27 Dec
ceramic crown of human teeth

Do I Really Need a Crown

Are you wondering why a dental crown may be necessary for your dental treatment? We hear this question frequently and given the cost, it’s understandable why patients would inquire about different options and want to learn more about why and when a crown is more appropriate and recommended option instead of a filling for example. This blog post will shed some light on this topic.

What Is the Purpose Of a Tooth Crown?

A tooth crown serves 2 main purposes: protecting a damaged natural tooth and restoring tooth shape, strength, and function.

It is a custom-made, protective, and durable cover that is placed over a damaged or weakened tooth, fully encasing it. It provides a strong and durable barrier, protecting the tooth from further damage. Note, this does not mean the tooth will never get a cavity ever again – the crown itself will not develop decay but the underlying tooth structure is still vulnerable to cavities for various reasons which we will cover in a separate blog post.

Dental crowns also restore the natural shape and appearance of the tooth, ensuring its strength, providing longevity, and enhancing its functionality. With a crown in place, you can confidently bite and chew without any discomfort or limitations.

Tooth Filling Versus Crown

See the differences between a filling and a crown made using CAD/CAM 3-D technology to repair decayed or damaged teeth.

Common Reasons Why You May Need a Dental Crown Instead of a Filling

Large Cavities

When extensive tooth decay or cavities cannot be fixed with just a filling, dental crowns are often recommended.

A composite tooth filling is a good solution for small cavities that are found before they have a chance to grow. If a cavity goes untreated for a long time, it tends to grow bigger and deeper, and negatively impact the tooth structure by making it too weak to support a filling. If a tooth becomes compromised to this extent, a crown is a better option to provide reinforcement for the damaged natural tooth and restore its shape, strength, and function, and provide long-lasting protection.

Additionally, if you are wondering when a cavity is too big for a filling, we covered that in a previous blog post on tooth cracks caused by large amalgam fillings where we shared a common rule of thumb: if the width of filling were to exceed 1/2 to 1/3 of the width of the tooth, a dental crown should be placed instead to prevent a tooth fracture.

Significant Tooth Fracture or Chipping

One common scenario where a crown may be recommended instead of a filling is when a tooth is fractured or has a large portion chipped. In such cases, a crown offers more extensive coverage and support compared to a filling.

To preserve the integrity of the tooth and avoid potential complications, the dentist will recommend a crown procedure to help restore the tooth's structure and functionality, prevent further damage, and provide structural support. These are important considerations that a filling might not be able to fully address and hence a crown will be a better option.

Root Canal Treatment

One of the main benefits of a dental crown is its ability to protect an already damaged tooth from further deterioration. If a tooth has undergone a root canal treatment, it was likely in a bad shape already with weakened tooth structure, so placing a dental crown to protect and strengthen the treated tooth will help avoid more extensive treatment in the future.

After a root canal procedure, a tooth may become more brittle and susceptible to breakage. In such cases, a crown is often recommended instead of a filling. A filling may be sufficient in rare circumstances where the tooth has a large amount of tooth structure remaining after the root canal therapy, or if it is a front tooth where there was less work done due to the single canal. In any case, a crown provides an extra layer of protection, reducing the risk of fractures and ensuring the longevity of the treated tooth.

You can look at it this way - a root canal therapy helps save your natural tooth with infected root so you don’t have to have it extracted while the crown helps strengthen and protect the treated tooth so it can continue to function and last for a long time.

Tooth Wear or Erosion

Dental crowns are effective in restoring teeth affected by excessive wear, acid reflux erosion, or grinding. They restore the natural shape, size, and appearance of worn or eroded teeth. Fillings are better suited for minor repairs and treating cavities caused by tooth decay.

Tooth crown on molar tooth

Dental Bridges or Implants

Other examples where fillings would not even be an option are treatments for replacing missing teeth where dental crowns play a crucial role such as dental bridges and implants. In such cases, the crown acts as artificial tooth or cap, and helps fill the gap caused by the missing tooth or is there to support a dental bridge on either side.

Cracked or Weakened Tooth

Cracked or weakened teeth can cause discomfort, sensitivity, and even further damage if left untreated or if not treated promptly.

While tooth fillings can be a temporary solution for minor cracks or weakened areas and are usually more suitable for smaller cavities or chips, they may not provide enough support and protection for more severe damage. A dental crown, on the other hand, covers the entire tooth, from the chewing surface to the gum line, offering comprehensive support and safeguarding the tooth from the continuous pressure that occurs during regular biting and chewing. It’s a stronger and more secure solution that reinforces the structure of a cracked or weakened tooth, preserves the tooth integrity, and helps extend its longevity.

Tooth Sensitivity

There are many reasons why teeth may become sensitive: from worn tooth enamel and tooth decay to periodontal disease, teeth whitening etc. If the sensitivity is caused by a cavity, a filling may be sufficient to address the issue. However, if the sensitivity is caused by a more serious issue, such as a cracked tooth, a crown may be a better option.

Cosmetic Purposes

Sometimes dental crowns can be used for cosmetic reasons, such as improving tooth shape, alignment, or discoloration. If you have discolored teeth due to root canal treatment or excessive fluoride or large resin fillings, they can be covered with a crown to improve their appearance. If you are unhappy with the shape or size of a tooth, a crown may also help. Also, if your teeth are crooked or have gaps between them, they can be covered with crowns to improve their alignment and close the gaps without orthodontic treatment.

Unlike the previous examples where protection and tooth structure support are key, if the purpose is cosmetic there would normally be other options to address these issues instead of crowns such as dental veneers and cosmetic bonding. The latter uses tooth-colored composite material (like the one used in tooth fillings) to address small gaps or improve appearance.

So How Do I Know When A Tooth Crown Is Needed?

Whether a crown or filling is more appropriate treatment will vary for each individual case and only a qualified dentist can assess your specific dental needs and provide guidance on the best course of action.

In general, when a tooth is damaged, the extent of the damage will determine the best course of treatment. If the issue is minor, a filling may be sufficient to restore the tooth’s function and appearance. However, if the problem is extensive, a crown may be a better option. A crown can provide more protection and support to the damaged tooth than a filling. A crown is a cap that covers the entire tooth, while a filling only fills in the damaged area. If the tooth is severely damaged, a filling may not be enough to restore it to its original shape and function.

Wondering about the differences between fillings and crowns and which one is better for you?

While you may find information online and consider self-diagnosis, only a dental professional experienced in dental restorations can provide a thorough examination and personalized advice based on your unique dental needs, determine if a dental crown or filling is necessary, and recommend the most suitable treatment plan. If you are seeking a second opinion, have more questions on crown vs filling dental restorations, give us a call or schedule a dental appointment online with  Dr. Tufa. We are here to help!


Heni Tufa

Dr. Tufa is a general dentist in Acton, MA who is also an Invisalign Provider and certified Botox dentist.