Case Study: Waiting Too Long to Have a Crown After a Root Canal


A patient in her early 60s returned to the office this week to get a crown.    She first came in just over a year ago presenting with many dental needs. As a very heavy grinder,  she had not only gum recession but severe abfractions (this is when grinding is so strong that tooth structure is gradually knocked out, much like an ax would take a wedge out of a tree when chopping it down). On one tooth she had taken out so much tooth structure that the nerve was actually exposed. On this particular tooth, a root canal was recommended.

Because of her personal economic condition, this patient waited four months to have the root canal performed. All went well without a hitch but she didn’t follow the advice to have a crown placed on this tooth as soon as possible.

This week, 8 months after the root canal, she finally presented for her crown. As a matter of routine, I take a new x-ray to make sure that all is stable after the root canal. Although the tooth was not hurting at all, I noticed a possible fracture on the tooth, both visually and on the x-ray. There was also a lot of bone loss on one side of the tooth which is another sign of tooth fracture. This patient was very upset by this recent finding.

I referred her to my surgeon who has a CT scan, and he confirmed my findings. After all the work she had done on this tooth, the tooth needs to extracted and an implant placed.

So, getting a crown on a tooth soon after a root canal is important. Time is of the essence! And the more a patient grinds their teeth, the more important it is!