nerve's response.

Yes it is always possible to have a crown redone. If it was already permanently cemented in, it will have to be cut off using a drill and will be destroyed. If it was only temporarily cemented, or if the cement is weak and it can be "tapped off" by the dentist, then the lab can remake it.This does NOT automatically mean you will need root canal. If the crown always seems to be too bulky, that can be a sign that not enough tooth structure was removed in preparing the tooth for the crown. Or, it could mean that an inferior (cheap) laboratory, as opposed to a high quality cosmetic laboratory was used. You should be able to view the crown on your tooth BEFORE the dentist permanently cements or bonds it in. YOU should give the final approval BEFORE allowing the dentist to permanently place it.

Any time you redo a crown there is a chance of causing it to need a root canal.  If it is a healthy tooth I put the odds at less than 1%.  The reason it may need a root canal is that if additional tooth structure is removed it may get closer to the nerve/pulp, resulting in an insult to it.  If the insult is too much for the nerve - that is you get too close then it can flare up and need RCT (root canal therapy).  If an old crown is not to your aesthetic taste, the greatest likelihood is that the lab did a poor job.  Sometimes the lab may be limited in what they can do id the dentist doesn't remove enough tooth structure to leave them enough room to build up a proper anatomical and esthetic crown.  I would suggest that if you redo the crowns use eMAX all porcelain crowns - they are the standard now.  They look much better than old porcelain over metal crowns and are strong enough to withstand posterior chewing forces.  A good lab is very hard to find.  I estimate only 1% of the labs out there at most can do a nice esthetic well-fitting restoration.  Most people don't appreciate a nice crown in the back - they go more for price.  My advice is to have the next dentist show examples of the labs posterior work before you begin.  I have been working with my lab for 7 years and I am still always impressed when I open it up because every piece he does for me is like a little piece of artwork.  He is 2-3 times the cost of the average lab, but definitely worth it.  

Crowns can safely be done and re-done.  Every time a tooth is worked on, the nerve in the undergoes some irritation but usually heals and returns to normal.  The fate of the nerve in the tooth can sometimes vary vastly from tooth to tooth and patient to patient.  Sometimes a tooth with a very small filling ends up needing a root canal.  Sometimes a tooth can undergo many fillings/ crowns and 're-crowns' and the tooth is fine.  

Going further you should be aware that a root canal is a possibility at some point in the future.

If you are not happy with the way a crown looks in your mouth, you should not have your dentist cement it in.  If you are unhappy with the crown you should communicate this to your dentist.  Your dentist should then communicate these deficiencies to the lab.  In most cases the lab and dentist should be able to fabricate a crown which is functional and aesthetically pleasing.

The short answer is yes.  You can have them re-done again for the third time and the chances a root canal would be eminent is unlikely.  We use a microscope in our office to carefully remove any old dentistry.  I can see the cement layer as gently remove that without removing tooth structure.  Sure, a few microns of tooth may come off but it will be close to what you had previously.  We do this procedure on a daily basis and many patients travel across the country to have this done.  We are happy to help you in any way.  Good luck. Dr. David Frey