Why Does a Tooth with a Small Filling Need a Crown?

Patients often won­der about why we rec­om­mend expen­sive treat­ments for teeth that don’t seem like they “need” it.  Today was an excel­lent exam­ple of why our rec­om­mended treat­ment may change while we are work­ing on a tooth, as well as why we say you need a crown when noth­ing really seems wrong.  Lastly, it is one of the most pow­er­ful rea­sons why I use dig­i­tal pho­tog­ra­phy to doc­u­ment and edu­cate patients, because when you can see for your­self, it’s a lot eas­ier to understand.

A Tooth with a Small Fill­ing Sud­denly Needs a Crown?

Take a look at this tooth please, and what do you see?  Prob­a­bly just a small tooth-colored fill­ing with some suspicious-looking grey areas on the sides, right? (click on it for a larger view).  From the x-ray, I knew the grey­ish area on the left side was from a cav­ity. It didn’t look all that big, though, so I rec­om­mended a new tooth-colored (com­pos­ite resin) fill­ing — really not that big a deal.

Cracked Teeth Usu­ally Need a Crown

Once I took the old fill­ing out, indeed we found some decay on that side of the tooth, but what wor­ried me most is what you can clearly see in the pic­ture — a crack run­ning from one side to the other across the base of the tooth. It is stained blue because of a dye we use to see the extent of a cav­ity or crack clearly — much eas­ier to see for the patient. The patient told me she had not had any pain when bit­ing, which is good, but kind of sur­pris­ing. These upper teeth (pre­mo­lars, which are behind the eye-teeth and in front of the molars) are the most likely to split all the way through, and if that hap­pens, there is no way to save the tooth. The only way to save the tooth long term is to both bond it and to “wrap” it within a crown, which will keep the tooth from spread­ing fur­ther apart.

Cracks in Teeth Don’t Show Up on X-rays

Your next thought might be, “Why couldn’t you see the crack on the x-ray, Dr. Payet?”  A very nat­ural ques­tion, too.  The answer is sim­ple: unless a tooth is cracked so badly that pieces start sep­a­rat­ing, they are too nar­row to show up or be vis­i­ble to the human eye.

What Causes a Cracked Tooth?

Save an Appoint­ment with Same-Day Porce­lain Crowns with CEREC

Here is where we can really help patients, too, with our CEREC same-day porce­lain crown sys­tem. We’d done sev­eral crowns for this patient 4–5 years ago, before we added CEREC tech­nol­ogy to our office, so she had never expe­ri­enced it. She was used to get­ting an impression/mold, a tem­po­rary crown, then com­ing back in a cou­ple weeks to have the real crown bonded in. Today, how­ever, after dis­cussing the sit­u­a­tion, we made her Emax porce­lain crown and bonded it in before she left. Need­less to say, she was very happy at not hav­ing a tem­po­rary crown, nor hav­ing to make a return trip and get numbed up again.   I for­got to down­load the fin­ished pic­tures of the crown, but I’ll add those in the next 1–2 days.

To make an appointment:

Request an Appoint­ment Online or call us at 704–364-7069.

We’ll look for­ward to meet­ing you soon!