There are significant differences between dental fillings and dental crowns, but they serve the same purpose: To restore a damaged or decayed tooth. When a dentist recommends one instead of the other, it’s important to understand why. The decision of dental fillings vs. crowns should lead to the best solution to the tooth’s problem without over-treatment and unnecessary cost.

Defining Dental Fillings

When a tooth has a cavity, the typical solution is a dental filling. Cavities, also called tooth decay or dental caries, are caused by bacteria. If brushing and flossing don’t clean the bacteria off the teeth, it has a chance to eat away at the tooth’s enamel. The result is a hole: a cavity. 

Dentists numb the area and use a drill to remove the decayed part of the tooth. They then fill the hole. They may use porcelain, composite resin, silver amalgam, or gold. The procedure is relatively painless and can be accomplished in one short visit. 

Fillings are a very effective solution, especially when cavities are found before they have a chance to grow very big. They stop the bacteria from spreading any further and restore the tooth to its normal condition. Fillings don’t last forever, but most have a life of at least five years and often much longer. 

Defining Dental Crowns

Dental crowns are also called dental caps. Like fillings, they can prevent future decay, but they do this by completely covering a tooth. They are also used in reconstructing teeth that are cracked or broken. 

Crowns are usually made from ceramic, porcelain fused to metal, resin, or gold. They are fashioned in a lab from impressions of the patient’s teeth and are made to look and feel natural.

When placing a crown, a dentist will first remove any decay or old fillings. They will fill the empty space with a composite material and usually place a temporary crown over it. The patient will come back for a second appointment so the dentist can replace the temporary crown with the permanent crown, sealing it into place.

Not only does the procedure take longer than getting a filling (two visits rather than one) it is also more expensive. The average cost of a crown is $800 to $1800, whereas, depending on the material, a filling will cost between $50 and $250. Like fillings, crowns will not last forever. They can be expected to last about 5 to 15 years. 

Cavity Size

Dentists are better than their patients at spotting cavities. Whether by sight or with an x-ray, they can often find tooth decay at its early stages. It’s easy to repair these tiny holes with a standard filling. 

One factor that determines dental filling vs. crown is the size of the tooth’s cavity. The longer a cavity goes untreated, the bigger and deeper it grows. And sometimes, even a tooth that already has a filling can get a second cavity. When the dentist sees that a cavity is taking up a large part of the tooth, he or she will usually suggest a crown. Especially if it gets to the point where the majority of the tooth is made up of filling material, there may be no more space to drill and fill. A crown is the best option. 

Tooth Condition

When a tooth has more filling than the actual tooth left, it’s probably time for a crown. Patients might wonder if it’s really necessary, especially if they don’t care how the tooth looks. 

The reason is that a tooth made up mostly of filling material is unstable. It will become too weak to support normal biting and chewing. This can result in cracking or breaking off the tooth entirely. It can also cause stress and pain on the surrounding teeth and the jaw.

A tooth made up of one large filling, or several smaller fillings acquired over time is still at risk of pulpitis. Pulpitis is a condition where the bacteria make their way to the root of the tooth and cause an infection.  

Because a crown completely caps off the tooth, it can prevent bacteria from going any further. If a patient is lucky enough to not already have pulpitis, a crown over a decayed tooth can prevent it. If pulpitis already exists, a root canal will be necessary. We’ll discuss that below, and how crowns play a part in the root canal procedure too. 

Cracked and Broken Teeth

A crown is molded to look and feel like a patient’s real tooth. For this reason, it is a good fix for a cracked, chipped, or broken tooth. 

Minor cracks may not be noticeable, but they give bacteria a perfect opportunity to start destroying enamel. A crack can also affect the strength and integrity of the tooth. A filling isn’t a practical option, especially if the crack is tiny. Rather than waiting until a cavity form at the site of the crack, or the tooth breaks because it is weakened, the dentist may recommend a crown.

Crowns are also a good solution for a chipped or broken tooth, and for the same reasons. It will eliminate the chance of decay while restoring a patient’s smile.

Root Canal

Crowns are an important part of a root canal procedure. Treatment involves hollowing out and cleaning the inner core of a tooth, filling it with a composite material, and then capping it off with a crown. 

Root canals can not be completed using filling material. A crown is the only option besides extracting the tooth. Missing teeth can cause movement of the remaining teeth and issues with the jaw, as well as an incomplete smile. A crown will save the tooth and make it possible for the patient to chew normally again.

Deciding on Dental Fillings vs. Crowns

Sometimes there is no debate about dental fillings vs. crowns. A huge cavity or broken tooth is an obvious candidate for a crown. Other situations may not be so clear.

A patient may have concerns about the cost of a crown and wonder if a dental filling will be enough. It is important for the patient to discuss their questions with the dentist. There may be a chance that the dentist can offer a filling instead. If they feel the crown is the best option, they will explain exactly why. Together, the patient and dentist can decide which is best for them between dental fillings vs. crowns.

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