Crown without root canal: is it possible and what to expect?

Although root canals and dental crowns are two different procedures, they share the same goal. To protect and save the tooth for as long as possible.

Root canal treatment involves treating the inside of the tooth when the pulp is irreversibly damaged. A crown, on the other hand, restores the visible part of the tooth.

You may think that placing a crown would automatically require a root canal as the two often go together. However, this is not always the case.

We will discuss in this article why a crown does not always require a root canal, when it is necessary, and what to expect in the long run.

Why would you need a crown in the first place?

A dental crown is a permanent restoration that covers the visible part of the tooth. It is one of the most common procedures in dentistry.

When your tooth is severely damaged by decay or trauma, it can no longer support a filling. In this case, a dental crown may be the only way to restore and save it.

It can also provide high aesthetic results when it comes to restoring front teeth. Although veneers are the best option in this regard, they have their limitations. Your dentist may recommend crowns over veneers if there are deep stains or significant damage.

In addition, dental crowns can also correct minor crowding or malposition, allowing you to avoid wearing braces.

For vital teeth, crowns protect the pulp from external irritants, including bacteria, plaque, and food debris. They can therefore increase their longevity in the mouth.

For non-vital teeth (with root canal treatment), they strengthen the tooth structure and protect it from further damage. Root canal teeth are more fragile and susceptible to cracking. This is why capping a non-vital tooth is a common procedure.

Why is root canal treatment not a prerequisite for a dental crown?

The principle of any dental treatment is to preserve as much healthy tissue as possible.

For instance, suppose you have stains on your teeth that can be treated with whitening. Why would you consider a more complex option, such as a filling or veneers that will sacrifice some of the healthy tissue?

The same goes for a tooth that will receive a crown. As long as the nerve is healthy and alive, there is no reason for a root canal treatment that will make the tooth even more fragile and vulnerable.

The situations where you will not need a root canal are when the decay is very far from the pulp, there is no sign of infection, and you do not have sensitivity problems. If you are getting a crown for an esthetic reason, such as repairing a broken front tooth or correcting a slight crowding, a root canal is also not justified either.

Saving the pulp means preserving the natural defense potential of the tooth. In addition, a vital tooth is more resistant to chewing forces than a tooth with a root canal. The latter is more exposed to fracture issues.

A study published in the Journal of Dentistry found that the success rate of crowned teeth does not depend on pulp vitality. Vital and non-vital crowned teeth have the same success rate. Moreover, a large percentage of teeth without root canal treatment (83%) will not show any symptoms over the next 25 years.

Cheung found that after 10 years, the survival rates of vital crowned teeth without root canal treatment were 84.4%.

Situations where root canal treatment is necessary:

There are situations where a root canal may be necessary to prevent potential complications and increase crown longevity. These include:

• Irreversible pulp damage: When tooth decay reaches the pulp, it can cause irreversible damage with a risk of infection.
  Symptoms include intense, stabbing pain with an extensive cavity. In advanced stages, a gum abscess may occur. If this is your case, a root canal will be required to disinfect the tooth and ensure a successful crowning procedure.


• A thin dentin layer: When your tooth is severely damaged and there is not enough structure to protect the pulp from the outside, there is a good chance that an infection will occur afterwards. . A root canal treatment would avoid this risk.


• Severe gum disease: Advanced gum disease can threaten the pulp and cause extreme sensitivity when you eat or drink. A root canal will allow the crown to last longer and save you from pain.