Most people arrive here with a specific question in mind: do I really need a crown, or would a filling do the same job?
It is a good question, and this page answers it. A crown and a filling solve different problems, and knowing which one your tooth needs makes the recommendation much easier to follow.
Filling, Onlay, or Crown?
Think of it as how much sound tooth is left, and where it is.
A filling replaces what decay removed. It works while the walls of the tooth around it are thick enough to take chewing force on their own. Most cavities are this.
An onlay covers one or more cusps without wrapping the whole tooth. It is the middle option, and it is underused. Where a tooth needs more than a filling but its outer walls are still healthy, an onlay rebuilds the chewing surface while keeping more of your own tooth than a crown would.
A crown wraps the tooth completely and holds it together. Once the remaining walls are thin enough that they would flex or split under load, no filling placed inside them fixes that, because the problem is the wall and not the hole.
In short: a filling repairs, an onlay rebuilds, a crown protects. Your dentist will explain which of those your tooth needs and why, and will usually show you the tooth on screen so you can see it for yourself.
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When a Crown Is Genuinely the Right Call
- A tooth has cracked, or has crack lines running down from a large old filling
- A cusp has broken off, which usually means the rest are under more load than they were designed for
- A very large old filling has left thin walls around it, and replacing it with a bigger filling only buys a year or two
- The tooth has had root canal treatment, which removes internal structure and the blood supply that kept the tooth resilient. Back teeth in particular fracture without coverage, and this is the single most common reason a successfully treated tooth is lost later
- Severe wear from grinding has shortened the tooth enough to change the bite
- A dental implant needs a crown on top of it, which is the restoration the whole procedure exists for
Notice what is not on that list: a tooth that simply looks discolored or slightly misshapen but is structurally sound. That is a veneer or bonding conversation, and both remove far less tooth. Crowning a healthy tooth for cosmetic reasons is a trade most patients would not make if the alternative were explained properly.
We make crowns here, in one appointment, rather than sending them to a lab.
Our CEREC Primemill mills the permanent crown while you are in the chair and our Programat CS6 furnace stains and glazes it to match. No impression putty, no temporary, no second visit. Our Learning Center compares same day and traditional crowns in detail.
Materials, and Why the Tooth's Position Matters
All-ceramic crowns handle almost everything now and are what we place in most cases. They are strong, they bond well, and they have no metal edge to show as a grey line at the gum if it recedes.
Where the tooth sits changes the priority. On a front tooth, translucency and how the material catches light matter most, because the crown has to disappear next to natural neighbors. On a molar taking heavy chewing load, strength leads. A heavy grinder needs a different choice from someone who does not grind, and if you do grind, a night guard is part of protecting whatever we place.
Your dentist will explain which material they are recommending and why, and it should be a reason about your tooth rather than a house default. See our knowledge and technology for what we have in the building.
Bridges: Using Crowns to Replace a Missing Tooth
A bridge replaces a missing tooth by crowning the teeth either side and suspending a replacement between them. It is fixed, it is usually quicker than an implant, and it does not involve surgery.
There is a trade-off worth understanding: the two supporting teeth are crowned whether or not they needed it. If they are already heavily filled, that is no great loss. If they are perfectly healthy, you are permanently altering two sound teeth to solve a problem with a third.
A dental implant does not touch the neighbors and preserves the bone underneath, which a bridge does not. It costs more upfront and takes longer. Which is right depends on the health of those neighboring teeth, how much bone is there, your medical history and your budget, and we will lay out both rather than defaulting to one. If a tooth is coming out soon, read socket preservation first, because that decision is easier to make well before the extraction than after it.
Crown Questions We Hear
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How long does a crown last?
Commonly ten to fifteen years, and often a good deal longer. What ends them is rarely the crown itself. It is usually decay starting at the margin where the crown meets the tooth, which is why brushing and flossing that edge matters as much as it does on a natural tooth, or fracture from grinding. A crown does not make the tooth underneath immune to anything.
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Does getting a crown hurt?
The tooth is numbed, and most patients find the appointment unremarkable. Mild sensitivity for a few days afterward is normal, especially if the tooth was already irritated. What is not normal is pain on biting in one spot that persists past a week, which usually just means the crown sits a fraction high and takes a couple of minutes to adjust. Call rather than living with it.
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Will it match my other teeth?
Back teeth are straightforward. A single front tooth is the hardest match in dentistry, because it has to sit beside a natural tooth with its own translucency and character. We shade match against your actual teeth and characterize the crown in our own furnace rather than accepting a flat result. If you are also considering
whitening, do it first, because a crown will not lighten later.
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My crown came off. Is it an emergency?
Urgent rather than an emergency, unless the tooth is painful. Keep the crown, it can often be re-cemented. Temporary dental cement from a pharmacy will hold it for a day or two, and household glue will not, it can make the tooth unrestorable. Call us and we will get you in. Our
emergency line is answered after hours by an on-call dentist if the tooth is hurting.
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Can I just leave a cracked tooth alone?
Sometimes, for a while, and your dentist will tell you if watching is reasonable. The risk is that cracks travel. A crack confined to the crown of the tooth is restorable. One that reaches below the gum and into the root often is not, and the tooth is then an extraction rather than a crown. Pain on releasing a bite, rather than on biting down, is the classic warning that a crack is progressing.
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What does a crown cost, and does insurance cover it?
Most dental plans cover crowns at a percentage once a clinical need is established, often with a waiting period and a frequency limit per tooth. Coverage is based on the tooth and the material rather than on where the crown was made, so a single visit crown is typically covered the same as a lab one. You will get a written estimate with your benefits applied before we begin. Our
payment options page lists the plans we work with.
Let's look at the tooth together.
Bring us a tooth you have been told needs a crown and we will show you on screen exactly what is happening and what we would recommend. Sometimes that is a crown, and sometimes it is something smaller.
