Myths about root canal treatment: After having endodontic therapy, the tooth has been completely restored.

In terms of creating a lasting repair for a damaged tooth, having root canal treatment is only a part of the total process that is required. Once the endodontic therapy has been completed, the prompt placement of an appropriate dental restoration is needed too. This final restoration will help to protect the integrity of those accomplishments produced by the root canal treatment as well as the tooth itself.

What purposes must the tooth's final restoration provide?

The permanent restoration that is placed in or on a tooth after its root canal treatment has been completed provides protection in two ways.

» The tooth's permanent restoration helps to prevent coronal leakage.

Coronal leakage refers to an phenomenon where contaminates from the mouth seep past a tooth's dental restoration and back into a treated tooth's root canal system, thus leading to endodontic failure.

» The final restoration helps to create a tooth state that is structurally sound.

The status of teeth that have had root canal treatment is often one where their structural integrity is compromised. A portion of this frailty is usually due to those original, often damaging, events (such as tooth decay and fracture) that have lead to the tooth's need for treatment. The fact that some tooth structure must be removed so the dentist or endodontist can access the tooth's nerve space adds further insult.

If the tooth is in a weakened state, the restoration that is placed after its endodontic treatment has been completed must be one that has a strengthening effect for the tooth. Otherwise the tooth will be at risk for breakage or outright fracture and the complications associated with them.

What type of permanent restoration will be needed for a tooth that has had root canal treatment?

The type of dental restoration that is used to restore your endodontically treated tooth will depend upon your dentist's interpretation of its needs. A well fitting dental crown will create an excellent seal over a tooth and at the same time provide a significant strengthening effect for it (the dentist may need to place a "core" or "post and core" in preparation for placing the crown). Increasingly, placing a dental crown on an endodontically treated molar has become the "standard of care" in dentistry. In some cases, however, the simple placement of a dental filling may suffice. Since this determination will vary on a case-by-case basis, you simply need to defer to the judgement of your dentist or endodontist when choosing a restoration.

How soon does the permanent restoration need to be placed?

Your dentist or endodontist will make a recommendation about the time frame that is appropriate for placing your tooth's final restoration. The term "as soon as is reasonably convenient," meaning not an emergency but definitely a priority might be considered applicable. In general, the temporary restoration that has been placed to serve in the interim typically can't be relied upon to provide a significant strengthening effect for the tooth. Additionally, the seal created by this temporary restoration will not be as lasting, and typically not as impervious, as that provided by the placement of a permanent dental restoration.