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“Can’t you just do a new filling instead of a crown?”

Dentistry seems so expensive!  Especially when your dentist tells you that your tooth needs a crown.  Is this really necessary?  As part of a dental examination, a good dentist will look at every tooth in your mouth and study the edges of all of your previous restorations or fillings.  You may not think anything is really wrong with your teeth but without a thorough examination, you cannot know this for sure.  You have probably wanted to ask your dentist this question, “Can’t you just do a new filling instead of a crown?”  And you should ask that question.  Your dentist should be able to explain why any type of treatment is recommended and the alternatives!

Does this tooth need just a filling?

Can’t you just wait until it hurts? 

The answer to this is absolutely no!  That is if you want to save your teeth and you also want to save money.  That’s right, you can save money by treating things before they hurt.  Doing a small filling on a tooth may cost about $200, doing a very large filling on a tooth may cost about $400.  By the time a tooth is broken down enough that it needs a crown it will also need a filling to reconstruct a base for a crown once all the defective tooth structure and old filling is removed (cost about $300) and then a crown (cost about $1,200.00).  See where the money savings comes in?  By the time that it hurts you may need to have a root canal to save the tooth (cost about $1400) plus the filling and crown needed above (total cost about $2,900.00!).

Is it worth it?  Well, that’s another question for another blog!

Now back to the tooth with the big silver filling in the photo!

Your dentist evaluates your tooth and notices a large filling with several radiating fracture lines across the remaining tooth structure.  You can also notice the rough edges of the filling.  These rough edges are often a sign that the filling is breaking down and needs to be replaced.  The dark areas beside the filling are where decay is leaking into the remaining compromised tooth structure and causing it to darken.

But you don’t have any symptoms!

It is normal not to have symptoms when decay is just starting.  By the time a tooth like this starts to hurt it may be because the fractures are extending down into the root of the tooth (Uh OH – the only option may be an extraction at that point). Or the decay may have gone into the pulp of the tooth where the tooth nerve lives. (The tooth might still be savable with a root canal, filling and crown)

Notice the fracture lines that were present below the filling! This tooth needs a crown to save the tooth!

So why can’t I just get a new filling instead of a crown on this tooth?

A filling, even a bonded tooth colored filling, just fills the hole without providing much additional support for the tooth to prevent it from fracturing.  A crown will surround the fractures and no matter how you bite on the tooth, or which direction the biting forces come from, the tooth will no longer want to fracture apart.  Once all the old filling and decay are removed from the tooth you can see the extent of the fracture lines.  A crown which covers the entire chewing surface of the tooth and the sides of the tooth where it is fractured will prevent these fractures from progressing to loss of the tooth IF the treatment happens before it is too late.

Our office cares about you and your teeth.  We will make sure you understand what is going on in your mouth so that you can make the best treatment decisions for you.  Dr. Gillis will perform a thorough examination of your teeth, the bone and gums around your teeth, your jaw joints and muscles and we always do an oral cancer examination.

Yours for better dental health,

Julie Gillis D.D.S.

Restoring Teeth, Restoring Smiles