I have severe erosion of top front teeth without decay or infection. Are root canals necessary before crown placement?

My top center teeth do not have enamel (consequence of chronic anorexia), and their edges are transparent. Two dentists said I need root canals before I can get crowns or veneers on them. One dentist, and author in the field of dentistry, said he can place crowns on them without doing root canals. They cause a LOT of pain, but I've been told when the crowns are in place, the pain will go away. My bottom teeth hit the backs of these thin teeth when I bite. I want to eat now, but it hurts.

Doctor Answers 4

Try going slow

The previous answer pretty much convered everything.  One thing I would add is that you might try having the teeth prepared for crowns without root canals and then go around in just the temporaries for a while to see how the feel.

Seattle Dentist

have severe erosion of top front teeth without decay or infection. Are root canals necessary before crown placement?

This is a difficult question to answer without seeing x-rays and actually examining you.  Your dentist who is recommending root canals most probably wants to insure that you won't need one later on, and if you have lost a lot of tooth structure, then that concept is certainly a viable one.
The other dentist most likely feels that not to do root canals without actually knowing for sure that they need to be done. This is a very conservative approach, and certainly not a bad way to go either as long as you realize that you may need one or more root canals sometimes in the future.
I might suggest you speak with your dentists about using EMax porcelain, as they are a newer type of porcelain that is extremely strong and can be made very thin without sacrificing strength.  They also fit very well and are very natural and esthetic.  The advantage of drilling less by using Emax is that the less drilling, the stronger the underlying tooth and also less chance of root canal. 

Norman Huefner, DDS
Laguna Niguel Dentist

Need veneers for teeth without enamel...

It has been my experience on the past ten years as a cosmetic dentist that it would be better to root canal both of these teeth prior to placing veneers and here's why:

If you take the chance and have veneers placed on these teeth without root canals, there is a high probability that you will need root canals later on in the not too distant future.  If you end up needing root canals after the veneers are placed, you will ultimately have to have the veneers cut off then redone after the root canals.  This means that you will have to pay for veneers twice, plus pay for root canals.  
It's up to you whether you choose to root canal first, but from a cost standpoint, I would highly recommend getting the root canals first.  Good luck and I hope this helps. Follow me if you have more questions.
Sarah Thompson, DMD

Sarah Thompson, DMD
Saint Louis Dentist
5.0 out of 5 stars 15 reviews

Dear Promo

It is a very difficult question to answer without proper records including photos, models and radiographs.  I would be inclined to trust the dentist who said you do not need root canal treatments to restore your teeth.  Your pain could be caused by exposed dentin.  If, however, your teeth are not long enough to restore, orthodontics, crown lengthening and sometimes root canal treatments are needed to properly restore the teeth.  Again, the dentist who is an author sounds like the one to trust.  I would have a good conversation with that dentist to find out what your options are.  Congratulations at moving forward with your dentistry.  Good luck!

Thomas Roberts, DDS
Seattle 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.