Should a cracked tooth have root canal before a crown?

[nervypatient]

Hi there - I am hoping for some advice for a current dental issue so that I can feel confident to talk it through with my dentist at my next appointment.

I recently cracked a tooth, it cracked around a large filling, and was advised to have a crown done, the prep for which has now happened. The tooth already feels stronger with a temp crown on but the pain on biting and sensitivity remains unchanged, particularly in the area where the crack is. Because I get anxious as a patient, I tend not to communicate so well in appointments and I don't think I made a very good case for how bad my tooth / sensitivity (hot/cold/sugar) pain was before crown prep - and i'm now wondering if I should be pushing for root canal to be done before the final crown is fitted? Dentist didn't feel it was needed as no sign of issues on the xray, no decay, and the large filling had just been re-done, but I guess that's my only hope for being totally pain free in that tooth given it has vertical cracks? Is there any likelihood of the nerve calming down?

Should I push for root canal, or can it be done as a secondary procedure once the final crown is fitted, if the whole pain situation does not resolve?

Thank you

 

[Gordon]

It's tricky, cracked teeth are horribly unpredictable, you really never know how they're going to go.

If it needs RCT later then it absolutely can be done through the new crown, it might be worth asking the dentist to cement the new crown in with a temporary cement so that it can be easily removed if the tooth still doesn't settle with the crown on.

 

[nervypatient]

Hello Gordon thanks so much for your reply, that is really helpful. I completely appreciate it is hard to know what is happening with cracked teeth and I understand my dentist wont have been able to see if the crack had reached the root because of its position (not visible on x ray).

As I am a nervous patient I don't always communicate well, I get a bit flustered and talk too much and don't always get my point across well. I feel I should have made it much clearer that I was experiencing symptoms of a crack that has reached the pulp/nerve and specifically asked if he'd consider root canal.

But I don't think its too late... I have ten days before the final crown is fitted and there's ample time for root canal beforehand. As a dentist yourself, would you prefer to hear from a patient who is experiencing a lot of pain and who is willing to pay for root canal, so that you could decide if it was necessary before the crown? I just always worry about coming across as an anxious woman and professionals maybe thinking that I'm telling them how to do their job.

Your support in this matter is helping me to be brave and send an email / call the practice next week!! ;0)

Ultimately just want the best outcome as quickly as possible, without having to potentially pay for two crowns if the first one has to be compromised for RCT.


Thank you again for your input.

 

[Gordon]

If it's still causing a lot of pain then going ahead with the RCT would be sensible. I hate to be the bearer of bad news though, sometimes with cracks, even doing an RCT won't fix it
It's really not unusual for patients to be unable to communicate in the surgery, you could try writing questions and stuff down in advance and bring it with you.

 

[nervypatient]

Hi Gordon, just wanted to thank you for your advice. I managed to convince that RCT was necessary despite my nerves, and had first appointment today. Feel instant relief from debilitating nerve pain and nausea. Quite remarkable. Hoping it continues with the next appointment in a few weeks, until completion and final crown. So glad I spoke up. This forum is very valuable to those who are nervous.

 

[Gordon]

That's very good to hear, thanks for the update. I hope it continues to go well for you.