I had a root canal treatment on a front tooth a couple of years ago. The appointment itself was excruciating and I wanted to get out of there as soon as possible. The dentist suggested doing a porcelain veneer on the tooth but as I said, I just wanted to get out of there pronto. Eventually, the tooth started turning dark so I needed to do a restoration. I went to a different dentist hoping it wouldn’t be such a horrifying appointment. This dentist did a dental crown, though. That made my tooth a tiny nub. Which was the right treatment?
Brooke
Dear Brooke,
From a dental school perspective, dentists are taught that you restore a tooth with a crown after a root canal treatment. That does not necessarily mean it is the best treatment for a front tooth. One of the problems is that porcelain veneers aren’t taught much at all in dental school. Combine that with the darkening of the underlying tooth and doing a porcelain veneer on a front tooth is beyond the cosmetic skills of most cosmetic dentists.
Why are Veneers a Better Restoration after a Root Canal?
Front and back teeth have different types of chewing stresses. When a back tooth breaks, it will usually do so between the cusps. Having a dental crown over the tooth protects that from happening. Front teeth, however, have no chewing stresses. Almost all their stress is lateral. The most likely break for the front tooth after a root canal is to snap off at the gumline.
As you can see from the image above, preparation for a dental crown removes quite a bit of tooth structure. this severely weakens the tooth at the gumline. On the other hand, the preparation for a porcelain veneer means only removing a tiny bit of tooth structure, about the depth of a fingernail. This allows the tooth to stay much stronger.
A Word about Your Nightmarish Appointment
Sometimes, when patients have an appointment that is very painful it frightens them from going to the dentist again. If you had trouble getting numb during a procedure, that is often caused by underlying anxiety. Many dentists do not yet realize the connection between anxiety and getting numb. The higher your anxiety, the more difficult it is to get numb.
The easy solution to this is to see a sedation dentist. They can give you a medication, either using nitrous oxide or a pill for oral conscious sedation that will relax you. For mild anxiety, I recommend the nitrous. For higher anxiety, I suggest the oral conscious sedation.
Be aware that the latter is very strong. you will need someone to drive you to and from your dental appointment, as well as stay with you until you are lucid and stable on your feet.
This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.