The question of who performs root canals and crowns involves both general practitioners and specialized dentists, depending entirely on the complexity of the case. These two common procedures—root canals for eliminating infection within a tooth and crowns for restoring a tooth’s structure—are fundamental to saving damaged teeth from extraction. The dental field employs a tiered approach to ensure the best possible outcome for any given situation.
The General Practitioner’s Role
The General Dentist (GP) serves as the primary care provider for nearly all oral health needs and is the first professional trained to perform both root canals and crowns. A GP’s education covers the full spectrum of restorative dentistry, making them fully qualified to address routine cases. They manage the vast majority of standard crown preparations, material selection (such as porcelain or zirconia), and final placement, which is a common procedure following significant decay or fracture.
For root canals, the GP typically handles straightforward cases, often involving single-rooted teeth like the front incisors or some premolars. These teeth generally have less complex internal anatomy, making the cleaning and sealing of the root canals manageable with standard dental equipment. The decision to perform the procedure or refer it out often comes down to the dentist’s individual comfort level and the specific anatomical challenges presented by the tooth.
Focusing on Root Canals
The specialist who focuses exclusively on the pulp (the soft tissue inside the tooth) and the tissues around the tooth root is called an Endodontist. This practitioner completes an additional two to three years of post-dental school training dedicated solely to diagnosing and treating tooth pain and performing root canal treatments. Their concentrated focus allows them to handle the most challenging infections and complicated internal anatomies.
Endodontists routinely manage cases like retreatment, which occurs when a previous root canal has failed and requires meticulous re-cleaning. They are also the preferred choice for teeth with highly calcified, curved, or narrow canals, especially the multi-rooted posterior molars where access is difficult. They utilize advanced technology, such as the dental operating microscope, which provides high magnification to navigate the intricate root canal system with precision. They are also trained in surgical endodontics, including a procedure called apicoectomy, which involves removing the tip of the tooth root and sealing the end.
Focusing on Crowns and Restorations
The specialist dedicated to the restoration and replacement of teeth, including complex crown work, is known as a Prosthodontist. After dental school, they undergo three years of advanced education focused on dental materials, bite mechanics (occlusion), and the aesthetic and functional rehabilitation of the mouth. They are essentially the architects of a patient’s smile and bite.
While general dentists place standard crowns, Prosthodontists specialize in complex restorative challenges requiring a comprehensive understanding of the entire oral system. This includes cases involving severe tooth wear caused by bruxism (teeth grinding), full-mouth reconstructions, or restorations involving dental implants. They possess specialized knowledge in designing crowns and bridges that integrate seamlessly with jaw function and surrounding tissues, ensuring long-term stability and optimal aesthetics.
When a Specialist is Necessary
The need to see an Endodontist or a Prosthodontist is determined by the complexity of the case, not just the procedure itself. For a root canal, referral becomes necessary if the tooth is a molar with multiple, curved roots, if the initial treatment has failed, or if the infection is severe. The specialized training and equipment of the Endodontist are designed to overcome these anatomical and pathological challenges.
For crown work, a referral to a Prosthodontist is recommended for full-mouth rehabilitation, cases where many teeth are missing, or when the patient has a history of bite problems or severe wear. The Prosthodontist’s expertise in designing complex restorations and planning treatment involving implants makes them the authority for these extensive plans. Most patients begin with their General Dentist, who makes an informed assessment and provides a referral to the appropriate specialist when the situation demands focused expertise.