Dental Crowns:
Do You Really Need One or Is There a Better Option?

🚀 Short answer

When your dentist says - you need a dental crown, usually it’s not something you get thrilled about.
Suspicion arises, and right away you start to wonder:
“Do I really need it? Is this just a pricey upsell, or is there a better solution for my tooth?”
From my experience as a dentist, there is always a small doubt present when it comes to some pricy treatment suggestion.
Especially if you don’t have any previous experience with such treatments.
On one hand, crowns are a fantastic solution for certain dental issues, and there isn’t a better solution.
On the other hand, they can be unnecessary in some cases.

Therefore, the question “Do I need a dental crown?” can’t be answered with a simple yes or no. Only valid answer is: “It depends”.

Let’s break down when crowns are absolutely necessary, when they’re optional, and when they might even be unnecessary or excessive.

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👑 Dental Crown

A dental crown is like a cap made of ceramics/metal-ceramics/zirconia placed over a weakened tooth to restore the tooth’s shape, function, and appearance.

✅ What Is Dental Crown Good For?

Dental crown reinforces the weak tooth structure and restores its natural function in food processing and esthetics. Most importantly, it prevents the tooth from breaking under pressure.
Why is this important?

Because once a tooth breaks, it can lead to more complex and expensive treatments Firstly, the extraction of the tooth, which then leads to dental bridges and dental implants.
So in a way, no matter how expensive the crown is, it is still cheaper than the alternative of losing a tooth and replacing it with a dental implant or bridge. Even more expensive if you leave a space in your mouth, which can compromise the neighboring teeth to tilt and shift, causing bite problems and digestion problems, so then even more teeth needs to be included into treatment and costs are just adding up.

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👍 When a Dental Crown Is Absolutely Necessary

In some situations it’s better to put a dental crown immediately or soon after the treatment, especially if the risk of tooth fracture is very high.

Here are the most common scenarios when a dental crown is absolutely necessary:

1. Endodontically Treated Teeth (Root Canals):

After a root canal, teeth become more brittle over time.
It doesn’t happen right away, but already after a year or two, the tooth elasticity is lost, and it becomes more prone to cracking. This is an especially important factor to consider for back teeth, which are under more pressure while chewing and eating.
Also, often the teeth that undergo the endodontic treatment have lost a lot of tooth structure in the crown area.
In this case, a crown needs to be placed as soon as possible to prevent the high risk of tooth fracture.

2. Severely Damaged Teeth:

If most of your tooth substance is gone due to tooth decay and held together with a filling, the risk of fracture is very high. Especially on back teeth which take the most pressure, but also the front teeth.
Without a strong foundation and tooth substance, the tooth is at risk of breaking under normal chewing forces.

3. Front Endo-Treated Tooth With Esthetic Concerns:

Root-filled front teeth get darker over time and natural color gets lost. There is a possibility for internal whitening, but usually the effect is limited and it doesn’t last long. A crown may be the most practical and aesthetic solution in the long term. I wouldn’t say that the crown is needed immediately after the endodontic treatment, but it is a good idea to plan for it in the future, especially if you want to have the best esthetic and reduce the number of visits, like you would have for whitening. Also, the prevention of tooth fracture still plays a big role in this case.

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🤔 When a Dental Crown Can Wait or Be Avoided

Not every root canal or filling needs to be immediately crowned.

This lies on the dentist’s expertise and judgment, based on:

• ✅ **How much natural tooth substance remains? **
• ✅ Position of the tooth (front vs back)
• ✅ Whether the tooth is root-filled
• ✅ Neighbor teeth condition - can chewing forces be distributed evenly?
• ✅ Bone support (gum health / periodontal status)

Examples when a dental crown can wait or be skipped:

• If a tooth has a small filling, or even a feeling that is bigger, but it doesn’t compromise the tooth structure.
• Tooth that is root-treated but structurally sound, and aesthetics aren’t a concern.

Unfortunately, this part is not something that can be easily determined by the patient. It requires a dentist to evaluate the tooth condition and make a judgment call. Still, it’s your decision at the end, and if you trust your dentist, you can go with their recommendation.

