Do I need a crown, or will a filling do?
Short answer: A crown is usually justified when more than about half the tooth structure is gone, when a tooth is cracked, or after root canal treatment on a back tooth. A filling is generally enough for smaller cavities with solid walls remaining. Because a crown costs several times more, it is worth asking exactly why one is being recommended.
This is one of the most common places a treatment plan jumps in price, and one of the least explained.
The actual difference
A filling replaces missing tooth material inside a cavity. It relies on the remaining walls of the tooth for strength.
A crown covers the whole tooth like a cap, holding it together from the outside. It requires removing a layer of the tooth all round to make room — which is why it is not a decision to take lightly in either direction.
When a crown is genuinely the right call
- Most of the tooth is gone. A large filling in a weakened tooth acts like a wedge; the remaining wall eventually splits, sometimes below the gum, sometimes unsaveably.
- The tooth is cracked. A crown holds the pieces together. A filling does not.
- After root canal treatment on a back tooth. Root-treated teeth are more brittle and take heavy chewing load; crowning them significantly improves how long they last.
- Repeated failure. If a filling in that tooth has broken more than once, the pattern is telling you something.
When a filling is probably enough
- A small or moderate cavity with strong walls remaining
- A front tooth chip, where bonding often looks excellent and costs far less
- An old filling being replaced with no crack and plenty of structure left
Modern bonded composite is strong, and a well-placed filling in a sound tooth can last many years.
What to ask
- "How much of the tooth is left?"
- "Is there a crack, and can you show me?"
- "What is likely to happen if we do a filling instead?"
- "Is this urgent, or can we watch it?"
- "What is the total cost, including any build-up needed under the crown?"
If you would like an independent view before committing, ours is free.
Common questions
Why is a crown so much more expensive?
It involves more chair time, laboratory work or in-house milling, materials, and usually two visits. Whether that cost is justified depends entirely on how much tooth is left.
Can I have a filling now and a crown later?
Sometimes — but if the tooth splits in the meantime you may lose the option entirely. Ask specifically what the risk of waiting is for your tooth.
Do all root-treated teeth need crowns?
Back teeth usually benefit substantially because of the chewing forces involved. Front teeth with plenty of remaining structure often do not.