There are numerous ways that dental crowns work. Basically crowns strengthen teeth while fillings weaken teeth. So then it follows that the larger a filling is, the thinner the surrounding tooth structure is. Then the thinner the surrounding tooth structure, then the even weaker the remaining tooth structure. With a crown a stronger and more intact material is placed over the tooth in order to hold the tooth together and to provide a stronger surface on which to bite and chew.
In this adjacent image is shown a tooth with decay around the fillings. Upon removal of the filling and the decay there is quite a bit of tooth structure missing. The resultant tooth structure is weakened and has a fair potential to break away. This can lead to complications. Instead of waiting for the tooth to break it would be more prudent to protect the tooth with a crown or partial crown. In doing this the tooth is strengthened and thus has less of a potential for future problems.
In the same way this tooth is strengthened by a crown or partial crown, a back tooth which received root canal therapy, like the one to the left, would also benefit from the strength of a crown. Teeth which have had root canal treatment no longer have a blood supply in the hollow layer of the tooth. Without the blood supply the tooth becomes more dry and thus more brittle. Things that are more brittle have a greater chance of splitting or breaking. As a result the back teeth are very highly recommended for crowns immediately following root canal treatment.
In addition, teeth which are severely broken down or which have severe wear would also benefit from crown coverage. In the same way the crown provides a strong and intact surface on which to bite and to chew. Fillings do fill space and can be used to replace large amounts of tooth structure. However, filling materials are weaker and do not bond to the teeth as well as crown materials. Large fillings are a compromised solution which may lead to increased problems and fees later. Crown materials like gold and porcelain and zirconia provide the stronger material with a greater potential to last for a long time.
To summarize, dental crowns, like the Cerec single-appointment crown shown above, work by providing a surface layer on teeth which is stronger and intact. This then provides for a longer term solution to dental problems. Certainly there are times when crowns can be over-utilized; patients rely on their dentist to provide their expertise on when a crown is needed. It serves patients well to select a dentist who is reputable and has very favorable online reviews.
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