Do I need a dental crown?

Seven Reasons Why You NEED a Dental Crown

A dental crown—sometimes referred to as a “cap”—is a type of dental restoration that covers your entire tooth instead of going inside of it like a filling. While we strive to practice minimally invasive dentistry by placing small fillings, there may be instances where that’s not an option. A dental crown is ideal in situations where the tooth cannot structurally support a filling. Here are several examples of when our Raleigh dentist will prescribe a crown for your tooth.

After a Root Canal


If you’re planning on having endodontic therapy completed anytime soon, you’ll also need a dental crown. Since root canal-treated teeth no longer have an active blood supply, they are not “alive” like the neighboring teeth are. This situation causes them to become a bit more brittle over time, which can predispose them to chipping or premature wear from everyday biting and chewing. Placing a crown over your tooth after a root canal helps you retain the tooth structure and keep using your tooth normally. Since the crown distributes biting forces evenly across the restoration, you don’t have to worry about certain points of the tooth fracturing off.

We tend to recommend a same-day CEREC dental crown on the same day as your root canal, or having a conventional crown placed within two weeks of your endodontic therapy is completed. Our Raleigh dentists will discuss the advantages of each so that you can select the one that’s best for your situation.


Replacing an Old, Large Silver Filling


Today’s white fillings age well; when they need to be updated, we simply clean out the old filling and replace it with a new one. But traditional silver fillings are a little different. Since they’re held into your tooth by a wedge cut into the enamel (mechanical retention, as opposed to a physical bond) they take up more tooth structure. Once they start to leak, give out, or need to be updated, a larger area of the tooth has to be prepped to place a new restoration. If the filling is extremely large, there may not be enough tooth left to hold an even larger filling. The natural progression is to preserve what’s left and go ahead and cover your tooth with a crown.

This scenario can be a harder pill to swallow for some people, because their tooth may not feel like anything is wrong with it. Even if the tooth doesn’t hurt or have an active cavity, certain protective measures need to be taken before the tooth breaks unexpectedly, because a fracture and potential nerve exposure could be even more problematic to address. The standard of care is to intercept at-risk teeth such as these before you run the risk of an emergency.


You Have a Large Cavity or Crack

It may seem like an outdated comparison, but a cracked tooth holds a lot of similarities to a “run” in a nylon stocking. Once it forms, it just gets longer and longer until the whole thing is involved. Cracked teeth can range from obvious to difficult to diagnose. A small crack in your enamel can gradually lengthen over time if it’s not addressed quickly. Placing a crown over a medium-sized crack can help to prevent the spread of damage so that you can potentially avoid the need to extract the tooth entirely.

With cavities, the situation is fairly similar. When only a small amount of enamel is compromised, we can easily repair the decay with a filling. But the larger the cavity is, the less of a “shell” of enamel is there to support a restoration. Rather than try to fill in a large void and risk fractures to the tooth that’s left, the better alternative is to put a crown over what’s left. Our Raleigh dentist will need to use an X-ray of your tooth to assess how deep the decay extends into the structure. If a cavity or crack reaches the nerve tissues, endodontic therapy will also be required alongside your dental crown.



If You’re Getting a Single Dental Implant

Are you replacing a missing tooth with a dental implant? Implants function like artificial tooth roots. Although a small portion of the implant is visible at the gumlines, they do not make up the “crown” portion that you chew or smile with; you’ll still need a restoration on top of them.

In the case of replacing one tooth, you’ll need an individual implant with a porcelain crown on top of it. The crown is fitted to your implant abutment similar to the way it would be a prepped tooth. Once it’s installed, your crown, abutment, and implant essentially make up a complete artificial tooth. It sets alongside natural teeth as an independent restoration. Simply brush, floss, and treat it like any one of your other teeth!


There’s Extensive Enamel Wear

Your enamel is the most durable structure in your entire body—even harder than bone. But teeth aren’t invincible. If you have a habit of clenching and grinding, or your teeth line up irregularly, it will eventually cause your enamel to wear against itself. Over years of wear, your teeth may start to look flattened or shorter than they’re supposed to.

When a tooth wears down, the only way to build it back up again is to put a crown over it. Placing crowns restores the optimal height of the teeth, allowing you to chew normally. This restoration process helps to add height back to your facial profile, where jaws might otherwise appear “short” or “scrunched”. It also reduces strain to your TMJ, allowing it to perform at an optimal level since the teeth bite together properly again.

Tooth wear has to be fairly moderate to severe before a crown is required. If you’re starting to see the early signs of erosion, chipping, or flat areas, be sure to meet with our Raleigh dentist to identify the cause of this anomaly. An alternative, preventative service may be the better option if the tooth wear is caught early enough.


You Need More than a Dental Veneer

Dental veneers are an excellent cosmetic treatment for enhancing your smile’s appearance. However, veneers only cover the front of teeth and just a slight area around each of the edges. They only offer reinforcement from one direction. When people are undergoing smile makeovers and they have a tooth that’s structurally compromised, a veneer may not be appropriate.

Instead, you can place a crown on weak or damaged teeth. The crown will provide the protection you need, without compromising aesthetic results. Since we can have your crown crafted from the same type of porcelain materials as a veneer, you’re able to plan your smile makeover where the restorations match one another. You can essentially have one crown alongside a set of dental veneers, without anyone knowing there’s a difference.

For people who don’t qualify for dental veneers, porcelain crowns are an excellent choice. A set of several crowns can add protection, integrity, and transform your smile all at the same time. So if you don’t qualify for veneers, don’t worry—your smile can still look gorgeous!


You Broke a Tooth

Severe dental fractures can be extremely scary and painful. Maybe you had an accident on a bike, slipped in the bathroom, or got elbowed in the mouth during a basketball game. Accidents happen. Depending on the severity of your fracture and how much tooth structure actually broke off, you may not be able to bond the broken portion back into place. At this point, your only option may be to cover the remaining portion with a crown to preserve what’s left. As long as the fracture doesn’t extend down into the nerve, we can prep the tooth structure that’s left and cover it with a crown. That way you can keep eating, drinking, and going about your normal routine. But if the break reaches the pulp tissue, you’ll need endodontic therapy prior to the crown placement.

If you break a tooth, do your best to get to our Raleigh dental office within the next hour. Contact us immediately so that we can arrange for your arrival. If you’re able to locate the broken tooth fragment, store it in a sealed container and completely cover it with milk, saline/contact solution, or tap water with a pinch of salt.



Same Day Dental Crowns in Raleigh

Raleigh Dental Arts has invested in innovative technology that allows us to mill and place custom ceramic dental crowns in just one appointment. Instead of necessarily having to send off an impression and wait two weeks, you can complete your dental crown treatment in a single visit. No extra numbing. No extra time off work. Just a custom, attractive restoration that helps your smile perform its best.

For more information about same day dental crowns or to find out if you need a “cap” at all, call Raleigh Dental Arts today!

Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.