If a root canal becomes necessary to treat extensive tooth decay, you may not have enough natural tooth material left to support a dental restoration. If this happens, your dentist may opt to create a dental post and core for you. Here’s what you can expect during this procedure.
What is a post and core in dentistry?
One of the goals of a root canal is to preserve enough natural tooth material to support a dental crown. In cases where there is not enough tooth decay to pull the tooth, but also not enough tooth material left after root canal to securely attach a crown, your dentist may use a dental post and core.
Essentially, a dental post and core procedure fills in the gap created by removing decayed material. It creates the original shape of the tooth that is needed for a crown.
When would I need a dental post?
There are two actual procedures: a dental core or a dental post and core.
A dental core recreates the shape of your tooth without additional support. A dental post and core includes a post installed at the center of the tooth before a core (the shape of the tooth) is built around it.
Further, a dental post is added when more than half of your tooth above the gumline is compromised by decay. If half or more of the tooth is present, a simple core is probably sufficient to anchor the crown.
A dental post does not inherently make the tooth itself stronger. It is there to offer a structure to build the core around. The tooth may still be very compromised by decay, but the presence of a dental post does help to make the crown more stable, secure, and durable.
What are the different types of dental posts?
Posts can be either prefabricated or custom cast. The post is made to be at least two-thirds of the length of the root canal and no less than the height of the crown in order to ensure secure and stable placement.
Prefabricated posts are placed at the time of the root canal, but cast posts take more than one visit. Non-metallic post materials are used when there is a chance of further tooth cracks or fractures. They are able to withstand more stress without breaking than other materials.
Some common dental post materials include the following. All of them have their 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: 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.
Post design really depends on the need of each individual patient. Dental posts can be straight up-and-down (parallel), tapered, smooth, serrated, or threaded.
The best dental post for the strongest and most durable use is the narrowest, longest parallel post possible for the individual patient. A longer parallel post allows forces of chewing and biting to be more evenly distributed. The smooth post places less force on the remaining root structure. This is unlike a threaded or serrated post that can place excessive force on the remaining tooth and root structure (causing potential failure).
Core materials used to surround the post most commonly include composite resin or silver amalgam, the same materials used in a filling.
What can I expect during a dental post procedure?
The dental post procedure is generally painless, as the root canal is a result of a tooth with nerve damage. For patients who are concerned about pain or worried about the procedure in general, dentists may offer a local anesthetic during the procedure or a mild sedative prior to the procedure. Nitrous oxide is also a possibility during the procedure for patients with anxiety that might otherwise prevent them from receiving dental care.
For a dental core only, the dentist uses dental core materials to build up and shape an appropriately-sized surface for the crown to attach to.
The procedure for a dental post is a bit different. After root canal, the dentist will drill a space for the post to be inserted. They’ll follow the guidelines above to determine the size, shape, length, and material for the post best suited to the patient. If the post is prefabricated, it can be affixed to the prepared space with dental cement or bonding. For cast dental posts, the dentist will use a mold to cast the post.
After the post is placed, the core is created around the post. Together a dental post and core creates a strong base for a dental crown. Your dentist will then follow the procedure for creating a crown. They’ll take an impression and send that impression to the lab to customize a crown.
The final stage is placing the crown with dental cement and checking fit and bite.
Aftercare for a dental post
As with a standard crown procedure, aftercare is not particularly extensive. Your bite may feel a bit off for the first few days, especially if you have needed a crown for a while. This should go away after a few days. If you are still experiencing a bite that feels off after a week, follow up with your dentist to make sure your crown is properly adjusted.
The post and core procedure itself should not be painful. If you do experience discomfort, over-the-counter pain relievers can help. Take them as directed, and speak with your dentist if pain persists.
Avoid eating hard or sticky foods on your new dental post, and brush and floss regularly. You should also visit your dentist twice annually for a regular cleaning. A dental post can last at least eight years with proper care, and often just as long as a crown (between ten and 20 years).
If you are looking for an experienced Phoenix area cosmetic dentist to discuss your dental post options, give AZ Dentist a call today.