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FILLING OR CROWN

February 14th, 2013

When a tooth has a need for restoration, your dentist will use many criteria to decide on the recommended course of treatment.  In today’s dental world, there are usually multiple options for treatment of any tooth.  We will use several criteria to suggest what we believe to be the best treatment for any one patient.  Remember, of course, that everyone is different.
So what criteria will determine the treatment for a broken or decayed tooth?  The first factor is how much of the tooth is missing?  Generally, if more than half the tooth has been lost or already replaced with a previous filling, then a crown is indicated for strength and durability.  Is the bite worn which might indicate a grinding habit?  This might indicate the need for more strength.  How healthy are the gums and the support for the tooth?  A periodontally compromised tooth may not have a good enough prognosis to have such long term treatment done.
But more than the dental factors must be considered.  What other treatment is needed and what are the financial implications?  We don’t want to have you spend your whole budget on one tooth, only to leave others untreated.  The whole mouth and the patient’s entire well being must be considered in treatment planning.
A filling can be an adequate treatment for almost any situation, but it will not be as long lasting as a crown.  Fillings can leave already weakened parts of the tooth exposed to further fracture.  And that fracture can happen in any direction, sometimes dictating the extraction of the tooth.  A crown done at the proper time can help prevent this scenario.  Talk to your dentist about the best option for you.
Another factor can be the patient’s age.  In very advanced years, a longer lasting restoration may not be necessary for acceptable function.  Often in advanced years the diet is softer and the biting force not as vigorous so that a filling will serve for many years.
Often we will plan to do fillings for and intermediate term so that we can control function and disease and then plan a course of treatment for crowns over a number of years.  We laughingly refer to these cases as our “Crown of the year” club.  It effectively spreads the financial burden over several years without risking tooth health.

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