Most people assume that they have no choice but to get a crown after a root canal. But patients who are concerned about the time, discomfort, and cost of a crown might wonder if they can skip this part of a tooth restoration. While placing a crown is the typical final stage in almost all root canal procedures, there are some rare cases when it might not be necessary. 

What is a Crown’s Purpose With a Root Canal?

A crown is a cap that fits over a tooth. It is formed to look and feel like the original tooth it covers. Common materials used for dental crowns are porcelain, porcelain fused to metal, or gold. 

Root canal procedures are done on teeth that are damaged or decayed to the point where a simple filling is not enough to fix them. Often, a painful infection called pulpitis has set in. Pulpitis is the result of a cavity eating all the way to the soft core of the tooth called the pulp chamber. Infected nerves and blood vessels in the pulp chamber must be removed or the infection could start to spread into nearby teeth and gums, or deteriorate the jaw bone. 

Dentists or endodontists perform root canal procedures by drilling into the tooth, cleaning out the infected tissue at the root, and filling the hole left behind. A crown usually serves as the final step. It seals off and stabilizes the tooth. The patient can resume normal chewing with a crown because it has the shape and strength of the original tooth.

The Cost of Root Canals and Crowns

Root Canal procedures cost anywhere from about $700 to $2000. Molars cost more than front teeth because they typically have a network of tiny canals, rather than just a single root, making the procedure more complex. Simple root canals may be done by a dentist. More difficult ones might need a root specialist called an endodontist, who will often charge more. 

Creating and placing the crown after a root canal is an additional cost. A dental crown runs roughly $800 to $1800. Not surprisingly, gold is the most expensive material. Porcelain or porcelain-coated metal is at the lower end. 

This additional cost can be difficult to manage, especially if the patient does not have dental insurance. Compared to the cost of a dental filling which usually ranges from $100 to $400, it is not a surprise that many patients wonder if they can do without a crown.

When It Might be Okay to Skip a Dental Crown

It is important to understand that the decision of whether to get a crown is not just a matter of preference for the patient. Getting a root canal without a crown might save money in the short run, but if it does not completely fix the tooth, it could end up leaving the tooth vulnerable to further damage. This will cost more money later, not to mention additional pain and inconvenience.

Because of their knowledge and expertise, dentists are able to evaluate what will work best—not just right now, but in the future. There are a few instances when a filling might be just as effective in protecting a tooth as a crown. 

• Location. Front teeth require less drilling due to having a single root. They are also not responsible for heavy chewing like molars. A front tooth could potentially have enough strength and stability with just a filling.
• Condition. If most of the tooth is still intact after a root canal, a filling might be sufficient. 

Remember, though, that root canal procedures are usually used to treat teeth that are already in bad shape. They are the next step when a regular filling is not enough to fix the tooth. If the tooth is damaged enough to need a root canal, it most likely needs the finishing touch of a crown.

Why Getting a Dental Crown Is Recommended

Getting a dental crown after a root canal is much more common than a root canal without a crown. Most dentists see it as a necessary step not just for that particular tooth but for the patient’s overall dental health. Crowns help in the following ways:

Reinforce the Weakened Tooth

One reason a dentist might recommend a root canal is if more than half the tooth is already made up of filling material which is not as strong as the natural tooth. The blood vessels and nerves in a healthy tooth bring in nutrients, keeping it strong and stable. Hollowing out the root during a root canal weakens its structure even more. The tooth can become brittle and crumble, especially when biting down on something hard. A crown can hold what is left of the tooth together and in place, making it strong enough to withstand chewing. 

Protect the Tooth From Outside Forces

A root canal procedure leaves a hole in the tooth that, even when filled, can be sensitive to heat, cold, and sweet foods. Capping off the hole with a crown instead can protect the tooth when eating and drinking, preventing pain and discomfort. 

Maintain the Tooth’s Look and Feel

Before a root canal procedure, the dentist takes impressions of a patient’s teeth and technicians in a lab create an exact replica. When the custom-made dental crown is placed over the tooth, it will look and feel like the real thing. After a short adjustment period, the crown will feel normal to the patient as they eat and talk. 

Porcelain and porcelain fused to metal crowns can even be tinted to match the rest of the teeth. If a root canal is done without a crown, the tooth could become gray or brown if it deteriorates. Crowns, on the other hand, do not change color as they wear out and they do not stain like normal teeth. 

Prevent Further Infection

Just as a crown will protect a tooth from heat and cold after a root canal, it will also seal it off from cavity-causing bacteria. Without a crown, decay can continue to eat away at the enamel, especially at the edges or a filling. This can lead to more cavities or another infection like the one that made the root canal procedure necessary.

While it is possible to get a cavity under a crown, it is rare. A crown after a root canal is a tooth’s best protection.

Avoid the Need for Retreatment With a Crown After a Root Canal

If a tooth breaks, gets too sensitive, or decays because it has had a root canal without a crown, it will need to be fixed again. These cases are sometimes referred to as “failed” root canals. The options are to redo the procedure (called retreatment), this time adding a crown, or, if the tooth is too damaged, it may need to be pulled.

Retreatment and extraction will both cost extra money, discomfort, and time in a dentist’s chair. Some people think of extraction as a final solution, but missing teeth can cause problems too. Dentures or a dental implant are usually recommended to maintain the patients oral and overall health.

Unless a dentist concludes that a filling is sufficient to repair a tooth after a root canal, it is best to opt for a crown. If finances are a concern, talk to the dentist about other ways to reduce the cost. If you need to find a dental professional who can do a root canal procedure and a crown, use our search tool to make an appointment with someone in your area.