What are the Alternatives to Having a Crown?

The alternatives to having a crown depend on the purpose of the crown or crowns.

If you are having a single implantor a traditional dental bridge then a crown will be necessary -period.

If the purpose is to protect a weakened tooth then the options are:

• Do nothing. Leave the tooth as it is. The tooth may have had a very large filling held in by a small amount of tooth for a number of years. If you decide to remove the filling then you can sometimes create more problems than you solve, especially if there is nothing technically wrong with it. You could end up removing that bit of natural tooth that is holding everything in, the tooth then breaks off to gum level and needs a root canal post, a core and crown. Bear in mind this may happen anyway, but sometimes it is sensible to listen to the saying, ‘if it isn’t broken then don’t fix it’.

• Fillings. If the tooth has broken or has decay in it, then something must be done. The simplest and cheapest thing is to repair the problem part of the tooth or replace the filling. This isn’t a long-term solution or indeed always possible or sensible. Every case is different and must be judged that way. The larger a filling is, the more likely future problems are and the better an indirect restoration (one made in the lab) would be. It is judging the point at which the long-term success of a filling becomes questionable and where the filling would be better acting as a core for a crown, in order to help preserve your tooth.

• A full coverage filling An alternative (be it not as good) to a crown if the tooth has been root filled. The filling must cover the whole top surface of the tooth to be effective.

• An inlay/onlay. In circumstances where filing down the core for a crown preparation will remove all tooth holding in the filling or weaken it considerably, an onlay/inlay may be a better choice. This would preserve the maximum amount of natural tooth.

• Extract tooth then fill the space. If the prognosis is very poor for your tooth, it may be better to simply have it taken out and consider the options for restoring the space.

If the purpose is simply aesthetic…
If you have a discoloured tooth or a crooked tooth or teeth, crowns are an option but please… please… please… consider preserving your healthy natural teeth as much as possible. Crowns are an irreversible procedure and you should carefully consider the other options available. It is important to consider how your mouth will be in 20 years time! Looks might be the most important thing to you now, but I can promise you the ability to eat will become more important in years to come.

Many options exist for improving the appearance of your teeth and no two mouths and cases are the same.

The options are:

• Do nothing

• Whitening

• Internal bleaching
• Braces

• Veneers

• Tooth bonding (composite veneers)

• Crowns

• Extraction and close or fill the space

These treatments can be done alone or in combination. Every case is so different and must be assessed individually as expectations, teeth, hygiene, dentist experience and more, all come into play. See treatment planning

Here we are entering the realm of cosmetic dentistry.

But, just for example (be it slightly extreme) a great improvement may be achieved by simply whitening your teeth and selectively bonding white filling material (composite) to change the shape of certain teeth giving you a vibrant and satisfying smile.

Since the solution is very conservative, you maintain most/nearly all of your teeth structure into the future, meaning all options still remain open to you further down the line. Contrast this with 8 crowns top and bottom which look great now, but two teeth die off as a result of the crown procedure and need root canals and replacement crowns, one fails, needs an apisectomy that doesn’t work and has to be extracted and replaced with an implant. It’s not often the dentist will tell you that- but the risk is a reality, be it small and terribly unfortunate. Wouldn’t you rather go into something being aware of all the possible outcomes?

I’m just trying to emphasize the importance of carefully considering and exploring all the options that will affect your long-term health. It may be that crowns are the way to go for you, as long as you are making an informed decision that’s what matters!

If the purpose is both aesthetic and protective…This is where crowns have most value as they provide excellent esthetics and great protection.