Quite a lot of us must have encountered a situation in which there is a broken tooth or large cavity present in the tooth and to restore the tooth, two choices are given by the dentist. Either the tooth can be restored with a large dental filling or a dental crown can be made for the tooth. Dental crown is given after dental filling of the tooth. As compared to dental fillings, dental crowns will be more expensive. Number of visits to the dentist in case of dental crown is also more as compared to single visit in dental fillings. The thing which comes to patient’s mind in such a situation is to opt for a cheaper and quicker option that is dental fillings for the restoration of tooth with large cavity. Before making final decision, it is important to evaluate certain considerations.  It is better to restore the tooth with large caries with a dental crown after getting it filled. As compared to large filling, dental crowns after fillings will have more of strength and will last longer and the protection of the tooth in case of dental crown will also be more.   Dental crown is superior in strength as compared to large dental filling and if long term is considered, then also it is a cheaper option.

What If Dental Crown Is Not Given For Tooth with Large Cavity

Dental filling if done on the tooth with large cavities will be stable for some time but it will not reinforce the weakened tooth structure as a dental crown will. To place a large dental filling, quite a lot of tooth structure is removed and it will result in weakening of the remaining tooth structure. Tooth will become more susceptible to fracture in such a case and if the fracture occurs below the gum line on the cervical portion of the root or crack line occurs vertically, then tooth extraction may also be required. To replace the missing tooth after tooth extraction, dental implants or dental bridges will be given to the patient. If a small portion of tooth crown is fractured, then dental crown may be required to save the tooth. That is why it is better to get dental crown after large filling is placed in the tooth.

Fracture of Tooth with Large Dental Filling

Tooth becomes liable to fracture and breakage in case of large dental fillings. If dental crown is given after dental filling, then it will provide strength to the tooth structure. Dental crown is a restoration which covers the tooth like a cap and covers the outer surface of the tooth and further increases the strength of the tooth. On the other hand overall strength of the tooth is not increased in case of only dental fillings.   

If there is small cavity present, then it can be repaired with a dental filling. Tooth remains intact in this case and is strong enough to bear the masticatory or the chewing forces.  Structural integrity of the tooth is affected in case of large dental fillings and it leaves the tooth with large filling at risk. So in case of large dental caries, patient should get a dental crown after getting it filled.

If it is a back tooth, then patient can get metallic or porcelain fused to metal (PFM) dental crowns for the tooth.

Tooth with Large Dental Fillings are Weak

Tooth with large dental fillings are weak. Dental filling can be placed in tooth with large caries but it will not increase the strength of the tooth. Tooth will become more liable to fractures in case of large dental fillings. Fillings will just occupy the space of the missing tooth structure but will not enhance the strength or will not reinforce the tooth structure as the dental crown does. With large dental fillings, there is risk of breakage.

If it is a back molar tooth which is subjected to more of masticatory or chewing forces, then the patient is advised to get a dental crown instead of only dental filling for large cavities. When chewing pressure is applied to the filled tooth, then it can act as a wedge. By continuing forces and stresses, tooth may also crack or fracture.

When To Place Dental Filling and When to Give Dental Crown

If the loss of tooth structure because of dental caries is more than 1/3 of the width of the tooth, then dental crown is preferred as compared to dental filling. If filling is done in case of loss of more than 1/3 of the width of tooth structure, then the strength of the tooth will be affected.

Advantages of Giving Dental Crown after Filling on Tooth with Large Cavity

Dental crowns are less likely to get dislodged and are less likely to break as compared to dental fillings. Dental crown will provide strength to the tooth and will avoid fracture and breakage of the tooth. No wedging affect is created by dental crowns. On the contrary, dental crowns will hold the tooth together.

To conclude, dental crown should be given on the tooth with much of loss of tooth structure to reinforce the weakened tooth structure and to provide strength to the tooth.
 

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  • dr ritz

    dr ritz 29 - December - 2011, at 00:38 AM

  • Irshad, If tooth is badly mutilated and only some of the tooth structure is left, then root canal treatment followed by post and core procedure and dental crown is given to the tooth. Post is a rod like structure which is inserted in the root of the tooth and on post, core built up is done with amalgam or composite restoration and dental crown is given on it. Support is derived from inside of the root.

  • irshad

    irshad 28 - December - 2011, at 09:55 AM

  • if the teeth has a bigger restoration on it as after root canal treatment, and after the crown preparation if there is much of tooth loss exposing the restoration, then how will a crown reinforce the strength? wont it fracture along the cervical margin?

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