Question:
My old dentist said I needed root canal treatment on my back bottom tooth
(the one next to where my wisdom tooth used to be). For various reasons I
left that dentist before the treatment was complete. My new dentist says
that after the root canal I will need a cap, otherwise there is a danger
that the tooth will split apart. This will cost me GBP 90 (about USD 150). I
am surprised that the first dentist didn't mention this, and I wonder if the
cap is really necessary or if my new dentist is talking me into expensive
surgery I don't really need. Any advice appreciated.
Answer:
If the tooth has a mate on the upper arch against which it functions, then
it will very likely need a cap. The back teeth are under a tremendous amount of
pressure when you chew. Just stick your finger back there and bite down if you
doubt what I say. To do a root canal, we have to hollow out the nerve chamber,
and that weakens the support the tooth has. Chewing on this weakened tooth can
cause a fracture of not only the part of the tooth you see above the gumline,
but also the root that lies below the gumline. This sort of fracture is
non-fixable the majority of the time, i.e. the tooth would have to be pulled if
this happened.
Now as far as your previous dentist not informing you....Sometimes we are so
focused on fixing your immediate problem (tootah ache) that we discuss the root
canal and forget about the follow up stuff. Or maybe your dentist was afraid
that you would get sticker shock if he presented it all at once, and decide
against getting the root canal done. Or maybe he didn't think you need it. But
most textbooks will tell you that a molar tooth that is under chewing forces
will need a crown following a root canal.
