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In regard to everything mentioned here but especially that of extracting vs rebuilding your teeth, only an evaluation by your dentist can really help in making that choice.

We will mention that generally speaking no type of replacement dental work is better at withstanding the forces created by grinding than natural teeth, that would include implants and partial or complete dentures. Also, in the case that the teeth are not replaced, then the bruxing forces will be directed to those teeth still remaining and therefore deteriorate them more quickly.

It's possible for crowns to wear through and/or break due to the forces of grinding. Also, the hardness/surface roughness of some types of porcelain-surfaced crowns can actually speed up the rate of wear of opposing teeth when bruxism is involved. So as beneficial as this solution can be, there can be continued problems.

The need for root canal and a dental crown are usually two separate issues. Dental crowns are used to rebuild and strengthen teeth. Root canal treatment is characteristically just used to treat the nerve inside a tooth that has become damaged or compromised. They are not an either/or choice, they accomplish different goals.

In your case (you don't mention any nerve-related problems), possibly your dentist feels that your teeth have worn so much that the nerve tissue inside them will be exposed when they are ground down for the crowns. If that's the case, then root canal treatment is indicated for teeth whose nerve is otherwise healthy.

If you wear a nightguard yet from time to time a tooth breaks due to the excessive forces you create, then its seems that the strengthening effect that crowns can provide would be beneficial.

If you wear a nightguard yet you still have the problem of general tooth wear, it implies that you grind your teeth during the day and therefore need to be wearing some type of appliance during the day too, or at least as often as you can.

As important as doing reconstruction work with your mouth is it seems that the fundamental underlying problem is that the effects of your bruxism are still not substantially controlled. And just as it has affected your natural teeth, it will tend to affect your future dental work too.

Especially if having dental work done is an issue for you, you need to know that the stage has first been set so that the work you do have done will be as successful over the long-term as possible. The source problem needs to be addressed, not just the symptoms it has created.

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