When should a crown (cap) be recommended for a tooth

The three most common situations where I would recommend a crown for your tooth would be:

  1. There’s only half of your tooth left. This could be because it broke, or there’s decay and you already have a big filling in the tooth. A filling is a good name for what we put in your tooth. It just ‘fills’; it doesn’t help the tooth stay together and truth is it weakens the tooth. I recommend covering the rest of your tooth with a crown at this point because if more of your tooth is lost due to breaking or decay, the amount of tooth left is pretty weak. I have had patients come in saying their crown came off and when I look at the crown, all tooth that was holding crown is broke off inside the crown. Then the only way to save the tooth is $$$; a root canal, building the tooth back up and a new crown. So I don’t want you to wait until that point. On the other hand, if you have a small filling and one of your cusps break off, I usually just suggest a new filling.
  2. If it is a back tooth and it has had a root canal, the tooth becomes considerably more brittle. Because it is so much more susceptible to breaking, a crown is best. If it is a front tooth with medium size filling in it and has a root canal, then I would recommend a crown at that point.
  3. If the tooth consistently hurts to biting for more than 10-14 days it might have what is called cracked tooth syndrome. It is cracked, but just hasn’t broken off. We will make sure that this is the problem, and if it is, a crown is the best way to keep it from breaking.

As we get older (and boy, don’t I feel it!) we accumulate cracks in our teeth. These cracks often will be visible as a dark line on the tooth. Everyone over the age of 40 has numerous cracks in their teeth. But if there isn’t any discomfort when biting, there is no reason to crown the tooth. Is it a weak point in the tooth? Somewhat. But the vast majority of these will not break, so suggesting a crown would be unnecessary.

These are the main reasons that I suggest to patients that a crown is a good idea.

If you have any questions, please let me know! Dr. Dave