Crown Vs Filling

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Dental crown vs filling – what are the differences and the similarities between these two restorative dental procedures, and when is your dentist going to recommend one or the other?

This article covers everything you need to know about dental crowns and fillings, so that you are fully informed about what both of these modern dentistry treatment options entail. We are going to go over how each of these procedures are performed, the pros and cons of each, and why a crown is often the better – and in some cases, the only – choice. 

When and why you might need dental crowns or fillings

Dental crowns and fillings are two of the most common restorative dental treatment options, intended to aesthetically and functionally restore decayed or damaged teeth, as well as to prevent cavities, and generally maintain a beautiful and healthy smile. 

Dental fillings and crowns are most often used to treat cavities and root canals. Sometimes, despite our best efforts, cleaning our teeth perfectly can be difficult. This is particularly true if you naturally have more grooves in your teeth, which can make it much harder to stay on top of your oral health and hygiene. 

Accidental damage is another reason why you may need either a filling or a crown. Whether you have bitten down onto something hard and cracked a tooth, or have been in a physical altercation of some description, dental fillings and crowns may be needed to mend the resulting damage. 

Dental fillings

Dental fillings can consist of a great number of different fillign materials. The most commonly used ones are porcelain, silver amalgam, gold, tooth-colored plastic, ceramic, or tooth-colored composite resin. Whether your teeth that have sustained damage as a result of tooth decay or impact, fillings can go a long way towards restoring their appearance, shape and function.

The dental filling procedure

If you need a filling because of a cavity, the dentist starts by removing and cleaning out the decayed part of the tooth. Once the tooth is clean and free from decay, the dentist is going to fill the hole with a filling material of your choice.

Should you choose composite resin, silver amalgam or something else?

Since dental fillings can be made from a number of different materials, it is worth considering which filling material is going to be the best option for you.

In most cases, porcelain fillings are the best and safest option, although composite material is both more popular and less expensive. The reason for this is that porcelain fillings are completely natural, whereas composite and metal fillings can cause allergic reactions in rare cases. Many patients also report that porcelain fillings feel more like tooth enamel and are more comfortable in the mouth.

Dental filling pros and cons

When the damage is relatively minor, dental fillings are effective at repairing decayed tooth enamel as well as chipped and broken teeth. They are also helpful in terms of preventing reinfection.

Getting dental fillings is a simple procedure, typically with no visual evidence of the tooth having been repaired afterwards, particularly if a tooth-colored resin or porcelain is used. Getting a filling rather than a crown also means that you get to preserve more of the natural tooth, which is a bonus.

However, dental fillings are not suitable for badly decayed or damaged teeth.

Dental crowns

Did you know that dental crowns, also called dental caps, are the only form of restorative dentistry that completely encapsulates and covers an existing tooth?

The dental crown is typically bonded to what remains of the existing tooth using a special dental cement. In other words, dental. crowns are more extensive – and in severe cases, much more effective – than a dental filling.

The dental crown procedure

The dental crown procedure is usually divided into two appointments. At the first appointment, the dentist removes any decayed part of the tooth and performs a root canal if needed. He or she then takes moulds of your existing tooth so that a perfectly fitting crown can be produced at the dental lab. At the second appointment, the dentist bonds the crown to what remains of the existing tooth.

Just like fillings, dental crowns can be made from a variety of different materials. The most popular and commonly used materials include porcelain, porcelain bonded to metal, zirconium and gold.

Dental crown pros and cons

Dental crowns cover the entire tooth and are visually very similar to dental implants or veneers, in that they look very similar to natural teeth.

The crucial difference between crowns and implants is that dental crowns preserve as much of the existing tooth as possible, whereas implants replace teeth completely. 

Crowns are super effective at preserving existing teeth and preventing decay.

There are no real cons associated with getting crowns. However, is important that the existing tooth is completely free from infection when the crown is installed – otherwise, the infection gets trapped under the crown.

Crown vs filling FAQ

How do I know if I need a crown or a filling?

Whether you are going to need a crown or a filling will depend on the extent of the tooth decay you have developed.

