If you have a tooth that has been compromised by trauma or decay, your dentist’s goal is to preserve as much of the natural tooth as possible. In most cases, they will try to use the least invasive dental restoration. To restore a tooth that does not need a root canal or extraction but is not strong enough yet for a dental crown, dentists will often rely on a dental core.

What is a core in dentistry?

The core of your tooth refers to the center of the tooth, not including the root structure, that appears above the gumline. This core can be damaged beyond repair while still leaving the outside of the tooth and its roots intact. If this happens, it is important to build up the center of the tooth to preserve it. This dental core build-up is sometimes referred to as a dental post and core or just a dental core.

Both a dental core and a dental post and core restoration help preserve your natural tooth.

In some cases, this procedure occurs as the first step of a dental crown. In others, the dental core or dental post and core is enough to restore the strength and health of the tooth.

What are the types of post and core materials?

The difference between a dental core restoration and a dental post and core is the amount of damage that needs repair. If more than half of the tooth is damaged above the gumline, then a dental post will also be used to provide more stability for the tooth. Otherwise, a dental core is sufficient.

For a dental core, the most common and effective material used is tooth-colored composite resin. This material is strong but flexible and bonds well to natural teeth. Additionally, composite resin blends well with your natural teeth to make this restoration less noticeable. In the past, silver amalgam was an option. Now, dentists are moving away from this material in favor of the longer-lasting, more natural-looking composite resin.

A dental post has a few more choices of material, each with their own pros and cons.

  • Zirconia: Very strong, but brittle and can fracture
  • Ceramic: Also strong but nearly impossible to remove if fracture occurs
  • Resin reinforced with fiber: A good option, but fibers can fray and cause the post to fail
  • Carbon fiber: Very much like original dental material but the dark color can show through teeth
  • Fiberglass: Less brittle than ceramic materials but challenging to manufacture.
  • Metals including stainless steel, titanium, gold, and gold alloy: Most often used due to their strength and flexibility

What can I expect during a dental core procedure?

A dental core procedure is much like the procedure for a filling. Because the decay is usually deeper than a filling, your dentist will offer you a numbing shot of Novocain. They may also offer nitrous oxide if you are feeling nervous or unsettled during the procedure. Patients who feel tremendous anxiety at the thought of dental work may be prescribed a mild sedative to calm them beforehand.

Once the area surrounding the tooth is numb, your dentist will use a dental drill to remove all of the decay. This is a crucial step. Any decay left behind can contribute to the development of recurrent caries, a condition where a cavity develops below a dental restoration. Decay can occur on the top, sides, and back of the tooth.

Once the decay is removed, the tooth will be rinsed to remove all debris. Your dentist will then apply a mildly acidic solution to etch the enamel. This provides the composite resin a grippy surface to adhere to.

The procedure itself

Once the teeth are cleaned and the acidic solution is applied, your dentist will insert thin pins with self-setting crews into the tooth. Just as a house has a framework of timbers to which insulation and drywall is applied, so, too does the tooth have this framework of pins. This gives the dental restoration more stability.

If, as noted above, you are missing more than half of the tooth above the gumline, your dentist may elect to set a post into the center of the tooth to provide more structure. In this case, the pins