One of the most common questions we hear from patients is: “Do I need the root canal or the crown first?” It’s a great question—and the answer depends on your tooth’s unique situation. Let’s walk through the difference between the two, how they work together, and how we help you decide what comes first.

First Things First—What’s the Difference?

Before we dive into the order of treatment, let’s make sure we’re on the same page.

  • Root Canal: This procedure treats infection or inflammation inside the tooth. It involves removing the damaged pulp tissue, cleaning and sealing the canals, and protecting the tooth from further infection.

  • Crown: A crown is a protective cap placed over a tooth to restore its shape, strength, and function—especially after it’s been weakened by decay, a fracture, or a root canal.

Think of a root canal as fixing what’s going on inside the tooth, and a crown as protecting it from the outside once it’s been treated.

Which Comes First?

In Most Cases: Root Canal First

If the tooth is infected or painful, the root canal needs to happen first. Why? Because the infection must be fully treated and the inside of the tooth properly sealed before a crown can be placed. Placing a crown on a tooth with an untreated infection can trap bacteria inside, which leads to more pain, more damage, and possibly more costly treatment later on.

So if your tooth is hurting, sensitive to pressure, or has been diagnosed with an infection—you’ll need a root canal before the crown.

In Some Cases: Crown First (With a Plan)

There are rare situations where a general dentist might place a crown first—but only with the understanding that a root canal might still be needed down the road. For example, if a tooth is severely worn or broken but not currently infected, a crown could be placed to restore structure and function.

However, it’s important to monitor that tooth closely. If pain, sensitivity, or signs of infection show up later, a root canal may still be necessary—often right through the crown. (Don’t worry, we’re trained for that too.)

What If I Already Have a Crown?

If you already have a crown and now need a root canal, don’t stress. In many cases, we can perform the root canal through the existing crown using a small access point. Once the treatment is done, your dentist can patch it up or replace the crown if needed.

Why Timing and Teamwork Matter

The root canal and crown go hand-in-hand, especially when it comes to long-term success. A root canal saves the tooth, and the crown protects it so it doesn’t break or reinfect. That’s why we work closely with your general dentist to make sure the timing is right, and that your tooth is fully restored from the inside out.

Still Not Sure What Comes Next?

If you’ve been told you might need both a root canal and a crown, it’s totally normal to feel a little confused. That’s where we come in. At Eastern Idaho Endodontics, we’re always happy to evaluate your situation and help you understand the best next step for your smile.