My dentist told me I need a dental crown on one of my back teeth. I went in thinking I just had a cavity and was expecting a filling. Now I'm being told I need a crown which costs way more. Is my dentist trying to upsell me or do I really need a crown instead of a filling?
Marcus
Dear Marcus,
This is a really common question, and it's good that you're asking it rather than just assuming the worst about your dentist. There are legitimate reasons a dentist would recommend a crown over a filling, and it has everything to do with how much healthy tooth structure is left.
When a Filling Is the Right Choice
A filling works well when the cavity is relatively small and there's plenty of strong tooth structure surrounding it. The filling material bonds to your tooth and restores its shape. For small to moderate cavities, fillings are the standard treatment and work beautifully for many years.
When You Need a Crown Instead
A crown becomes necessary when the damage to your tooth is too extensive for a filling to hold up long-term. Here are the most common situations:
- •The cavity is large and would require removing so much tooth structure that a filling wouldn't have enough tooth to bond to
- •The tooth already has a large existing filling that needs to be replaced
- •The tooth has cracks or fractures
- •The tooth has had a root canal, which makes it more brittle and prone to breaking
- •There's decay on multiple surfaces of the tooth
Think of it this way. A filling patches a hole. A crown wraps around and protects the entire tooth. If the hole is too big, a patch won't hold. You need the full protective cover.
The Risk of Choosing a Filling When You Need a Crown
Here's where it gets important. If your tooth genuinely needs a crown and you opt for a filling instead to save money, you're taking a real risk. A large filling in a weakened tooth can lead to the tooth cracking or breaking. If the tooth breaks below the gum line, you may lose it entirely. Then you're looking at an extraction and a tooth replacement like a dental implant or bridge, which costs significantly more than the crown would have.
How to Know If Your Dentist Is Being Honest
If you're unsure, there's nothing wrong with getting a second opinion. A trustworthy dentist will show you X-rays and explain exactly why a crown is needed. They should be able to point to the extent of the decay or damage and explain why a filling won't be sufficient.
At our office, we believe in conservative dentistry. That means we always try to preserve as much natural tooth structure as possible and recommend the least invasive treatment that will give you a lasting result. If we recommend a crown, it's because a filling simply won't protect your tooth the way it needs to be protected.
This blog is brought to you by Ahwatukee Dentist Dr. Harveer Kaur.
Filed Under: Restorative Dentistry Tagged With: dental crown vs filling, dental crowns, dental fillings, Ahwatukee Dentist, restorative dentistry, cavity treatment
Dr. Harveer Kaur, DDS
Dr. Kaur is the founder of Kokopelli Dentistry, serving patients in Ahwatukee and Chandler, Arizona since 2017. She specializes in family and cosmetic dentistry.
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