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Dentistry - Crowns and root canal
Expert: Lawrence Spindel DDS, www.lspindeldds.com - 10/22/2009
Question
My wife went to the dentist because one of her teeth hurt. The dentist told her that she needed two root canals and two crowns. My wife went into his office and endured a procedure for about two hours. She believed that she had had the root canal. The dentist is now saying that that was the prep for the crown and he does not do root canals. I am under the impression that one needs to have the root canal before getting crowns put on. Am I wrong or did this dentist just do a $2600 procedure that may get messed up when my wife gets a root canal from a dentist who does root canals? Also, we told the dentist that we had $2000 coverage from insurance and couldn't afford much more than that if that helps.
thank you
Answer
Dear Chris,
A root canal can be completed if planned properly, without damaging your wife's crown. If an endodontist is able to remove a temporarily cemented crown then usually there will be no damage and the crown will not be ruined or have to have a hole drilled in it.
That being said, in my practice if a patient is diagnosed as needing a root canal and a crown I usually do the root canal first and crown second. If a patient has financial limitations and can only afford the root canal at the present time I place a long term IRM temporary in the tooth and often will do the needed crown the following year. On occasion, a patients tooth is so badly decayed that making a temporary crown can be done first to protect the tooth, but I usually do not intentionally take the impression for the final restoration until after the root canal is completed. If a patient does have financial limitations we try to help stage a patients dental treatment over time and fabricate the crown the following year. If a patient has dental insurance, most will have additional funds available the following year.
A dentist should inform a patient prior to initiating treatment his plan and the proposed order of treatment. Possibly, your wife's dentist may have told her his plan at the time of her visit and she may have went along with it. I have found that some patients are embarrassed to say no to a dentist at the time their dental visit, but afterwards, after speaking to a spouse,realize that they wish they had not gone ahead with the proposed treatment plan.
I completely understand your reason for being upset, especially since you may not have the funds needed to have both root canals completed by the specialist in 2009, if the crown work is completed this year. Do not authorize the second crown to be completed. Also, call your dentist and politely ask him for an explanation. Explain your financial situation and your wish to have the root canal started prior to any additional work on the crowns if possible. Politeness is in order, since your wife has not completed her crown and I think you would like to have her dentist complete her treatment in a 'pleasant environment'. If you are not satisfied with the dentists response then you probably should try and find a different dentist for your wife's future dental work.
Additionally, as pointed out, depending on your finances and the condition of your wife's teeth, some of her work may possibly completed in 20010 when additional insurance funds will be available. Hopefully her dentistry can be planned in an order that will help you better manage the finances and insure her future dental health. I have written a brief article on staging dental treatments and I have include a link to it below. If the link does not work, then just copy and paste the url into your browser.
http://www.lspindeldds.com/staging_dental_treatments2
I hope this information is helpful and I would be happy to discuss any follow up questions you may have.
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