I need a root canal on a front tooth and I received different recommendations from two top dentists on how to handle the tooth after the root canal. One dentist said she recommends placing a veneer over the tooth and the other dentist says that a crown is best because, from his experience, the tooth might dry out and turn dark. My niece is a dental hygienist and she said it could go either way. She suggested that I get a third opinion, but I don’t want to have to see another dentist about this. Which is the right option – a crown or a veneer? And why would I get two different answers from the dentists? Thanks. Jamison

Jamison - Dental school teaches dentists to protect a tooth with a dental crown after root canal treatment. Your natural tooth must be prepared by grinding it down enough for the crown to completely cover it without irritating it. The crown will be bonded or cemented to your tooth.

Top Dentist Recommendations - Crown or Veneer for Front Tooth?

Front and back teeth have different functions. Back teeth are used for chewing and grinding. The pressure on them from chewing food is much more significant than the occasional pressure on front teeth, as when you first bite an apple.

Back teeth

A crown covers the entire tooth—from the gumline to the chewing surfaces and cusps. So it protects back teeth from breaking or splitting under pressure. A dental crown is definitely needed to protect a back tooth after root canal treatment.

Front teeth

Front teeth don’t have a chewing surface. When you bite with them, the upper teeth push backward on the lower teeth, and the lower teeth push forward on the upper teeth. If a front tooth is prepared for a crown, it will weaken the tooth and make it difficult to resist future impact. A skilled cosmetic dentist can use a porcelain veneer to protect your front tooth after root canal treatment.

The photographs below show a front tooth prepared for a crown (left) and two front teeth prepared for veneers (right). Although the crown preparation was more conservative than usual, the teeth that were prepared for veneers have much more of the natural tooth structure intact. Generally, when a tooth is prepared for a porcelain veneer, only .5 millimeter of tooth enamel is removed from the front of the tooth only.

Which Top Dentist Should You Choose?

It’s also good to note that in most cases, tooth discoloration results from root canal filling materials—not from the tooth drying out. An alternative is to use a white fiberglass post to strengthen the tooth and to seal the opening with a dental composite. This process delays discoloration for years and enables a skilled cosmetic dentist to use a porcelain veneer to protect a front tooth.

If one of the top dentists you’ve seen is recommending a porcelain veneer for your front tooth, she likely has experience and skill in this area.

What Should You Do?

• Ask the dentist how many front teeth she has restored with porcelain veneers after root canal treatment.
• Ask to see actual patient before-and-after photos of her work.
• After your conversation with the dentist, if you’re still uneasy, we suggest that you schedule an in-person third opinion with an accredited cosmetic dentist.

The post is sponsored by Chatham, NJ cosmetic dentist Dr. Allyson Hurley. For 11 consecutive times, Dr. Hurley has been named a top dentist by NJ Monthly magazine.