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Do I Need A Crown?

My dentist recommended I have a crown. Do I have any other options?


Let’s first look at what a crown is.  A crown covers all the sides and the chewing surface of your tooth. There is nothing else that covers a tooth in the same way a crown does, so there really is no equivalent treatment, but there are other choices you might make.


A crown is recommended:

   When you have lost a large part of your tooth to decay

   When you have lost a large part of your tooth to an accident

   When you break off a large part of your tooth

   When you have a filling that covers 75% or more of your tooth

   When you’ve had a root canal


In the first four items of the list above, the result is that you have less of your own tooth structure to help hold a filling. For the last item on the list, a root canal removes not only your tooth’s nerve, but its blood vessels as well. The blood vessels are what provides nutrition to your teeth. When there is no nutrition, teeth can break more easily. This process is similar to that of trees in the Fall. When the sap stops flowing to the leaves, the leaves change color and eventually dry out and can be destroyed more easily. Since a crown wraps around the sides and top of your tooth, it can help protect your tooth against breaking or splitting.


Now that you know what a crown is and why it is recommended, let’s look at some of the other choices you could make:


Lab-made fillings: You may see or hear these referred to as inlays or onlays. Unlike the silver or white fillings which are more commonly placed by dentists, the inlays or onlays are made as one piece by the dental lab either from metals like gold or from tooth colored materials like porcelain. They are then cemented to your tooth. Because they are one-piece, they are less likely to break than fillings done in the office, but in some cases they may cost almost as much as a crown. Some offices now have milling machines that can make something similar while you wait; however, only time will tell if these materials last as long as those used by a dental lab.


Large fillings: In some cases, your dentist can place a large silver or white filling in your tooth. If there is not enough of your tooth left to hold a filling, you may need a retention device to give the filling something more to hold onto. While these do work in some cases, there is some evidence that these devices cause microscopic fractures in your tooth that may grow over time. In addition, filling materials do have limits, so your filling may not have the same shape or contours that your real tooth did. And if more of your tooth or any of the filling material breaks or fractures, you may need to have a crown done anyway.


Stainless Steel Crowns: If a lab-made crown is a custom fitted suit, a stainless steel crown is a one size fits most piece of clothing . A lab-made crown is custom fit to your tooth. Stainless steel crowns come in several sizes and are silver colored. Your dentist will pick the size that fits the closest and modify it to fit your tooth.  They do not seal as tightly around your tooth as custom-made crowns and are more likely to allow food, liquids and saliva to leak around them. This leakage can cause another cavity, one which may be harder to detect. They may be a good choice if you need a short period of time to save up for a lab-made crown.


Remove the tooth: This is often the least desirable option. Anytime a tooth is removed, the bone that was around the tooth gets smaller and other teeth can shift or move. In addition, replacing the lost tooth will probably be as expensive or more expensive than doing the crown.



Each dental situation is unique and this article is only meant as a guide. If your dentist has recommended a crown to you, it may be best to ask him or her to show you why the crown is being recommended and to ask if there are any other treatment options available to you. If you do not have a dentist or would like to discuss other treatment options, please call my office at 440-960-1940 to make an appointment or you can use the contact form on my website at www.drjrobb.com


*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.

Jennifer G. Robb, DMD is a general dentist who sees both adults and children.
1320 Cooper Foster Park Rd. W
Lorain, OH 44053