When determining if a tooth needs a crown or just a filling in terms of cost, Dr. Stuart Rich says it's important to not be short-sighted, because the tooth can end up splitting entirely and that would be far more expensive altogether.
A dentist in Auburn, Washington, Dr. Rich says when making this decision, it's important to be use a dentist that has the patient's best interest in mind and shouldn't be "sold" on healthcare. Most dental offices today have inter-oral video camera equipment, which gives patients a tour of their mouth in close up detail and the dentist should be able to show you pretty clearly why a crown would be necessary.
There are fillers out there to bond the tooth but they're not "bulletproof," explains Dr. Rich because if you have a fracture that's extending down the side of the root approaching the gumline, that has to have a crown. No bonding material out there is strong enough to do that. Similar to splitting firewood, over time, a filling will split apart a tooth.
As an alternative to crowns, there is something called an extensive build-up, using the bonding material and offering a temporary solution. This can get the decay out and partially splints the fracture back together and buys you some time to get the crowns done. Loosing the tooth altogether is 4-6 times the cost of a crown, by the time a bridge or implant is put in.
The standard accepted care is that if the filling exceeds two-thirds of the width of the biting surface of the tooth, it really needs a crown. Even more so if that filling extends down the sides of the tooth or if it has a fracture line or crack.
Dr. Stuart Rich is a dentist with Sleep Solutions Northwest in Auburn, Washington. He is a leading sleep expert with Sleep Better TV, providing online, sleep disorder breathing video content and is a featured network of Sequence Media Group.