A question I get asked at least once every week, “Why do I need a crown? Why can’t I have a filling?” First, what exactly is a crown? A crown is a full coverage restoration, meaning, it encompasses the entire tooth from the chewing surface to the gumline. A crown helps hold the tooth together so a piece of it doesn’t break.
We place crowns on teeth whenever the tooth isn’t strong and we are trying to prevent it from breaking. A tooth is not strong when it has a very large cavity, the tooth is already broken, there are significant cracks in the tooth, or there is a very large filling in the tooth. When one or more of the above are present, a tooth needs a crown. For example, a tooth has a large existing filling and now has a cavity present, or a tooth has a large existing filling with significant cracks in the remaining tooth structure.
So why don’t we place a big filling, see how long it will last, then, crown the tooth when it finally breaks? Teeth are very weak whenever there is as much filling material as tooth, or, more filling material than supporting tooth, making it very prone to breaking. And teeth break very unpredictably. The tooth can break into the nerve, in which case root canal treatment is needed prior to crown placement. It can break all the way to the bone, which makes it very difficult to restore if it is even restorable. Or a tooth can break in half where all we can do is remove it. A crown will always be more supported and a better long term restoration with as much natural tooth as possible supporting it. If we wait until the tooth breaks, there will be much less of a stable base to support the crown.
See your dentist regularly so he or she can help prevent tooth breakage, and, possible tooth loss. Like everything in our bodies, if you wait until something hurts, the treatment is much more complex and often more costly.