Should root canal treatment be done on the support teeth for a bridge?

I have a missing molar on both upper sides. In neither case is there enough bone for an implant, so bridges are needed – given my nocturnal grinding problems, I’ve been advised to get them sooner rather than later (bridges would also deal with my main sites of decay recurrence and filling dislodgment). I’m now in Argentina and able to get them done very cheaply, with a dentist I’m comfortable with. However, he plans to do root canal treatment on the teeth that will be the supports of the bridge; he says it's for practical reasons, to facilitate the work overall. I’ve spoken to two dental surgeries back in Australia, and in both cases they say it is better to leave the support teeth alive (eg to avoid later brittleness), and only to do root canal if there is a problem with those teeth. Do you have any view as to whether it is indeed a bad idea to remove the nerves unnecessarily? Or is it a way of reducing the chance of future decay/pain problems in the teeth within the bridge? Thanks!

Should root canal treatment be done on the support teeth for a bridge?
I see no reason for doing the root canals on perfectly normal teeth. If they were to need them later, the bridge won't be in the way; they'll take it out while working on the root canals.





The ONLY logic I see to this is if the dentist is going to put in screw-and-post crowns after the root canal, which *might* be stronger than the teeth. That's where they put a threaded anchor piece into the jawbone at the tip of the root, then screw the crown down using that anchor. This might make sense, given you've mentioned not enough bone for implants.
Reply:Unless those teeth are decayed or are causing pain, there is no requirement fora root canal.
Reply:I agree with the dentists in Australia, if the teeth are healthy then it is always better to leave the teeth "alive". Putting posts in teeth after root canals does not add stength as lay people think, they are put in for retention of a core/filling material that the crown/bridge fits onto. I would get a second opinion and you are right for checking this out.





You also have to remember that doing root canals will not prevent future decay. The decay can still happen whether the nerve is in or not, it makes no difference with decay and root canals.





The only logical reason, with the limited information that I have, is that the dentist will have to grind your teeth down for the bridge and if you are a grinder, as you mentioned, you may not have room to grind and if he does, he will be into the nerve, then a root canal would be indicated.





Also, you can have root canals done later on once the bridge is in place if needed. A root canal specialist (Endodontist) can make a small hole in the top of the crown and by using a microscope, in some cases, perform a nice root canal and the hole can be filled in.





Good luck !
Reply:You mentioned you are a grinder. If that is correct there is a good chance you have very short molars. I f that is the case the dentist may need to do selective root canal to be able to place post and buildup and then shave the tooth. This does not make your teeth any stronger or prevent future decay however mechanically speaking it might be the only way to give you a retentive Bridge.
Reply:It is usually better to keep the teeth vital. On average, a bridge should give you about 10 to 12 yrs of good service, then if you are like the rest of us, the bridge will fail ( usually due to decay where the bridge is connected to the tooth/teeth). A vital tooth will pain and let you know that something is wrong before the decay ruins the tooth. A root canal will remove the nerve and because of this, the decay runs rampant internally before it is discovered clinically . The repair/rebuild of a bridge that has root treated abutments is often quite difficult. If however you do decide to do the root treatments, please consider reinforcing posts and a core before placing the bridge. At least you will address the fragile nature of root treated teeth.