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Do I Really Need a Crown? Five Things You Should Ask


Since crowns are one of the more common restorations that people need on their teeth, most dentist are regularly asked the question, “Do I really need a crown.” It is a completely fair question because even with insurance, crowns may cost you hundreds of dollars at a time.

The reason they are recommended frequently is that a dental crown is often the best option to extend the life of a tooth for years to come. However, there are options in treating a tooth which may delay the need for a crown. You should be cautious when a dentist you are seeing for the first time recommends a number of crowns.

At Dentaltown, we evaluate all options and review them with you before recommending a crown or set of crowns. We consider you our partner in maintaining your dental health and we will take the time to fully explain our treatment plan recommendations. If you have been told by another dentist that you need a crown, please come see us for a free second opinion.


Show me and tell me why a crown is needed.


If it hurts when you bite down, it is possible that your tooth is cracked. If a tooth is cracked, it is a serious condition and does usually require a crown. Unlike a broken bone, the fracture in a cracked tooth will not heal.

Vertical cracks that travel to the gumline may require a full-coverage crown. If the crack goes below the gumline, the tooth may require a root canal, with crown lengthening or possibly even extraction.

However, make sure that the tooth is cracked and not just “crazed.”  Craze lines are very common and not harmful. Most every adult back tooth has craze lines. These are just simple stress lines that do not necessarily indicate a crown.

Since craze lines do not  effect the structural integrity of your tooth, you can choose from a number of different options to fix them. The least invasive of these  is whitening, which can bleach the stains from the crack to significantly reduce its visibility.

However, craze lines that exhibit deep stains or are very long could suggest a developing crack.  Ask your dentist for either an inter-oral photograph or a hand held mirror to show you the crack.


What are my options?


In some cases, while a crown is one option, there can be others. You might opt for a filling instead. Keep in mind, however, that a filling does not prevent you from needing a crown later on. Also, if a substantial portion of your tooth needs filling, a better solution is usually the crown because fillings do not give you the same kind of protection as crowns do. Also, if the filling is extremely large, it can cause the tooth to break, making it irreparable.


What are the implications of waiting?


  • Nothing will happen.

  • The tooth could chip- simple repair. Or it could crack and would need a crown.

  • In rare cases waiting could cause a root canal to be needed.

  • The tooth could split, which could require crown lengthening or extraction.

These are things that your dentist should be prepared to talk over with you.


Is a Root Canal needed?


Most crowns do not need root canals. If a tooth is not infected or acutely inflamed, it will not need a root canal.


Does an old, really large silver filling mean I need a crown?


If a silver filling is 2/3 the width of the tooth or more, it could require a crown. The small amount oftooth that is left in an old filling like this can get compromised. It is up to your approach. If you want to be proactive and prevent it from cracking, go with a crown. If you are more conservative, you can take the approach if its not broke, don’t fix it.

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