In cases where the tooth decay is detected in time, meaning early on, a dental filling is good enough to address the issue. However, if the decay has progressed and taken over most of the tooth and even the surrounding gum tissue in some cases, only a root canal followed by a dental crown will suffice.

Why do I need a crown instead of filling?

Dental crowns are necessary when the tooth decay is extensive. The reason being that a crown preserves as much as the natural tooth as possible, while preventing further damage to the tooth in question.

In minor cases of tooth decay, the dentist recommends tooth fillings, as they will be sufficient to get rid of the tooth decay and prevent further damage. In other words, when your dentist recommends a dental crown instead, it is because the tooth is badly decayed and cannot be saved with fillings alone.

Why do dentists prefer crowns over fillings?

Dentists favour crowns over fillings in cases where the decay or the damage isn’t minor enogh to be fixed with a filling.

Once damaged, a tooth can never heal naturally, but a dental crown works like a cap, covering the damaged tooth, effectively holding it together and preventing further cavities.

A tooth with several large fillings but without a crown is more vulnerable to cracking completely, or becoming reinfected.

Can I get a permanent filling instead of a crown?

Not always. 

In some cases, you may be able to get away with only getting small dental filling, but if the tooth decay or damage is more severe, a crown is your best and sometimes only option. 

If you have had a root canal, a crown is also needed, since the tooth structure now consists primarily of composite resin. This leaves the tooth more vulnerable to cracking or sustaining other forms of damage than the surrounding teeth – a crown is needed to protect it.

What is worse a crown or root canal?

In terms of pain and discomfort, a root canal procedure is significantly worse than the restorative dentistry required to fit a crown over an existing tooth.

A root canal procedure is performed to remove tooth infection and bacteria from tooth roots, which can be a rather unpleasant experience, even with anesthetic.

Once the tooth roots have been cleaned up, a temporary filling is usually put in place before a permanent crown is installed. The crown installation itself is not a pleasant experience as it puts a lot of pressure on your jaw, but it is usually a rather brief and smooth procedure.

What are the disadvantages of dental crowns?

When you get a dental crown, it is very important that the tooth and tooth roots underneath are completely clean, with no lingering infection that could flare up again. 

The reason for this is plain and simple: If the dentist puts a crown over an infected tooth, this effectively traps the infection and leads to further tooth decay, not to mention further discomfort and tooth pain. 

To make sure that no infection gets trapped under a new dental crown, the dentist usually waits a couple of weeks after performing the initial root canal procedure.

During this two-week interval, the tooth decay will make itself known if there is any left. If no infection flares up again, the dentist can safely assume that the initial root canal procedure was successful at eradicating the infection, and can go ahead with the crown install.

How long can a tooth go without a crown?

Although it is possible for a tooth structure to survive for several weeks without the support and protection of a dental crown, your tooth should not be without a dental crown for long. A couple of weeks between a root canal procedure and having the crown installed is all right, however.

Is there an alternative to getting a crown?

Yes, in some cases you may choose to get dental veneers, also referred to as porcelain veneers, instead of crowns.

Veneers are made of thin shells of porcelain, and unlike crowns, they are only used for the teeth at the front of your mouth.

Conclusion: Are crowns or fillings the best solution for tooth decay?

When it comes to replacing broken or decayed tooth material and preserving the remaining tooth structure to the greatest degree possible, dental fillings and crowns are both highly effective.

In minor cases, fillings are enough to mend the damage. But in many cases, when the tooth decay or damage is rather severe, a crown is going to be the best and sometimes the only option. A crown completely encapsulates what remains of the existing tooth. This effectively holds it together while protecting it from further cracks, chips and decay.

Dr Febin Mary George - Editor

With more than 10 years as a dental surgeon, Dr Febin Mary George is passionate about educating consumers around the world to help look after their teeth.

She completed her Bachelor of Surgery at the Century Institute of Dental Science and Research Centre in 2010.

Alongside editing the International Journal of Dental Clinics she has also written for major publications including Thrive Global.