Check out our post “How to Recognize a Great Dentist: 10 Trustworthy Signs” for tips on choosing the right dental professional.

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👎 When a Crown Is Not a Good Idea

Let’s break it down into 3 key points:

1. Healthy Tooth - no fillings, no root canal, no esthetic concerns.
2. Multiple Crowns for esthetic reasons only - Hollywood smile craze.
3. Better Alternatives Available - like whitening, veneers, inlays, or onlays.

Healthy Teeth:

If your tooth is healthy, no fillings or a small filling present, not root-treated, but you want a crown just for esthetic reasons, it’s often overkill.
Remember, we are just talking about dental crowns, not dental bridges, it’s a whole other topic. Also, sometimes if a tooth is not positioned well, if no orthodontic treatment is an option, and you want to improve the esthetics in the upper front teeth, you may want to consider crowns, but there are also other alternatives.

Multiple Dental Crowns for Esthetic Reasons:

The trend of getting multiple crowns for a “Hollywood smile” can lead to unnecessary tooth damage.

Keep in mind that crowns require significant tooth structure removal, which is irreversible. This is especially concerning when patients ask for crowns on healthy teeth just to achieve a certain look. Still, it’s far better to at least consider some of the alternatives before going for crowns.

Better Alternatives Available:

• Tooth Whitening: If you want whiter teeth, professional whitening is a less invasive option that preserves your natural tooth structure, and it looks more natural.
• Composite Bonding: For minor chips or discoloration, composite bonding can be a great alternative that requires minimal tooth alteration.
• Porcelain or Zirconium Veneers: These are thin shells that cover the front surface of teeth, providing a natural look without the need for extensive drilling.
  They can be a great option for improving aesthetics without sacrificing too much tooth structure.
• Inlays/Onlays: These are used for larger cavities and can be a less invasive alternative to crowns, preserving more of the natural tooth structure.
• Orthodontics: If your teeth are misaligned, braces or clear aligners can correct the issue without the need for crowns.

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⬇️ What Are Downsides of Dental Crowns?

While crowns are great for restoring function and esthetics, they do have some downsides:

• ⚡ Tooth Structure Removal: Crowns require significant tooth structure to be removed, which is irreversible.
  Once you drill a healthy tooth, there’s no going back, and no material can replace it.
• ⚡ Sensitivity: After placement, teeth may be sensitive to hot/cold for a while.
• ⚡ Gum Irritation: Crowns can irritate gums, especially if they don’t fit well.
• ⚡ Cost: Crowns can be expensive, especially if you need multiple ones.
• ⚡ Longevity: Crowns need replacement after some period of time, depending on how well the oral hygiene is. The average lifespan is 5-15 years, but it can be longer with good care.
• ⚡ Bite Issues: If not shaped properly, crowns can cause bite problems, leading to discomfort or even tooth damage.
• ⚡ Aesthetic Variability: The final look depends on the lab technician’s skill, and not all crowns look natural.
• ⚡ Potential for Root Canal: If the tooth is too damaged, a root canal may be needed before placing a crown, adding to the cost and complexity.

All these downsides make it crucial to evaluate whether a crown is truly necessary for your specific situation. So it’s really important to have a good dentist who can assess your tooth condition and recommend the best course of action. How to find a good dentist? Check out our Patient Advice blog post for tips on choosing the right dental professional.

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👨‍⚕️ Final Word: Trust the Right Dentist

A dental crown can be a lifesaver for a weak tooth, or an over-treatment if done without proper indication.

As a former dentist, I would say:

Only crown a tooth when it’s truly necessary, and always consider alternatives first.

Of course, don’t make this decision without consulting your dentist.
So, make sure you have a dentist that you find trustworthy.
A good dentist will explain to you why a crown is needed (or not), what the alternatives are, and what the long-term consequences might be.

And remember:

• Crowns are great – when they’re truly needed.
• A natural, healthy tooth is still the best kind.

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Want more helpful breakdowns like this one? Check out our Patient Advice blog for trustworthy dental guidance without the fluff.