When a tooth decays or breaks, most people's first question is: will a filling do? The answer depends mainly on how much healthy tooth is left. If most of the tooth is sound, a filling is usually enough. If a large part has been lost, or the tooth has cracked, a crown that covers it may protect it better.
Between the two there is also a middle option: the inlay or onlay. In this guide we explain what each one is and how we decide, based on one simple principle: keep as much healthy tooth as possible.
The filling
A filling closes the cavity left once the decay has been removed. Today it is usually made of a white material, composite resin, which bonds to the tooth and comes close to its natural colour. It is usually done in one visit, with local anaesthetic where needed.
- It suits small and medium-sized cavities, minor chips and replacing old fillings that are not too large.
- Advantage: only the damaged part is removed, without preparing the healthy tooth around it.
- Limit: when a filling has to be very large, the thin walls left around it can crack under chewing forces.
Inlay or onlay: the middle option
When the damage is too large for a simple filling but the tooth does not yet need full coverage, an inlay or onlay may be discussed. This is a piece of ceramic or resin made in the laboratory from an impression of your tooth and bonded into place. An onlay also covers one or more cusps, the raised points of the chewing surface.
It usually takes two visits and keeps more healthy tooth than a crown. It does not suit every case, though, because it needs enough sound tooth around it to bond properly.
The crown
A crown is a cap that covers the whole visible part of the tooth. The tooth is prepared all the way round, we take an impression and, while the crown is being made in the laboratory, you wear a temporary one. At the second visit the final crown is tried in, adjusted and cemented.
We usually discuss a crown when:
- A large part of the tooth has been lost, through decay, a fracture or a very large old filling.
- The tooth has cracked and hurts when you bite. A crown holds the tooth together and can help stop the crack from spreading, although this cannot be guaranteed in every case.
- A back tooth has had root canal treatment. These teeth are often more brittle, and in many cases coverage is recommended for protection, depending on how much tooth is left.
- There is heavy wear from grinding or erosion that has made the teeth shorter.
- Support is needed for a bridge, or a crown is going on an implant.
The drawback is that more tooth is removed than with a filling, and this cannot be undone. That is why we do not recommend a crown for a tooth that can be served well by something smaller.
How we decide
The decision is made after a clinical examination and, usually, an X-ray. We look at:
- How much sound tooth is left and how thin its walls are.
- Where the tooth is. Back teeth take much greater chewing forces than front teeth.
- Whether there are cracks or pain on biting.
- The condition of the nerve and root. If decay has reached close to the nerve, root canal treatment may be needed first.
- Your bite, and whether you grind your teeth.
We explain your options in order, from the smallest intervention to the largest, and what you gain or lose with each. If you have been told elsewhere that you need a crown and would like a second opinion, it is entirely reasonable to ask for one.
Do not leave a broken tooth for later
A tooth that has chipped or cracked is worth having checked soon, even if it does not hurt. Minor damage that can be fixed with a filling today may need a crown later, and a crack that deepens can reach the root. If you are in pain or have swelling, tell us when you call so we can see you as soon as possible within our opening hours.
Cost and GESY
For adults, GESY covers one clinical examination and one cleaning a year; fillings, inlays, onlays and crowns are not covered. The cost depends on the type of restoration and the material, and we tell you after the examination, before treatment begins. You can read more on our Crowns & Bridges treatment page.
Frequently asked questions
Does having a crown fitted hurt?
The preparation is done under local anaesthetic, so you usually feel only pressure and vibration. Afterwards there may be mild sensitivity for a few days. In a tooth that has had root canal treatment, sensitivity is usually even less.
What are crowns made of?
Most today are all-ceramic, with a shade that matches the neighbouring teeth. In some cases, especially for back teeth that take heavy forces, another material may be discussed. We choose it together, depending on where the tooth is and how you bite.
Does every root-canal-treated tooth need a crown?
Not always. Front teeth with little tooth loss can often be restored well with a filling. For back teeth, which take more force, coverage is recommended more often. It depends on how much tooth is left.
How long does a crown last?
Many years with good care. The tooth under a crown can still decay at its edges, so brushing, flossing and regular check-ups are needed, just as with natural teeth.
My old filling is large. Does it need to become a crown?
Not necessarily. If the filling is in good condition and the tooth has no cracks or symptoms, we often simply keep an eye on it. If it is worn, has decay at its edges or the tooth hurts when you bite, we discuss the options.
Book an appointment
If you have a broken tooth, a large old filling or have been told you need a crown, call us on 77 773 003 or send a message on WhatsApp or Viber to 95 133 089. At DentLux Clinic in Aglantzia, Nicosia, we will examine the tooth and explain what options there are, and why.
