My tooth doesn’t hurt, but my dentist said it has a crack. Do I need a crown?

A full coverage restoration, commonly referred to as a “crown” or “cap” is a common procedure completed by your general dentist. If you are reading this article, chances are you were recently recommended a crown by your dentist. Let’s explore your treatment options and see what is best for your oral health. 

  1. Why would I need a crown?
    • Cracked-Tooth Syndrome: If it hurts when you bite down, it is possible that your tooth is cracked. A cracked tooth can present with a wide array of symptoms, but often requires a crown as the treatment modality. Depending on the extent of the crack, your treatment options can include a dental crown, crown lengthening, or extraction. Unlike your bones, a fracture in a cracked tooth will not heal on its own and requires treatment. 
    • “Stress” lines: It is very common that a dentist will inform you that your tooth has “craze” or “stress” lines. This often presents with large amalgam (“metal”) fillings. While your dentist will want to monitor this condition closely, it doesn’t mean that a crown is needed. Factors that influence the dentist’s decision are often based on your parafunctional habits and your past dental history: Do you grind or clench your teeth? Have you fractured a tooth before? Is the tooth causing you pain? 
    • Large “silver” or amalgam filling: If your filling comprises more than 2/3 of the width of your tooth, it is a possible that you will need a crown. The concern is that the remaining tooth structure is unsupported and at risk for fracture. You can be proactive and prevent the tooth from fracturing with a crown. Otherwise, you can follow a more conservative approach of “if it isn’t broke, why fix it” and wait; however, this decision may result in you requiring additional dental treatment
  2. What happens if I delay treatment?
    • Nothing: It is possible that the tooth doesn’t fracture or cause you any discomfort. However, it is importance to have regular check-ups with your dentist to monitor the tooth. At Wilmette Dental, Dr. Robert Madrigal, DDS uses an intra-oral camera to document the tooth’s condition and show his patients the presentation of the tooth. Dr. Madrigal informs his patients of their options and makes them aware of early signs that a crown should be completed. Symptoms include cold sensitivity, sweet sensitivity, pain with biting, throbbing, or aching pain 
    • The tooth can fracture above the gum line: If a minor fracture occurs, you will now need to have a crown completed as long as the tooth is deemed restorable by your dentist
    • Root Canal: The tooth can fracture, involving your pulpal tissue (“nerve”), and require a root canal treatment prior to a crown
    • Unrestorable fracture: The tooth can split in “half” or fracture below the bone level, which will require the tooth to be extracted 

Wilmette Dental’s Dr. Robert Madrigal, DDS Recommendation:

It is important to have regularly examinations and cleanings with your dentist, so your oral health can be closely monitored. The use of intra oral cameras are essential for your dentist and yourself to track your tooth’s condition and understand your best treatment option. 

Our philosophy is to perform comprehensive dental treatment to aid in conservative treatment options. It is vital to treat issues early and be proactive, to prevent our patients from needing additional dental treatment. 

If you are interested in a consultation with Dr. Madrigal, please reach out to Wilmette Dental at 847-251-0085. 

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