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Root Canal Final Restoration -- Do I need a crown?

March 15, 2017
Posted By: Evolve Dental Care
Dental Crowns in Allentown PA

You just had a root canal procedure done. It wasn’t that bad, was it? But now what happens? What kind of root canal final restorations best for me? Do I need a filling? Do I need a crown?

You’ve done the right thing for your tooth and yourself by not having it extracted. Replacing your extracted tooth later would involve a lot more time, pain, effort and expense! 
Replacement would require either a dental implant or dental bridge at the very least; more expensive, more time-consuming. 

Having a root canal (dentists call it endodontic treatment) saves you time and money over the long haul. But now that you have completed the root canal part of saving your tooth, it becomes even more important that you now have the most appropriate restoration for your tooth. In this article, we’ll give you the information you will need to understand and discuss with your own dentist the thinking and rationale behind his/her decision for using a specific final root canal restoration be it a filling or a crown.

Root Canal Final Restorations/Condition of the Tooth  

The type of final restoration recommended for an endodontically (root canal) treated tooth is directly related to factors involving its condition at the completion of the root canal filling. 

  • How much of the tooth is left that could support a “regular” filling?
  • Are there parts of the tooth left that look like they might fracture off while eating or biting?
  • If it’s a back tooth, does it look like chewing forces could fracture the tooth in half?
  • Was there a large filling in the tooth originally?
  • Did the tooth have a lot of decay to start with?
  • If it is a front tooth or a back tooth that shows when smiling, is it discolored?
  • Is it a front tooth that is a bit crooked? 

Crowns Versus Fillings


Large amounts of decay or prior large fillings usually indicate that a crown is the best final restoration.  The reason behind this decision comes from the fact that if the tooth was originally restored using a large filling or the tooth was severely decayed, some remaining parts of the tooth may fracture off if a large filling is used for the final restoration.

If a severe fracture below the gums happens, very often the tooth may not be savable and will need to be extracted. In other cases, the tooth may actually split in half. There is no fix for this situation except extraction. Crowning the tooth prevents fractures from occurring. 

In some cases, finding the openings to the roots canal openings may be very difficult and may require the dentist to remove tooth structure “inside” the tooth. This situation usually indicates a crown as the best restoration of choice.

Some teeth that have very large portions of the tooth missing may require a post being placed down into the root(s) for stabilization. These cases in almost all instances require a crown.

A root canal treated tooth may be discolored and “show” during smiling or speaking. These teeth are indicated for crowns if bleaching or whitening procedures are unable to correct the discoloration.

There may be a root canal treated tooth that is mildly or moderately crooked. If these teeth are front teeth, a crown can be fabricated that will correct the problem. 

The smart patient will elect to have a crown done as the final restoration in the first four instances above where much of the tooth structure is missing.  Most people will elect to have a crown done if they have a discolored or crooked tooth. 

It is true that a crown may be expensive compared to a silver or tooth colored filling, but if the tooth ends up being extracted, all the time, expense and effort invested in the original root canal and filling will be wasted. Plus, there will be an additional fee for an extraction!


In the following situations, small to moderate size fillings are indicated because of little or no structural damage to the tooth. A tooth may have a small amount of decay or a small filling and still need a root canal. In these cases, the decay may have been small, but very deep going close or into the nerve. 

The tooth might have sustained an impact from an accident or in some cases damaged from grinding the teeth (bruxism) and need a root canal even though the tooth is completely intact. 
There are also some rare cases where it appears as if there is nothing wrong with a tooth, but the nerve has become “non-vital” meaning there is no blood supply or nerves going to the inside of the tooth. Root canal treatment is indicated for these teeth even though they may not cause any symptoms.                                                            

Now you should have enough information to make an informed decision regarding root canal final restorations regarding your own unique situation. 

Call our Allentown PA Dental Office

Dr. Amir Mojahed and Dr. Sunny Mojahed and their knowledgeable staff at Evolve Dental Care are ready to answer your questions about crowns, fillings or any of our other quality and affordable family dental services. Please give us a call today!

“At Evolve Dental Care, we think you and your family deserve to be treated with the same kindness and gentle treatment we would expect for our own families”.

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