What are fillings and crowns?

Fillings and crowns are restorations that replace tooth structure. A filling restoration will basically “fill” that part of the tooth that was damaged while a crown covers the entire surface of a tooth, protecting the damaged tooth. Both restorations will restore a damaged tooth back to its’ normal shape, function, and look.

Why fillings and crowns are needed

Fillings and crowns restore a tooth back to its’ normal shape, function and look. They can help repair damaged teeth or fix cosmetic issues. They may be needed because of a cavity, a crack, a chipped or broken tooth, wear or a previous restoration that is failing. They can correct discolorations, gaps or crowding. It is important to treat these teeth with fillings or crowns because these conditions can result in serious consequences and problems if they’re not taken care of.


If a tooth has a cavity it is important to remove the decay before it gets bigger. Decay can rapidly spread throughout tooth structure. If decay is left untreated, the tooth can fracture and become sensitive, painful or abscessed. The more tooth structure that is damaged, the more treatment required, such as a root canal. If the decay is extensive enough, the tooth could be beyond fixing and need to be taken out. Removing the decay early and restoring with a filling or crown can help prevent further problems and treatment.


A crack is a fracture line separating sound tooth structure. If left untreated the crack can progress further into the tooth causing severe pain and the tooth may need a root canal. The crack can spread down the root of the tooth or across the tooth causing it to split and need to be removed. Bacteria can enter the site of the crack and a cavity can form. If the crack is small, a filling can be done decreasing the chances of a crown, root canal or extraction being needed. A crown is required when there are several different fracture lines in a tooth or the crack line is seen extending further into the tooth. The crown acts like a helmet, protecting the tooth from cracks progressing further into the tooth.

Previous restoration failing

Older fillings and crowns often wear out with time and need to be replaced. The number one reason previous restorations fail is because decay gets around the tooth structure supporting the filling or crown. This is recurrent decay and it can result in having to remove the entire restoration to clean up the decay and place a completely new filling or crown. To help dental work last, we recommend good oral hygiene at home and routine cleanings, exams, and radiographs.


Teeth that have wear have a major functional issue going on. Good tooth structures is being reduced or eroded away. The teeth will start to look thin, short, discolored or jagged. The wear can start to progress at an even faster rate if not caught early. Teeth are in danger of sensitivity, pain and breakage. The further the damage to the teeth, the more treatment needed later.

Chipped teeth, crowding, spaces, discolorations or stains

Tooth colored fillings and all ceramic crowns can fix cosmetic issues. Misaligned or broken teeth are harder to clean and become plaque traps, making it easier to get future cavities and gum disease. These esthetic restorations can replace unnatural looking restorations containing metal. Older silver restorations can start to corrode and leak over time. Replacing them helps prevent futures cracks and decay.

Filling vs. Crown

Both fillings and crowns will help restore teeth and have them feeling and looking natural again. Fillings are best for smaller cosmetic and functional problems. When decay, wear, a break or crack line is more extensive, the tooth becomes weaker and is likely to fracture more. A crown is then recommended to strengthen that tooth and protect it from further problems discussed above. Crowns are excellent options for making larger cosmetic changes as well. Often both a filling and a crown are needed to restore a tooth back to health when severely damaged by decay, fractures or failing restorations. You may hear the filling called a “build up” with the crown. It essentially builds the damaged area back up with filling material, giving the tooth structure needed for a crown to be done.

More information

Dr. Brian will talk with you about the options you have regarding treatment and discuss which he thinks will be best for you.
You can learn more about different types of fillings or crowns, see patient photos, what to expect with treatment and how they are done.
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