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The Job's Not Complete Until the Filling is Done

Dr. Bruce W. Overton
Diplomate - American Board of Endodontics
Dominion Endodontics

If you are one of the "fortunate patients" who needs a root canal, or has had a root canal in the past, you may know that having endodontic therapy is only part of the treatment in restoring your tooth to full function. In fact, the root canal is not technically considered complete until the final restoration has been delivered by your dentist.

A final restoration can be a crown (cap), a silver filling, or a composite (tooth color) filling. These restorations provide both a protective seal, or barrier from leakage into the root of the endodontically treated tooth, and structural support for chewing and smiling.

The goal of endodontics and restorative dentistry is to retain your natural teeth with maximum function and pleasing esthetics. Occasionally your dentist will place a temporary filling in the tooth once the root canal phase of treatment has been completed, but you must remember that "temporary" means just that, temporary. The maximum time you should have a temporary filling in your tooth is 6 weeks. A final restoration is a must and you will need to return to the office of your dentist for the final restorative phase of treatment.

As far as what type of restoration is required, the safest and most reliable opinion will come from your dentist. In general, all posterior teeth (bicuspids and molars) should receive crowns (caps). Crowns provide full coverage protection since our back teeth are under so much force when chewing. A crown will more or less hold things together if you have a heavy bite, or if you enjoy chewing crunchy snacks.

Should you need a root canal on a front tooth, you may be able to get by without a crown since the front teeth are designed for cutting and incising, not chewing. If your front tooth has been structurally compromised due to decay or an injury, however, a crown is a must and will serve to protect the tooth.

What if your tooth already has a crown? You may or may not need to replace the existing crown. All you may need is a simple core filling to restore the surface of the crown. Your dentist will be the best judge of whether of not to save your existing crown.

Finally, one big misconception of root canal therapy is the belief that it will keep the tooth protected from decay or gum disease. You still need to maintain daily oral hygiene which includes brushing, flossing, or perhaps use of a fluoride rinse. Neglect in this area will result in eventual loss of the tooth, regardless of how well the root canal or restoration was done by your dentist. There is nothing that your dentist can do, that you can't undo through inadequate oral hygiene.

Please keep in mind that your dentist knows best when it comes to deciding which restoration is best suited for your root canal treated tooth. Just as you would not build a house without a roof, the same applies to your tooth. With proper oral hygiene, and regular visits to your dentist, there is no reason you cannot keep your natural teeth for the rest of your life.