How Often Are Root Canals Needed Right After Putting in a Dental Crown?

What causes this to happen? What is the procedure? Is an entirely new crown needed?

Doctor Answers 9

Root Canal after a crown

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Any trauma to a tooth can cause a tooth to need a root canal.  Trauma can be grinding your teeth, having a filling done, injury ,biting on something hard, etc.  Teeth have live tissue inside of them and this is what dies over time and sometimes suddenly.

Are Root Canals Always Needed With Crowns?

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Root canals are only performed on teeth with crowns when they are absolutely needed.  Most of the time a crown can be done without the need for a root canal.  When needed, they can be performed due to decay, a necrotic (dead) nerve, or pulpal inflammation from the the preparation of the tooth.  It is many times difficult to know which teeth will need  root canals until the crown has been permanently  cemented.  In these cases, a small access hole is made in the top of the crown and the root canal is performed.  This hole is filled at the end to seal it and a new crown should not be needed.   

Root Canal Treatment and Crowns

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There is a statistic that 5% to 7% of teeth that receive crown restorations end up needing root canal treatment.  That means that 93% or more don't need root canal.  The reason that this happens sometimes is that crowns in most cases are placed on teeth that are filled heavily in the first place.  They have a history of being filled and refilled.  All this treatment traumatizes the nerve inside the tooth which can eventually die.  This leads to the necessity of doing a root canal treatment.  So to answer your question, it is not that likely but possible that a tooth will need a root canal treatment after a crown treatment.

Martin Frankel, DDS
Toronto Dentist

Root Canal after Crown

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Crowns are usually diagnosed because the teeth involved have had extensive damage from decay, fracture or repeated attempts to treat the tooth with fillings. All of this is very hard on teeth and can sometimes lead to pulpal death. Usually this is obvious before a tooth gets a crown.  Sometimes not. On rare occasions a tooth decides to die after a crown is placed. It's not just because the crown was placed, it's because of all of the cumulative trauma to the tooth from everything the tooth was exposed to beginning with the tooth's first cavity

Ted Murray, DDS
Dubuque Dentist

Root canal after a crown.

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Yeppers! Often a root canal is needed after crown work. The dental pulp (nerve) "hates" any dental work being performed near it. Often the nerve dies, warranting a root canal. You don't have to re-do the crown if it is in good shape as verified by an X-ray. (ie. no decay, root exposure or open gaps.

Mitchell A. Josephs, DDS
Palm Beach Dentist

Root canal after crown

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When a tooth is prepared for a crown by a dentist, the tooth structure encompessing the nerve can be thick and stable or thin and weak. Most of the time, a dentist can get a good enough feel for the need of a root canal while preparing the tooth and will warn the patient...or not. If the patient is sensitive after the crown was started, It may even be indicated to wear the temporary for an extended period until symptoms subside. A final crown could also be placed with temporary cement for a few months just in case so that the crown doesnt have to be damaged when doing the root canal. 

A root canal specialist will drill through a permenatley placed crown-regardless if it is new or old. I personally believe a new crown should be made-regardless. 

A normal complication.

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I have a favorite saying in my practice," Teeth don't appreciate being messed with".  Every time a dentist works on a tooth for any reason the tooth can react unfavorably and sometimes require root canal.  This is no fault of the dentist.  As dentists we try to foresee these situations and do a root canal first if it is likely the tooth will need it however many of us also have a tendency to try to avoid it if there is a chance of not needing it. 

Root canal treatment after crown placement

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The usual treatment sequence is to perform the root canal, if it is necessary, before placing a crown on the tooth.  Once a crown is permanently cemented onto the tooth, it will either have to be cut off and replaced with a new crown once the root canal is finished, or a hole can be made through the crown and later patched up with a filling material.  Although this is not very common, root canals can become necessary after crown work if the prep comes close to the nerve and violates the root canal system.  Best, Dr. Elizabeth Jahanian

Elizabeth Jahanian, DDS
Los Angeles Dentist

Root Canal after a new crown was placed

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I’m sorry to hear that you’ll need a root canal.  It’s relatively infrequent that you’d need a root canal after seating a crown, but it does happen sometimes.  Whenever you perform significant work on a tooth there’s a chance the nerve may react unfavorably.  When that happens the nerve needs to get cleaned out, which means a root canal is necessary.  You don’t always need a new crown, it depends on your unique situation.  Often the Root canal can be performed through the crown.  Meaning the dentist can drill a hole through the crown and perform the root canal that way.  Then seal it up with a filling.  Good Luck!   

Peter Mann, DDS
Manhattan Dentist

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.