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Crowns, Bridges, Dentures, Implants

Filling Replacement with A Crown

11/20/2006

Question:

My filling cracked in my molar. When I went to the dentist, he said I had to see an endodontist for a root canal evaluation or at the minimum, I would need a crown. The tooth was asymptomatic, I just bit into something really hard and cracked the filling. They won`t answer my questions. Why would I need a crown to replace a filling? Couldn't he tell by the x-ray if I needed a root canal?

Answer:

A root canal is needed when the tooth dies. Each tooth that is alive (vital) has blood vessels and nerves in the center of the tooth. Most of the time, the tooth becomes painful (symptomatic) during certain points in its progression from being alive to dead. At times, teeth can die without any pain. A general dentist should be able to clinically test and evaluate if the tooth is alive. If the tooth has died for a time, an infection will probably develop at the tip of the tooth’s root, and this can be seen from an x-ray (radiograph).

A crown is placed on a tooth to prevent it from breaking (fracturing). If a tooth has more filling (restoration) than actual tooth structure, it has a high chance of breaking. If a root canal is carried out on a molar and a filling material is placed, there is usually more filling than actual tooth structure left.

Thus, a crown is needed if there is more filling than tooth structure or if a root canal is done on a molar, to reduce the chance of the tooth breaking.

Hope this helps. Please feel free to contact me if you have any further questions.

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Response by:

Alvin  G Wee, DDS, MS, MPH Alvin G Wee, DDS, MS, MPH
Associate Professor of Restorative Dentistry
College of Dentistry
The Ohio State University