ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Do I really need that crown?

Updated on August 5, 2010

broken tooth

a broken tooth with old filling needing a crown
a broken tooth with old filling needing a crown

Do I really need that crown?

Many people come and go in our dental practice with teeth hurting and teeth with pending needs. Dentistry can be so preventative if people would only look at it that way. It would be hard for your family doctor to look at you and say, you're going to get sick next month, but in dentistry we can tell people, if you don't fix that tooth, it will start hurting soon.

The picture above shows a tooth with an obviously old filling, the tongue is on the right and the cheek on the left. There is an obvious crack in the tooth on the right side and another one on the left. Cracks can form from grinding your teeth at night while sleeping, clenching, biting down on a hard object such as a popcorn kernel, and just old fillings wearing out. A tooth with a large filling is at risk already because the insides of the tooth have been hollowed out to clean out decay. The amalgam filling is packed in to replace the decayed area. Amalgam fillings were originally thought to only last 7-10 years but I see them in teeth 15-20 years old. And no, in my opinion, these people are not suffering from some form of mercury poisoning. It's amalgamated- which means the mercury is combined with the silver to make a new material. A well done silver filling can last many years. But if it bothers patients, we tell them we would be happy to replace those fillings for you.

When chewing, teeth put an incredible amount of force on the object between them. That is why a crown is the obvious substitute for a broken-down filling of this size. The walls of this tooth will not support another filling, it is simply a waste of time and money because then the tooth is at risk for breaking a large corner off. Or worse, waiting on a time bomb like this means the tooth could crack all the way down to under the gumline between the roots. Now, you can no longer crown it, it must be pulled. A natural progression of a tooth like the one shown above would be a cavity forming beneath the filling or starting in the crack. From there, the tooth could abscess and the patient would present with pain, now needing a root canal and a crown. (more on this later). Or the tooth could continue to digress and eventually crack and break. Now a crown is definitely needed. If the tooth has only partially broken, it still might be possible to simply crown the tooth, but if the nerve has been damaged from the trauma, a root canal is needed. A crown simply covers the whole tooth like a ski cap on a head, so that is why it is also called a cap or crown. The entire tooth structure is then supported from the root edge up.

Why do I need a root canal if the tooth is already dying? The decaying material makes bacteria which starts coming out the bottom of the tooth showing as a dark spot beneath the tooth on an x-ray. Or it can be seen as a small red bump that releases a bad taste in the mouth. The nerve is dying and must be sealed off or the tooth will usually hurt bad. Antibiotics are given to heal the infection and the pain will subside. However, if the tooth is left untreated, the infection will come back. People can and do let this go sometimes and will present with broken teeth, or a half rotting shell of a tooth. Trying to cap a shell of a tooth is more difficult and can require a pin to help support the tooth. Plus if your toe or finger were rotting, would you just let it go if you didn't feel any pain from it? All those toxins being released in the mouth and body are not good for your heath. And yes, people have died from abscessed teeth. Your immune system is on constant demand working against this bacteria. But now you have the added expense of a root canal. Changing out the filling at first sign of a crack might have saved this from happening.

Once a root canal is done, the tooth can become brittle and so a gold crown supports the tooth for strength during chewing. A crown can be either all gold, or gold with a porcelain covering over the top to mimic tooth color. Sometimes the porcelain will break off the crown, but the gold is still in place underneath, and if needed, the tooth can be smoothed and is usually okay.

The sad thing is many fillings are placed in the mouth around the same time. Six year molars can have fillings by age 8-10 or usually in the teen years when brushing habits aren't as good. The 12 year molars can wait longer or decay soon after arriving in the mouth simply because of the age of the patient and location in the mouth. Unless the child is well disciplined in brushing their teeth, this is a prime time for many cavities to develop. Seeing a dentist regularly can avoid this. How you ask? Sealants can be placed in the mouth, fluoride administered and oral hygiene instructions given. Small cavities can be filled before before they progress into larger ones. Each time a filling comes out, it leaves a slightly bigger hole and a closer chance of needing a crown.

What if I just pull the tooth, I have lots of other teeth to chew with? Once a tooth is removed, several things start to happen. The opposing tooth that normally meets this now missing tooth will start to over erupt out of it's place. This exposes more of the root of the tooth which is not covered with super hard enamel. Now it is at greater risk for decay. And the empty space that remains causes drifting of the teeth around it. A tooth behind it will now drift forward or even start to lean slightly. Teeth in front can rotate and the occlusion changes in the mouth. The occlusion is how you bite your teeth together. If you have ever bit down on a new filling and it "hit" first, you knew it needed to be adjusted down to the level of the other teeth. When you have teeth shifting around in your mouth, this can become a problem. The only way to stop this or fix this is with a bridge. So now instead of one crown and that expense, you need two crowns on either side of the empty space connecting with a crown in the middle at three times the cost.  

I say, get in to see your dentist and save money on the front end.  It's your mouth!


    0 of 8192 characters used
    Post Comment

    • profile image


      5 years ago

      Needing a lot of crowns?? Whiten the rest of your smile before you start the process! Check out this link below for a great teeth whitening deal!


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)