Dentistry/Crown and Root Canal
The back part of my upper R. first molar broke off on 26/1/2015. My dentist tapped this tooth (I did not feel pain) and looked at the X-ray, and then said that root canal was not necessary. He said that filling and a crown would be necessary. He also said that after fitting the crown I should have regular checking. He said that removing the crown would break it and damage the tooth, thus if there are problems in the future he would make a hole in the crown and do root canal.
I feel that if root canal is not necessary I prefer not to do it. However, will making a hole in the crown break the crown, weaken the crown (and therefore the chewing ability of the tooth) and allow bacteria to enter ?
On the other hand, if one opts for the root canal treatment, does root canal treatment prevent dental problems from happening in the future? Is it that after doing the root canal treatment, a post would be placed in the root canal and make the crown stronger (than the tooth without RCT) and more able to chew ?
Doctor, what do you think: RCT or no RCT ? Is this dentist right ?
There are a couple issues here, so let me see if I can help you with your decision. First, drilling through a crown to do a root canal is standard procedure since trying to take the crown off may break the tooth and often ruins the crown, so your dentist is giving you good advice. There is always the chance that the crown could be weakened, but that really depends on the filling and amount of tooth structure under the crown. After to root canal is done, a filling is placed in the hole that was frilled into the crown, so there is no leakage.
Doing a root canal if one is not really needed is not a good idea either. Root canals have a high success rate, but nothing is better that what is naturally inside the tooth...the nerve and blood supply.
A post is really only designed to support the underlying filling, it does not strengthen the tooth. In fact there is some risk to post placement as post can cause the tooth to split or fracture. They are a valuable tool, but not used unless absolutely necessary.
Overall, it sounds like your dentist is suggesting the correct treatment for you.
Gary Backlund DMD, MSD