Can the coronation of my tooth wait until January '09 when my treasury will be filled?
May 15, 2008 6:56 AM   Subscribe

How long can I wait after a root-canal on a molar to get a crown put on?

So I took rotten care of my teeth for the last few years (went through an irresponsible "Mummy isn't forcing me to go, so I won't" stage coupled with a move to a new city away form my family dentist).

I had some pain in back molar and, after doing copious research, found a great dentist here in Toronto.

Thus far, he has performed:

1 dental exam
1 full xray
1 partial xray
1 polishing
2 scalings (preventative and perio)
1 basic filling
1 root canal
1 “restorative service” on the root canal tooth

I had booked three further appointments. 1 to take care of some small cavities located under a sealant placed by my former dentist. 1 to prep my root canaled tooth for a crown and 1 to place the actual crown.

My dentist (and the Canadian Dental Association's website) indicate that post-root canal your tooth needs the support of a crown in order to prevent cracking and futher damage (since it is now essentially dead).

My problem is that I have just reached the maximum dental benefit of $1500 that my company insurer is able to pay for the calendar year.

Needless to say, I am loathe to pay $1500 or so for a new crown when my benefits provider should be covering 50% of that cost.

My question: how long post-root canal can I wait until getting the crown placed without risking damaging my tooth too badly? Can I wait until January 2009 when Great West Life will kick in its share?

Further info: the dentist in his "restorative service" on the root canal, removed the temporary filling and replaced it with a permanent one. It's not like I still have the piece of putty in my tooth...

I know you are not necessarily a dentist, nor are you MY dentist, but I would really appreciate your advice!
posted by elkerette to Health & Fitness (14 answers total)
My dentist told me to wait a couple months between the root canal and the crown for just this reason. Perhaps yours would be amenable to the same. However, my root canal was finished in November and the crown was done in January.
posted by mkb at 7:02 AM on May 15, 2008

I, certainly not on the advice of my dentist, waited 3 years between root canal and crown. It may not be recommended but it CAN be done.
posted by MeetMegan at 7:06 AM on May 15, 2008

I was in the same situation as you elkerette, so I sought a second opinion from another dentist. Here's what she told me. Theoretically, you don't need a crown on a root canal. But since the root-canal tooth is now dead (i.e. no nerves), the tooth will become brittle, and has a much higher likelihood of breaking. If it breaks, it comes out altogether, end of story. The crown is there to protect the tooth from breaking.

So, you need to ask yourself this question: are you prepared to live with the risk that your non-crowned, root-canalled tooth might crack in two and break, until such time as you can afford to have a crown put on?
posted by LN at 7:21 AM on May 15, 2008

You might want to find out if your dentist would make a temporary crown for you and if so how much it would cost. I had a root canal done but started having really bad TMJ problems. At the request of the doctor treating my TMJ, all work was halted on working on my crown (I was having it done through a dental school and the whole process took longer and several more appointments than what I gather is normal). It took over a year to sort out my jaw problems, but I was fine with just the temporary crown during that period.

Good luck. Dental problems are no fun
posted by kaybdc at 7:36 AM on May 15, 2008

Definitely at least ask about a temporary crown, or just get the tooth really packed with the filling material. I've had a couple back molars like this for, well, a good couple of years now. I had planned to get braces, which would have probably caused the crown to need to be replaced due to the movement of the teeth (or something...), so everyone involved wanted me to wait to get the crown done. Considering it was going to take a good number of years before the braces were to come off and this didn't seem to be a problem for either my dentist or ortho, I'm sure waiting until Jan won't be a problem at all.

In the end, I still don't have the braces, nor have I had the real crowns put on... guess I should get on that. I hadn't even really thought about it for a while until this question now, to be honest.
posted by cgg at 7:50 AM on May 15, 2008

Having survived a half-dozen root canals with several different dentists, I've always received the same advice: wait a couple of weeks to a couple of months to get the permanent crown put on, but no longer. The root canal process weakens the tooth, which can cause it to split, which can cause a root fracture, which requires the removal of the tooth.

That being said, I once went three years with a temporary crown. I definitely don't recommend it.
posted by chez shoes at 8:07 AM on May 15, 2008

I've done the "years without a crown" thing. With hindsight, it was a big mistake. (Some of this was due to a previous dentist, but that's water under the bridge.)

