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There is nothing healthier for the gums than having natural tooth structure resting on them. Removing this tooth structure and replacing it with a crown can make cleaning and maintaining the restored tooth much more difficult, especially if that crown does not fit properly, has open or protruding margins, rougher surfaces, or open contacts which can attract and trap food. Most of the time there is also nothing more natural and aesthetic than being able to maintain the original size, shape, anatomy and color of the tooth.
So why do dentists tell their patients that if you’ve had a root canal, then you’ll need a crown? They say it as if it were an automatic, absolute rule or some kind of dental law. This defies common sense! There are no absolutes. Every person is an individual and every situation is different. What may be appropriate for one person may be the wrong thing to do for another person.
Imagine this… imagine you had a very large old silver-mercury (Amalgam) filling in the center of your big molar tooth and it failed, with a deep cavity around it and you had to have a root canal because the nerve became infected. The root canal was completed later and you were left with about 1-2mm of good tooth structure around where the old filling and cavity were. What’s still there looks like your tooth…same size and shape, just hollow in the center. You want to maintain this tooth structure because the gums are healthy around it. The adjacent flossing contacts are intact and food is not trapped, and you like the look and color of your tooth.
An average dentist, who went through traditional dental school, would probably suggest preparing this tooth for a crown after a root canal treatment, which translates to removing most of the good tooth structure you have left. They would cut away that remaining 1-2mm of enamel that you had, bond a post to the newly filled root with this root canal sealer, and have a crown that fits around that post and core with not very solid tooth structure to be kept. Teeth with posts are much more likely to break. And, if a post and crown tooth fails, it is often a catastrophic failure that would require extraction and bone grafting followed by an implant and a new implant crown.
However, you have another option. There is another way that not everyone knows yet. A new, more biological approach to dentistry. With this biological approach to dentistry, one could cover the internal aspects of the tooth with bio-simulating materials that restore the internal connections and durability of the tooth and then use the special layering techniques, adhesive protocols and biocompatible materials that are proposed. in Biomimetic Dentistry to replace what was missing and mimic the natural biology and characteristics of the tooth structure being replaced. This can often be done in one visit and can save valuable time, money and the good structure of your teeth.
Now that you know… what form of dentistry would you rather have done in your mouth? Now there may be times when doing a crown after a root canal is actually the best option. If there is a tooth that is severely cracked and needs full crown coverage, then it may be indicated in that case. When an old crown is replaced, then yes, it makes sense to create another new crown in its place. Often, an inlay or overlay (indirect partial coverage restorations) can be used instead of a crown after root canal treatment to provide support for thin, weakened veins and give stability to the tooth without removing more of the underlying good tooth structure third of the tooth. .
So, let’s ask that question again… Why do dentists tell their patients that if you’ve had a root canal then you will definitely need a crown? The answer…because that is what is taught in dental schools and residencies around the world. The next question is, why is this the protocol dentists are taught to treat a root canal treated tooth? Why is a tooth with very deep decay near the nerve condemned for root canal treatment? Why does this tooth now have to have a place attached deep into the root? Why must this degraded tooth now be further compromised by removing the rest of the tooth structure and preparing it for a crown, which can compromise the health of the surrounding gum tissue? The answer… this is a technique that the average dentist around the world can understand and practice and use most of the time in this situation without having to improvise, think outside the box or use acquired techniques with further continuing education.
You may choose to be treated by an average dentist with cookie-cutter techniques and someone who doesn’t question protocols that defy common sense, but then ask yourself, is this what you would really choose to do if you did your due diligence and had the knowledge to do you have now It might be more convenient to see that average intern because it’s on your plan or close to you, but is it worth it when it could be more costly down the line? I encourage you to visit our website www.drmarclazare.com to learn more about what a Biomimetic Dentist certified in Biomimetic Dentistry can do to save your tooth structure.
I am very proud to be one of the few certified Biomimetic Dentists and Certified Biomimetic Instructors not only in New York but in the country. Once my mind was opened to how we can save more teeth from unnecessary root canals and invasive preparations using the techniques, materials and protocols of Biomimetic Dentistry and Biological Dentistry, I can never go back to the assembly line protocols I was taught in dental school years ago. Graduating from dental school may feel like achieving that Black Belt in Karate, but that’s just the beginning. Lessons and learning don’t stop at first grade. There are nine degrees until you become a Master.
If I have piqued your curiosity and you would like to learn more about Biomimetic Dentistry, please email us at office@drmarclazare.com or call us at 332-334-8290 to schedule a consultation with me or my colleague Dr. Teresa Fay.
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