Hi. I’m in need of some dental advice. I live in a medium-sized town in Thailand (not a major city like Bangkok or a bigger town like Chiangmai). Due to an infection in a 2nd premolar tooth (lower left side), the dentist decided to do a root canal. The root canal was completed and a temporary filling put in. After some consideration, the dentist has recommended just putting a permanent filling on the tooth, rather than a crown (not a strong recommendation; more like “I think this would probably be the best way to go”). The reasons she gave are: (1) She did some chewing tests (with red dye) to see how much the tooth would be used in chewing, and because the tooth is out of line (it protrudes toward the back of the mouth), she said that it would not be used much in chewing food. (2) She also said that because the tooth is hollowed out, it is weakened, and that the significant shaping she would need to do on the top part of the tooth would further weaken it. She seemed to be saying that a crown on this tooth would not be as strong as other crowns, though she did acknowledge that putting a crown on the tooth would make it stronger than just doing a permanent filling. (3) The filling is less expensive (though I don’t mind paying for a crown if it’s better for the tooth). (4) She also said that it would be difficult to shape the crown properly because of the misalignment of the tooth but also said that with careful work, she could do it.
She said that as long as I didn’t bite directly down on something hard (like almonds, which I eat fairly often), she thinks the tooth would hold up ok with just a permanent filling. But I don’t always pay attention when I chew, and I’m afraid that with just a permanent filling, the tooth might break if I would bite down on something hard. The dentist said that if the tooth would break, a bridge would be needed, which would be more expensive than the crown, and (I’ve heard) would also be difficult to clean. From what I’ve read, most Western dentists recommend crowns for any molars.
So my question is, would a crown be significantly better, or would a permanent filling suffice? Thanks for any help.