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Why crowns are recommended on root filled teeth

If bacteria gets into the nerve space inside a tooth, this can lead to irreversible damage of the nerve (causing acute pain and sensitiviy) and eventually to necrosis (death) of the nerve. Root canal treatment is a procedure we perform routinely to treat this condition. After treatment, we often recommend the tooth has a crown placed on it for protection.

If bacteria gets back inside a root filled tooth again, it can become infected again and the root filling can fail. The most common cause for the failure of root canal treatment is a crack in a tooth. A crack or root fracture is a break in a tooth which then allows bacteria to re-enter the inside of a tooth which has been cleaned by the root filling. If a tooth has a root fracture, it is not possible to stick things back together again, so prevention of this developing is important.

Before a root filling is done (or a root filling is repeated) the tooth is thoroughly investigated to check for a crack being present. This tooth (a lower premolar) had an area of extensive infection around it and on the first x-ray which was taken, the root looked normal.

A second x-ray taken of the same tooth shows that the root is split in half. Even if the old root filling was removed, the space in the tooth disinfected and re-sealed with a new root filling, bacteria would re-enter the tooth through this crack in the root and the root filling would fail.

Crowns can protect teeth from fracture.

A crown on a tooth is like a helmet or thimble over the top of the tooth holding everything together. When you bite and chew, there are huge wedging forces which cause a tooth to flex and bend. A crown will stop these wedging forces from causing the tooth to split and fracture giving it a much better long term prognosis.

More information about how crowns can protect teeth can be seen at

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1 Comment

Aayushi Jain
Aayushi Jain
Apr 29, 2020

Whenever we think of a dentist, one of the first things that comes to mind is ‘toothache’ and ‘root canal’. Infact, a large majority of the people fear root canal treatment as they believe it is a painful procedure.

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