In theory, you could live your entire life without the crown, just like you could drive for decades without car insurance as long as you don't get in an accident or get pulled over or buy new tabs. It's a question of luck--the longer you wait, the less likely your luck is going to last that long.
posted by gimonca at 8:27 AM on May 15, 2008

I'm reluctant to comment on dental issues (I'm English).

However, FWIW i lived my life with a temporary filling in a root canal for for almost 20 years. Got it properly filled about 3 years ago, and had one change of dentist since then and now. Neither dentist has even mentioned putting a crown on the tooth to me.

I was a private patient for the first, so it's unlikely that they didn't want to do expensive work on an NHS patient. I don't doubt that it's beneficial to crown a root canal, but don't think you need to fear imminent tooth explosions if you eat things that aren't soup.
posted by bifter at 8:39 AM on May 15, 2008

I just had a root canal done on a molar by an endodontist and they made me sign a form that I would get a "permanent restoration" within 6-8 weeks. That was the first time I had ever been asked to sign such a form, but this particular endo is really big on followup care. They told me that molars tend to be under a great deal of pressure from chewing, etc. and that there was a good chance of failure if not covered with a crown. But that could have been my particular situation (there was a hairline fracture in the tooth that necessitated the root canal in the first place).
posted by cabingirl at 8:44 AM on May 15, 2008

I went about 2.5 years without a crown after my root canal. However, around 2 years, the repaired part of the tooth started to break a bit and needed a bit of fixing. At 2.5 years the majority of what had been repaired broke and I sucked it up and bought the crown. As you actually have insurance, if I were you, I'd definitely wait the year.

re: cabingirl's comment regarding molars and pressure, my root canal was my upper left molar; second from the back (my wisdom teeth are still hiding). No headaches from my jaw doing stupid things, and I didn't take particular care to chew with my left side (altho I have had to swear off molases kisses, sigh). My original tooth fractured while I was eating an eclair. Yes, an eclair. As it didn't hurt, the tooth had apparently been in a pretty bad state.
posted by nobeagle at 9:41 AM on May 15, 2008

In the anecdotal spirit of this question, I killed one of my top incisors by falling on my face in the bathroom at camp. I was 14. I had a no-fun root canal on the tooth, and the dentist left a temporary filling in the tooth, so bleach pellets could be put in to keep the tooth from going grey.

Ten years later, I had the temporary filling replaced with a permanent filling, with no other work done on the tooth.

Ten years after that (this past fall), I finally had a crown put on it. The tooth was only just then getting dry and brittle enough to worry about. So, in some cases, I guess you can go 20 years between root canal and crown.
posted by girlbowler at 11:12 AM on May 15, 2008

I've got a root canal plus crown prep that's been waiting two years. It seems fine to me, and my dentist doesn't seem overly concerned. I imagine individual teeth and situations may be different. Why not ask your dentist?
posted by oneirodynia at 12:24 PM on May 15, 2008

I had a temporary crown, waited too long to get the permanent crown, and now have a bridge. A very expensive bridge. Looks like I'm just unlucky, based on a lot of the previous replies, though.
posted by pyjammy at 12:48 PM on May 15, 2008

I once did that, only I waited a couple of years before getting the crown put on. I was lucky and my tooth didn't split, but I did have to have the root canal redone because there was a low grade infection at the tips of the roots.

The second time was a longer and more drawn out process, despite going to an endodontist the second time. (insurance is nice, it pays for expensive specialists)

Just don't chew hard things with that tooth and you'll (probably) be fine until January.

Oh, and just for what it's worth, I had to have the rearmost upper molar pulled along with the adjacent wisdom tooth that was impacting it so severely that it cracked the molar in two, and I don't miss it at all, so if it's at the end, don't worry too much about it.

Or just get a nice plastic (or resin or whatever they make them from) temporary crown. I had one break in half while I was waiting to get a real crown, though. My dentist replaced it at no charge, and the second one didn't do that. I was surprised he didn't bill my insurance company. Maybe he makes enough on the real crown not to care, I don't know.
posted by wierdo at 2:03 PM on May 15, 2008

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