Do I really need a crown?

Why Do I need a crown?


Help Dr Buttars just said I need a crown on my tooth! Is this necessary? Do I really need this or is Dr Buttars Just trying to finance his new pair of skis?

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.

The reason they are recommended so frequently is that a dental crown is often the best option to extend the life of a tooth for years to come.

 The reason dentists would recommend a crown is multifactorial. 

1.     Protecting the tooth. 

a.     The main reasons for a dental crown are to protect the integrity of compromised tooth/teeth. 

b.     Crowns are recommended when there is less than 50% of tooth structure missing.  Missing tooth structure can be either in the form of decay and/or filling material.

2.     Chips and Cracks.

a.     Crowns are recommended when there are cracks or chips within the tooth structure.  Cracks and chips are not always visible externally and may also exist internally.

3.     Root Canals

a.     After a tooth has had a root canal, it usually becomes more brittle and is at a higher risk or breakage (mostly back teeth as there are a lot of biting forces on our back teeth).

4.     Cosmetics.

a.     For some a crown is recommended because the appearance, shape, color or spacing does not meet the patient’s expectations.  A crown can overcome the above concerns and restore a beautiful, long lasting restoration

But Dr Buttars can it wait?

So what really are the implications of waiting?

1.     Nothing will happen.

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

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

4.     The tooth could split, which could require additional surgery or even extraction.

The truth is your tooth can survive for a little while without the crown, but you never know when it might be too late.  If it bothers you, it’s too late. Sadly the number one reason patients get a tooth extracted is when there is a delay in getting a crown.

 So what are my options?

Thanks to modern advancement in dentistry, there are three options for crown restorations.  Unfortunately dentistry has not come up with the perfect material and there are both advantages and disadvantages to each option

1.     All Gold Crown

a.     Gold is the closet material to a perfect dental material.  It’s commonly referred to as “the gold standard” in dentistry.

b.     Gold crowns are super strong at very thin thicknesses and require very little tooth reduction to gain strength

c.     Gold is very close to your natural teeth hardness and thus wears evenly with your adjacent teeth. 

d.     Gold often lasts the longest and produces the tightest seal between tooth and crown.

e.     The main disadvantage to gold is well its gold color.  Thus it mainly indicated for the very back teeth that require extra protection from the heavy biting force, but often can not be seen.

f.      Due to the high price of gold, these crowns are often the most expensive

2.     Porcelain Fused to Metal (PFM)

a.     A PFM crown has a gold interior with a porcelain cover to make it strong, yet still white.

b.     PFM crowns require more tooth reduction in order to accomidate the extra bulk required for both the gold and the porcelain.

c.     PFM have been around for a long time with great results.  However it is more prone to fracture between the metal and porcelain, often resulting in crown replacement. 

3.     All Ceramic Crowns

a.     These are the most advanced crowns around.

b.     Due to the lack of a metal center, they reflect light very similar to the way a natural tooth does.  Making them the most cosmetic and natural looking. 

c.     The main disadvantage is that they need the most aggressive tooth reduction in order to obtain the needed thickness for strength and to prevent breakage.

d.     They are also the hardest to get a near perfect union between tooth and crown and will need replacement sooner than a full gold crown.


At Elevated Dental, 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 to your satisfaction!