Monday, March 25, 2013

Why Crown A Root Canal Treated Tooth

Many often wonder if it's absolutely necessary to crown a tooth after it has been treated with a root canal. Well, nothing is absolutely necessary. It all depends on the desired outcome. If losing a tooth is not of much concern, then a crown is not necessary. It all depends on each person's priorities. If the desired outcome is to keep the tooth for as long as possible and hopefully for a person's entire lifespan, then YES, a crown is necessary.
Take a look at the chart below. Here we see that the percentage of teeth that fracture is significantly higher when the tooth is not protected with a crown. These percentages change depending on the timeframe we're looking at. I got the chart from Google Images and therefore do not know what timeline we're looking at.

I see numerous fractured teeth almost daily in my practices. People often ask how long they have until the tooth will fracture after a root canal if a crown is not placed to protect it. I cannot answer this question with preciseness. It may take as little as a couple hours or it may take years. One thing is certain though, as time increases, the percentage of teeth that fracture also increases. So if we want to keep a tooth for many years to come, then a crown is absolutely necessary.

A common occurrence when a crown  is not placed

So why is a root canal treated tooth more susceptible to fracture when not crowned?

In the diagram below, we see a depiction of a tooth treated endodontically (with a root canal). Here we see a hollow tooth. The problem with this is that when subjected to chewing forces, microfractures develop at the weakest points. These fractures spread just as windshield fractures do. The fracture will inevitably spread. A crown encompasses the tooth and redistributes the forces. This will protect the tooth from undesirable forces and thus significantly prevents fractures.

Weakened tooth structure

In conclusion, if you place enough value on your smile and your ability to chew food adequately, then you must a crown a tooth that has been treated with a root canal.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Tuesday, March 12, 2013

What Exactly Is A Root Canal?

There is so much misinformation about root canals in the public. For some reason most people are incredibly terrified of root canals. This may be due to many people on television over dramatizing root canals. We may also have friends and family telling us their horror stories with root canals.

Here's a little secret.............ROOT CANALS DON'T HURT!

Many of you may be asking yourselves how this could be the case. The problem is that the vast majority of the population does not visit a dentist except for when there is an emergency. When you have an infected or inflamed tooth, there can be significant pain. This will prompt a visit with the dentist. The dentist may then tell them that they need a root canal. They will then associate the pain and the root canal. However, the root canal doesn't cause pain. The pain is the result of an infected or inflamed tooth. The good news is that once you're numb, there is no pain with the actual procedure.

In the diagram on the left, an inflamed pulp is depicted. In this case the inflammation was caused by the large area of decay in close proximity to the pulp. When this occurs, you may experience pain when there are rapid thermal changes on a tooth like when you eat or drink something cold. You may even feel the tooth throb as if you can feel your heart beat in your tooth. These are tell-tale signs of inflammation within a tooth.

The diagram on the right is depicting an infected tooth. In this case, the nerves and blood vessels are necrotic (dead). Therefore, pain is not elicited with hot or cold. However, there can still be significant pain when biting pressure is applied. This is because the surrounding bone is also infected and any pressure on the tooth will be felt in the affected areas of bone. You may notice an area of swelling in the face or in the tissues surrounding the infected tooth. You may even notice a foul taste originating from a small hole in the gums where pus may drain from.

So what do we do in these cases? A root canal!

A root canal is really quite simple. The sole goal of a root canal is to remove the pus, bacteria and diseased/necrotic tissue. That's all it really is. Once the canals are thoroughly cleaned, we then seal the canals to prevent recontamination of the canal spaces. In the radiograph (x-ray) below, you'll see an example of two teeth that have been treated. Notice the black areas at the tips of the root. These are areas that have an abscess. The white areas are the canal spaces that have been sealed.

If you understand what I just said about root canals, you will no longer fear them. I hope this has helped the fearful.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit