[Keram38]

I just had a root canal treatment done today. The dentist filled in the root canals and now I have to go back next week. He recommended that I have crown on that tooth (bottom left 7) and because I had my tooth in front of it (bottom left 6) taken out last year he also recommended I have an implant there.
Now I'm not sure - should I have crown and implant done too? I don't mind my gap as it is too far at the back of my mouth so even if I smile you can't see it.
Obviously, I would prefer just to have filling done instead of a crown on bottom L7.
Also, it would be so very expensive, looking at around £1700.
Any idea? Dentist says he will do the filling but I'm just confused what should I go for...

[Wondergirl]

Having been through similar decision making, I'll tell you what I know to be true from what my dentist told me.

Putting a crown on a tooth that has gotten a root canal is done because there is often not much left of the tooth. A filling would probably chip away over time, so that you'd have to return periodically for more work on the tooth as it becomes more and more fragile. A crown would give the tooth stability and longevity. The implant would replace the missing tooth, would keep your bite from changing (upper teeth will shift in the absence of lower teeth), and would keep the lower gums from shrinking.

I'll PM the dental expert about this thread, and she will give you a much better explanation.

[flossie]

Hi Keram,

Wondergirl has given you good information.

When a tooth has had a root canal the nerve is removed from the tooth leaving no moisture inside. When there is no moisture inside the tooth becomes brittle and can fracture with day to day wear. Often teeth that have had root canals will fracture beyond repair and will need to be removed. A crown will definitely give the tooth more support and reduce the risk of losing the tooth in the long run.

As for the implant to replace the missing tooth... there is actually another option that would take care of both problems. You could have a bridge place which will include a crown on the tooth that has had the root canal, there will be a false tooth attached and then another crown on the tooth in front of the space. This would be less costly in the long run.

There are a couple of reasons for not placing a bridge... 1. if the tooth in front of the space has never had a filling done on it and 2. the bone where the missing tooth is will not stop resorbing.

When a tooth is removed the body naturally allows the bone to resorb. When an implant (the part that gets placed under the gum) is placed the body thinks there is a root there and will regenerate bone in the area. A crown would eventually have to be placed but it wouldn't have to be done right away.

Depending on how long you have been missing the tooth that the dentist wants to replace with an implant, it may be more than just a simple implant procedure. The dentist has to know how much bone is there and the density of it. You may need to have some bone grafting done first in order to support an implant. Here in Canada patients are generally sent to have an MRI done to be sure they are candidates for successful implant placement.

Teeth will eventually shift and tilt to fill in spaces where others have been lost and if the tooth above the space isn't hitting a tooth on the bottom, it will continue to erupt until you have to have it removed too.

I hope this gives you a little more information to help you with your decision making. In the end, your teeth are yours and you can choose to do what you want or don't want to do.

Good luck!