Introduction
When a worn or damaged tooth needs restoration, the typical process often involves grinding it down by about 75 percent to create a nub. A hollow crown is then cemented over the original tooth to restore its shape. While this process might be necessary, it can feel uncomfortable, wasteful, and even painful.
The dentist may tell the patient that the tooth is too damaged to hold fillings and needs to be replaced with an artificial crown material. However, the natural tooth is always a better option, and taking care of it is less work than maintaining a crown.
Issues and Problems with Crowns
Dental crowns are often used to restore damaged or worn down teeth, but they come with their own set of challenges. One common issue is the gap that can form between the crown and the natural tooth at the margin. This gap can allow food particles and other substances to enter, leading to decay. It is difficult to completely seal the margin, and many patients may not clean their teeth properly, making it easier for decay to develop around the crown.
Additionally, the margin of the crown can sometimes cause irritation to the surrounding gum, leading to gum recession. This can result in looseness of the crown and may even lead to gum disease.
Foreign cement material left beneath the gum line often contributes to permanent irritation or gum disease. Over time, the porcelain material of the crown can also be prone to cracking or chipping, which may make it more susceptible to decay and require replacement.
Moreover, crowns don’t always prevent the need for a root canal. If there is decay at the margin or cracks in the porcelain, it can lead to an infection in the pulp or the soft tissue inside the tooth. Crowns can also change color over time, causing them to stand out compared to the natural tooth color.
The cost of crowns can be quite high, ranging between $500 and $3,000 per tooth, not including additional dental procedures that might be necessary before the crown can be applied. If the crown becomes damaged or doesn’t fit well, it may need to be replaced.
Inlays or Onlays
If your dentist suggests a crown, there may be a better and more conservative option: inlays or onlays. These are forms of partial coverage that save more of your natural tooth structure without the need for heavy grinding.
Inlays and onlays are often called indirect fillings because they are made in a dental laboratory from porcelain. These restorations are bonded either inside (inlays) or on the surface (onlays) of the tooth to cover decayed areas.
The fit is tailored carefully, ensuring a perfect seal that allows for normal brushing and flossing. Unlike composite fillings, inlays and onlays provide better protection for tooth enamel and are less likely to cause decay at the margin.
They are also slightly more expensive than traditional fillings, but the cost is half the cost of a crown, making them a more affordable option for restoring a damaged tooth.
Resin Composites
One effective method for restoring teeth without the use of crowns, onlays, or inlays is using composite resins. These tooth colored plastics and glass materials harden inside the patient’s mouth when exposed to primary blue light.
The dentist prepares the tooth by applying the resin in layers, and each layer is hardened with a light wand. This process allows the resin to be shaped to fit the tooth precisely.
The dentist will then polish the resin to prevent staining and wear, ensuring that the restoration is both functional and durable.Recent studies have shown that these resins provide long lasting tooth restorations.
This technique requires expert dental skills and is often part of a conservative approach to saving as much of the original enamel as possible. William Linger, DDS, MAGD, a dentist based in Charlotte, NC, specializes in this method, offering patients a range of procedures designed to protect and restore their natural tooth structure while avoiding more invasive treatments like crowns.