When you have a tooth that has a large cavity or has broken, you have several options for how to fix it. The two most common options are to fill the inside of the tooth or to crown around the outside of it.
When your tooth gets a cavity, or tooth decay, it needs to be removed to protect the remainder of the tooth. The empty space remaining then gets “filled” to help the tooth retain shape and ability. Small cavities are easily fixed with a filling, as most of the tooth remains intact and can withstand normal chewing pressure. If the decay covers a particularly large area, or an area on the outside of the tooth, it will present more of a challenge for the dentist to fill it suitably so that it will last. A large filling, though a quick fix and very cost-effective, may also act as a wedge so that when pressure is applied, the filling also offers pressure outward, and a portion of the tooth may actually break off. Because a filling does not reinforce the tooth, any tooth portions that remain are at risk for breakage. Not all large fillings will be problematic, though, and dentists won’t know for certain which teeth may develop problems. Additionally, not every tooth that fractures will be difficult to repair.
Unlike a filling that sits within the tooth and is made of materials tolerated within the mouth, a crown binds around the outside of the tooth and is made in a dental laboratory. The materials used to make crowns are substantially stronger than those used for fillings, and the way they are attached is much more secure; therefore, they are much less likely to break or be dislodged. The manner in which the crown cups over the tooth allows it to offset the pressure caused by normal biting and chewing. If a fracture is observed in your tooth, it is almost certain your dentist will want to use a crown to hold the tooth in one piece. A tooth that has sustained any type of significant damage is generally a good candidate for a crown.
So Which Should You Choose?
If your tooth is damaged enough that you are considering these options, it’s a good idea to get a second opinion to help you decide. While crowns are more expensive and take longer to repair, they might save you more money in the long term. Fillings are generally less expensive and quicker to repair, but they run a higher risk of failing. Thoroughly discuss your specific tooth issue with your dentist so you understand the impact of either choice.