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The Dreaded Root Canal & The Infamous Crown
You know it as the worst procedure to get done at the dental office. Even worse than pulling teeth! (That joke NEVER gets old!)
It’s the dreaded root canal. I don’t think I’ve come across a single patient who has had a GOOD root canal experience. They just don’t happen. They’re unicorns. And here’s the reason why:
When do I need to get a root canal done?
Usually, an infection or abscess is causing you a bunch of pain. You go to work and pop half a bottle of Motrin to make it “tolerable” for a few weeks. Then the throbbing gets so intense it starts waking you up in the middle of the night. The infection that started out as a nuisance has ballooned into a swollen abscess filled with an ocean of nasty bacteria. You (or your significant other, because you’re in so much pain now you can’t even talk on the phone) finally make an appointment to be seen by your dentist and the treatment is clear: you need a root canal.
Unfortunately, the local anesthetic (numbing agent) we use to calm the pain down and get you out of pain and discomfort doesn’t work in areas with large infections. The acidity of the infection counteracts the anesthetic and makes getting numb much more difficult. That means your dentist can’t get you numb, no matter how many injections he gives you.
The end result is the patient, you, has to get the procedure done without being completely numb. This is not a good situation for anyone involved, the patient OR the dentist. In the presence of an abscess, getting a root canal done can be a painful procedure.
What if I don’t have an abscess?
If there isn’t an infection and you need a root canal because your tooth is starting to crack or there’s decay under an old filling, and you’re not having significant pain, the chances are good you’ll be able to get profoundly numb before getting a root canal.
But a root canal isn’t normally a standalone procedure. After root canal treatment your tooth is left very brittle and prone to splitting (which leads to an extraction) and wasting that root canal procedure you just paid good money for! You need to protect the fragile tooth underneath with a crown. Many times I get asked when I prescribe a crown as the recommended treatment to restore a broken tooth “Do I need a root canal?”
The answer is – usually not.
This is another one-way street in dentistry. Every time you get a root canal you need a crown on the tooth, but NOT every time you get a crown do you need a root canal.
A crown can be done on a healthy tooth and it isn’t necessary to do a root canal on it. That isn’t ALWAYS the case, but it usually is. So the next time your dentist tells you to get a crown done, don’t worry about needing the root canal. But if your dentist tells you you need a root canal, be prepared to get a crown too.