Getting a crown or a filling are common dental procedures that are done to repair a tooth that has become damaged or decayed. Both procedures aim to restore the tooth’s structure, function, and appearance. However, there are some key differences between crowns and fillings that determine when one may be recommended over the other.
In the opening paragraphs, we’ll provide quick answers to common questions about crowns versus fillings:
Quick Answers
Can I get a permanent filling instead of a crown?
Yes, in some cases a permanent filling may be used instead of a crown if the tooth decay or damage is minimal and does not affect the entire tooth.
When is a crown better than a filling?
A crown is recommended for teeth with extensive decay or damage that undermines the tooth’s structural integrity. Crowns fully cap and protect the entire tooth.
Is a filling a permanent solution?
Fillings can last many years but may eventually need replacement. Crowns are designed to last longer than fillings.
What are the advantages of a filling over a crown?
Fillings preserve more natural tooth structure, require less invasive tooth preparation, and are a more cost-effective option when suitable.
When is a Filling Appropriate?
Fillings are most appropriate for minor to moderate tooth decay or fracture that does not affect the entire tooth. Specific cases where a filling may work instead of a crown include:
- Small cavities – Fillings can repair small areas of decay on the tooth surface.
- Fractured cusps – Broken pieces at the biting edges of the tooth can be rebuilt with filling material.
- Minor fractures – Small cracks or fractures confined to one area of the tooth.
- Small defective fillings – Existing fillings with recurrent decay can be repaired with new filling material.
The key in these situations is that the tooth damage is localized and does not encompass the entire tooth. Fillings are excellent options for repairing such targeted areas of decay or damage.
When is a Crown Recommended Over a Filling?
While fillings are suitable for small, localized tooth defects, crowns provide complete coverage of damaged teeth. Reasons a dentist may recommend a crown over a filling include:
- Extensive decay – Large cavities, rampant decay, or recurrent caries lesions that undermine tooth structure.
- Cracked or fractured teeth – Cracks extending beyond one area of the tooth, or vertical root fractures.
- Weakened cusps – Extensively broken cusps from decay or fracture compromise the tooth’s integrity.
- Prior large fillings – Existing large fillings indicating significant loss of tooth structure.
- Extensive defects – Teeth with defects from injury, grinding, or large old fillings.
- Need for support – Compromised teeth requiring a crown for retention and support.
In these situations involving more extensive damage, crowns are better solutions to protect the entire tooth and prevent future problems.
Key Differences Between Fillings and Crowns
There are several key differences between fillings and crowns that influence when one option may be more appropriate:
Extent of damage
Fillings repair localized defects while crowns address damage affecting the entire tooth.
Tooth preservation
Fillings conserve more natural tooth since less drilling is required. For crowns more tooth structure is removed.
Durability
Crowns are designed to last longer than fillings under chewing forces.
Coverage
Crowns fully encase the entire tooth while fillings only patch a specific area.
Cost
Fillings are a more cost-effective option for minor damage. Crowns have a higher upfront cost.
Preparation
Crowns involve more extensive tooth reduction compared to fillings.
Materials
Crowns can be fabricated from stronger materials such as porcelain fused to metal.
Appearance
Crowns made of porcelain can mimic the natural color and translucency of teeth.
Longevity
Properly cared for crowns typically last 10-15 years or longer before needing replacement. Fillings may last 5-10 years but need replacing more often.
Filling Procedure
Getting a filling is a relatively simple procedure. The basic steps include:
- Numbing – The area is numbed with local anesthesia to prevent sensitivity or pain.
- Decay removal – Any decay is drilled out to leave a clean, hollowed space.
- Etching – The bonding surface is roughened or “etched” to help the filling adhere.
- Applying filling – The filling material is placed and shaped.
- Hardening – Composite resin fillings are hardened with a curing light.
- Finishing – The filling is smoothed and polished to match the tooth.
The procedure is completed in a single dental visit. Minimal anesthetic is needed and healthy tooth structure is preserved since less drilling is required compared to a crown.
Crown Procedure
Crown placement is a multi-step process requiring more extensive tooth preparation:
- Numbing – Local anesthetic blocks sensitivity for the procedure.
- Tooth preparation – The tooth is reduced in size to make room for the crown material.
- Impression – An impression is taken of the prepared tooth for the crown fabrication.
- Temporary crown – A temporary crown is placed to protect the tooth between visits.
- Crown fabrication – The permanent crown is designed and milled based on the impression.
- Cementing – At a follow-up the permanent crown is tried in, adjusted, and cemented.
The extensive tooth reduction required for crowns is a main downside. However, crowns are more durable and provide protection for teeth too damaged for fillings.
Cost Comparison
One of the advantages of fillings is they are a more economical treatment option when appropriate. According to the national dental fee survey, costs for different types of fillings vs. crowns are:
| Procedure | Average Cost |
|---|---|
| Amalgam filling | $118 – $201 |
| Composite resin filling | $139 – $235 |
| Porcelain-fused-to-metal crown | $875 – $1493 |
| All-ceramic crown | $861 – $1469 |
As shown, the cost of crowns is significantly higher than fillings. For patients with limited dental budgets who only have minor tooth defects, fillings can provide an affordable repair option.
Filling vs Crown: Longevity
The durability and longevity of fillings versus crowns is another consideration in choosing between the two options. Some general comparisons regarding longevity are:
- Fillings typically last 5-10 years before needing repair or replacement.
- Well-placed composite fillings may last 10-15 years or longer.
- Porcelain and porcelain-fused-to-metal crowns often last 10-15 years or more with proper care.
- All-ceramic and all-metal crowns may function for 20 years or longer.
Whilecrowns are designed to outlast fillings, fillings can still provide reasonable durability in situations where less tooth structure will be removed.
Filling vs Crown: When to Get a Replacement
Both fillings and crowns may eventually need replacement. Signs a filling or crown should be replaced include:
Fillings
- Decay around the edges of the filling
- Chipping, cracking, or fracturing of the filling
- Worn spots on the filling
- Sensitivity or pain around the filled tooth
- A loose filling
- Visible gaps between the filling and tooth
Crowns
- Chipping or fracturing of the crown
- Worn or rough spots on the crown
- Dark lines visible at the crown edge
- Abscesses or damage to the tooth root
- A loose crown
- Receding gums around the crown
Getting fillings or crowns repaired or replaced as soon as signs of problems appear will help preserve the remaining tooth structure and avoid more extensive treatment later on.
Filling vs Crown: Which is Right for Me?
Choosing between a filling or a crown depends on factors specific to each patient and tooth. A dentist will make treatment recommendations based on:
- Amount of decay or damage present
- Location and extent of cracks/fractures
- Strength and integrity of remaining tooth structure
- Patient’s oral health status and risk for further decay
- Patient’s desired budget for treatment
During an exam, your dentist will evaluate if a filling is adequate for repair or if a crown is needed. For instance, minimal decay confined to one surface could be amenable to a filling, while a fractured cusp needing structural support may call for a crown.
Discuss your individual case with your dentist to decide if a filling or crown will provide the most appropriate, long-lasting repair.
Conclusion
Fillings and crowns are both excellent options for repairing tooth decay and damage. While crowns offer complete coverage for teeth with extensive defects, fillings can provide a more conservative solution when damage is minimal. Considering factors like the location and extent of decay and fractures along with a patient’s time and budget can help determine if a filling may be sufficient or if a crown is the better choice. With an assessment by a dentist and good communication about dental goals, patients can choose the ideal treatment to restore their teeth to full function and aesthetics.
