Should I get a crown for my front tooth (#8)?

Question

I had a hairline fracture in my maxilla about 4 years ago, which resulted in getting a root canal done on tooth #8. The root canal went smoothly. I noticed recently in some pictures that my tooth is discoloring a tiny amount. Otherwise, the tooth is fine. I asked my hygenist about it and she recommened I get a crown on it. She said later on, it might crack on something, b/c the tooth does not have a nutrient supply. She said it would become brittle and it was better to be safe than sorry. I am in my mid-20s so of course I am worried about the long-term ramifications of my decision. What should I do? What type of crown should I get?

I have another appt. scheduled in a week. My dentist never said anything to me so I do not know how reliable he is. One more question: Once I have a crown put in, if I were to bleach my teeth, would the crown be bleachable also?

My dentist did mention bleaching internally. But he did not recommend it now. Maybe later on in life. He suggested I get all my teeth bleached first and then get #8 bleached internally. But would that weaken #8?

Answer 1

Internal bleaching... WOW.. who still does that? I dont know anyone that still does that! I'm a Dental Assistant, 14 yrs. and still going... I havent seen that done in like 10 freakin years. I suggest a 'procera' (all porcelain) crown also.

Fact is, if you had a Root Canal done, its NOT a 'vital' tooth anymore. Theres no nerves running through it anymore. Which means no nutrients are being supplied to the tooth anymore. So, YES its going to discolor. Eventually turn a yellowish brown or blacken color. The tooth becomes brittle, as well. Rule of thumb, is on an anterior tooth, its not necessary to have a crown done. But, if its already fractured.. Get the crown...BUT bleach ALL your teeth first!! Once you get that crown made, you wont be able to change the color by bleaching. Porcelain.. wont bleach. But it can/ does stain, over a period of time. Werid, i know.. but true.

Another thing... Crowns/Veneers are not cheap! And no matter how great the doctor is or how great the lab that makes the tooth is... it wont last forever. It's going to depend on YOU! And how well, you take care of it. It can last 1 month.. it could last 25 years...

Answer 2

"And now for something completely different......."

I will be the one to go out on a limb here and suggest something other than a crown. I will assume that your tooth (#8) was not cracked in the initial trauma, since you did not mention that. The rest of my answer is based on that assumption, so just discard this information if your tooth was damaged in some way.

While it is pretty widely accepted that posterior teeth should be protected with a crown after having root canal treatment, many anterior teeth do not need crowns. In your case, there would still be a considerable amount of tooth structure remaining and you may do just as well without a crown. (Again, this is assuming there was no damage to the tooth and no prior fillings.) Front teeth DO take some load, but it simply does not compare to the loads applied in the chewing teeth in the back.

In spite of a couple of the answers above, it may still be possible to bleach the tooth back to an acceptable shade. This would have to be done by the dentist, as it is done internally. The filling in the back of the tooth is removed and then some bleaching chemical is sealed inside the tooth. The process might be heat-accelerated in the office or you might just keep the stuff in there for a week. You go back and have the tooth checked and, when it is finally light enough, you just replace the filling in the back of the tooth.

Your dentist MUST be familiar with internal bleaching before you attempt this. If certain steps are left out, you can do some real harm to the tooth and bone. If you ask about it and your dentist advises against it for some reason, you will have to go with his/her recommendation.

So there's my recommendation. Ask about internal bleaching for tooth #8.

Now to answer some other questions.

At age 25, you can expect that this crown would not last the rest of your life. Although I saw a patient today who has SIX original porcelain crowns on her front teeth that were done in about 1970, you can't count on your crown lasting more than 20-25 years. This is a "good life" for a porcelain crown. If you get the crown now, it will be made to match #9. This is the hardest shade to match - the adjacent central incisor. This is actually the only tooth that has to be a PERFECT match. There is so much more than just "what color" that has to be determined and communicated to the lab that it is very difficult to get it perfect. At age 20, we know that your teeth are going to darken considerably over the next decade of life. If you are mid-20's, I would suspect that a perfect shade today will be too light in ten years. You can try to bleach the rest of your teeth to brighten them up to match your crown. Be aware that the crown will NEVER get lighter if you bleach your teeth.

_IF_ you end up going with a crown, I'd ask about Procera or Lava. If the tooth has darkened, you will need some degree of opacity to mask this out of the shade will still be too dark. These are two products that provide this opacity and they are very strong - when done correctly.

I'd suggest you ask your dentist about the shade change and see what he/she says about your treatment options.

Answer 3

I have had a root canal in tooth #8 also, my dentist said I had plenty of natural tooth structure remaining so it would be fine to wait on the crown. He also offered veneers as an option. I opted to wait for now, and have had no ill effects. I protect it when I play soccer with a mouth gaurd, and am extra cautious when eating things like bagels and apples. It is a bit darker 13 years later. I have had a bleaching tray made with a space made JUST for that tooth, I add the bleaching material to just that area and it is very noticeably lighter after I wear it overnight. My concern with internal bleaching is I have read some studies that it can cause internal resorbtion of the root, if that happens there isn't much that can be done. not to scare you, just wanted to share the info I have looked into.
When/if you make the decision for a crown my dentist friends suggest procera (all porcelain) not PFM porcelain fused to metal, as we age and our gums receded a bit, it shows the metal and just isn't a great look. As for bleaching once you have a crown, you are locked into that shade, most people opt to bleach first then match the crown to the lighter shade.
Good luck

Answer 4

You should definetly get a crown. It will fall apart. I had a root canal when I was 15 and I didn't get a crown. Half of it broke off one day and if I hadn't been lucky enough to have a really good dentist it would have been pulled. It's better to have a crown then no tooth.

Answer 5

At your age, most dentists would recommend an all porcelain crown as a final restoration. Some of the newer materials are strong and nice looking. Since the tooth has a root canal, insurance will likely pay for it (if you have insurance) - at least a portion of the fee.

Ask your dentist to pre-authorize treatment with your insurance company, and then discuss what lab materials are available. Make sure your dentist is experienced with esthetic crowns.

Answer 6

Yes, have the crown done BUT bleach first. Many people like crest white stipes they work great, hard to keep on but they do work. Do this at least a couple week before you go in for a crown. And your Hygienist was right, the Root canal teeth get brittle.

Answer 7

You should deffinetly get a porcelain crown. Not only for asthetic reasons but also because, just like the hygienist told you, your tooth will become brittle and most likely break. Good luck with everything!

Answer 8

Do you know WHY you need 8 crowns? Are you sure you can trust your dentist? Consider a second opinion without giving away why you are there. Depending on WHY crowns were recommended, they might be the only satisfactory solution to your problem OR they might be one big pay day for your dentist!!!!

Answer 9

you should get a crown since the root canal the tooth is not very strong i went through this and my front tooth broke off so i had to get a screw in tooth do it before it is to late i wated to long

Answer 10

If your insurance covers it, then yes. Mine covered the root canal but not the crown. It would've cost me almost $1000. Never did get the crown. That was 3 or 4 years ago & no problems yet, knock wood.