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Dentistry/Crown on a wisdom tooth


My wife has all her wisdom teeth.  She developed decay under a filling in #17 that looks close to the pulp on X-rays, so it might not be possible to restore with a simple RCT.

I know that the conventional wisdom is just to extract the wisdom teeth at this point.  This would be very psychologically traumatic for my wife however, and she would rather restore it if possible.  Fortunately money is not a problem for us and we wouldn't take it into account in treatment planning.  I think the real considerations for us is whether the tooth can be restored successfully and are complications likely.

Assuming the tooth can successfully receive RCT (I realize this can be harder on a wisdom tooth), do these teeth present additional problems when doing a crown?  In case it helps, her wisdom teeth erupted perfectly straight and don't look to me visually different from her other molars.



Dear Jonathan:
I understand your concern and I do understand your wife's attachment to her wisdom tooth, pardon the pon.
However, let me help you make a rational, educated decision.
There is no blanket statement about wisdom teeth removal or any other treatment.  Each situation is individual and each person has different circumstances and needs.
People, and unfortunately most dentists, think that the first step in treatment of a tooth with extensive decay and/or hurts is doing the root canal treatment.  That is NOT a proper way to approach it.  A fantastic root canal treatment is useless without a properly execute and fabricated crown.  Even the American Association of Endodontists states that a root canal without a proper crown is a waste of effort.  I have seen too many people spend good money on root canal treatment, only to find out that the tooth cannot be restored.  What a shame.
In your case, if the tooth is functional, i.e. has an opposing tooth and is properly positioned, you can attempt to have it restored.  For most people it is a considerable expense and commonly, I just advise most to just have the tooth removed.  Most people do not use their 3rd molars and they are out of proper position anyway.  All they are is a plaque trap that the patient cannot clean.
However, if, as I said, you can afford to have it fixed, and the tooth is functional, the first step is to have your dentist, or prosthodontist prepare the tooth for a crown and fabricate a provisional restoration.  If that can be done properly, then, and only then, should you have root canal treatment performed.  The properly made new crown should be delivered within 3 weeks following the completion of the root canal therapy.  This sequence will yield the most predictable result for you and your wife over time. now you know...
Best of luck,


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Zev Kaufman, D.D.S.


I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.


Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

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