Dear Patient, I agree with both the endodontist and your dentist. A crown should not be necessary if this is the only trauma the tooth has suffered, and it doesnt have any missing enamel or large fillings in it. The eye tooth also called the canine, but professionally called cuspid, is one of the strongest teeth in the mouth with a robust, long root. Our teeth are living structures, with nerves and blood vessels that nourish the tooth from the inside. A tooth without the pulp nerve blood vessels is often called a dead tooth, and can be more brittle than a live tooth, However, putting a crown on top of it, will require grinding away healthy enamel and dentin, and wont do anything to make the root of the tooth where most fractures occur less brittle. The only reason to fabricate a crown would be to replace missing tooth structure, such as from decay, or if the crown part of the tooth was missing or fractured. The best advice I could give you would be to be careful from now on and avoid biting into very hard things. Be careful with popcorn unpopped kernels are a serious risk, hard candy, bones, hard nuts, etc. Continue to always wear your occlusal guard. Get checked for an airway problem, since bruxism is highly correlated with sleep breathing disorders such as sleep apnea. Best of luck to you. Robert M Hersh DMD

Without seeing an xray, its hard to make a final treatment recommendation. You may be OK without placing a crown on this tooth for now but at least your dentist should check and most likely adjust your bite so there is no heavy biting pressure that can contribute to a fracture.

Do I Really Need a Crown After a Root Canal on a Canine Tooth?

Thank you for your questionthis is a common and important concern.

In general, whether a tooth needs a crown after a root canal depends on both the location of the tooth and the amount of remaining natural tooth structure. Canine eye teeth are unique in that they are long, singlerooted teeth with strong structural integrity. Unlike molars, which are subjected to heavy grinding forces and have thinner walls after root canal treatment, canines often hold up wellespecially when theres minimal structural damage.

That said, your situation includes two key factors
1. Youve had a root canal which can make a tooth more brittle over time, and
2. You grind your teeth bruxism, which does put extra stress on all your teetheven with a splint.

If the tooth has not lost significant structure and the access cavity was small, you may not need a crown immediatelyespecially with careful monitoring and use of your nightguard. However, over the long term, a crown might be considered as a protective measure, particularly if any signs of wear, fracture, or structural weakening develop.

The most important thing is to work closely with a skilled restorative or cosmetic dentist who can evaluate the tooths current condition and monitor it over time. With good oral habits, regular checkups, and consistent use of your occlusal guard, many root canaltreated canines can last decadessometimes even a lifetimewithout a crown.

Wishing you continued good dental health!

Warmly,
Dr. Steven Davidowitz
Cosmetic Restorative Dentist NYC
Dr. D

Most of the time correct, root canal treated teeth would benefit from crowning to prevent fracture or breakage. This is because teeth are often heavily damaged and weakened to begin with. In some less common situations, the benefit of leaving a tooth uncrowned may outweigh the benefits of crowning. This is highly situational and it would help to have a dentist experienced in crowns and who can monitor the tooth closely.

1.Type of occlusion is really important to make that decision and also how much tooth structure was decayed or involved. Generally for anterior teeth root canal treatment access is from lingual side, not involving removal of large tooth structure, and in normal occlusion we do not chew with anterior teeth and fracture of anterior tooth is very rare and doesnt recommend Crown.
2. If the occlusion is not normal bite, or tooth has large decay which require large build up or change in the shade of the color of tooth, crown is recommended.

You are correct that the majority of teeth that have had a root canal need a crown. This mostly applies to teeth in the back of your mouth or teeth in the front that had large decay and are already compromised. If your tooth died simply because of the trauma, then it likely does not need a crown. Continue to wear your occlusal splint and go to your regular dental appointments for monitoring. People can go many years with their tooth stable like that.

If the access opening to do your root canal is small, a crown may be optional.

Short answer is yes. Anterior teeth do not get the forces that back teeth receive. So on a back tooth with multiple cusps, if a root canal is performed, it is recommended to have a cuspal coverage restoration. For front teeth, you are usually safe not to do the crown if there are not other large fillings in the tooth that would weaken its structure. I would recommend a night guard to protect the tooth from any nighttime unconscious clenching or grinding habits (often time people are unaware that they have this habit).

The standard of care is to get a crown. Root canal teeth are more prone to fracture. A crown and possibly a new splint would give the tooth the greatest chance of long-term survival.

Drew Shulman, DMD, MAGD