Fix the tooth, keep the smile looking like you.

Filling or crown: which does my tooth need?

It comes down to how much healthy tooth is left. A filling repairs a small or medium cavity, or a small chip, by replacing the damaged part with tooth-colored material. A crown covers the whole visible tooth when there isn't enough strong structure left for a filling to hold.

We'll show you intraoral photos and x-rays of the tooth so you can see the cavity or crack yourself, then explain why we're recommending one over the other. If there's more than one reasonable option, we'll say so.

Tooth-colored fillings

We've switched from silver fillings to composite resin, a blend of fine glass particles and resin that bonds to the tooth to support and strengthen it, and is shaded to match it. Nobody sees a filling when you laugh, and because the material bonds, we can often remove less healthy tooth to place it. A small cavity caught early usually needs nothing more than this.

Most fillings take one visit. We numb the tooth, clean out the decay, build the filling up in thin layers, harden each layer with a curing light, and polish it so your bite feels normal. You can eat once the numbness wears off.

What about my old silver fillings?

There's no need to replace a silver filling that's intact and healthy. But older fillings can crack, leak at the edges or let decay sneak in underneath. If we see that on your x-rays or photos, we'll show you and talk about replacing it with a tooth-colored filling or, if the tooth has been weakened, a crown.

When does a tooth need a crown?

A crown fits over the whole tooth. It seals out the bacteria that cause decay and infection, and protects the tooth from the force of your bite. We usually recommend one when:

• A cavity or old filling is too big for a new filling to last
• A tooth is cracked, or a corner of it has broken off
• A back tooth has had a root canal and needs protection from chewing forces
• A tooth is badly worn down from grinding
• It's anchoring a bridge, or sitting on top of an implant

Crown materials: what are my options?

Every crown balances looks and strength. Zirconia, E.max and porcelain are all metal-free and made to match your natural teeth. We offer several materials and help you pick the right one for the tooth:

• Zirconia: very strong and tooth-colored, a good choice for back teeth and for people who grind
• E.max: a glass ceramic with natural-looking translucency, popular for front teeth
• Porcelain: lifelike color for the teeth people see most
• Porcelain fused to metal: a tooth-colored surface over a metal base
• Gold: very durable and gentle on the teeth it bites against, when looks matter less

How getting a crown works

A crown usually takes two visits. First we numb the tooth, remove any decay and shape it so the crown can slip over it. Instead of a tray of impression putty, we take a quick digital scan. You leave with a temporary crown while a dental lab crafts the final one.

At the second visit, typically a couple of weeks later, we remove the temporary, check the new crown's fit, color and bite, and bond it in place. Be gentle with the temporary in between: skip sticky foods, and call us if it comes off.

Making fillings and crowns last

Fillings and crowns can't decay, but the tooth around them can, especially at the edges. Brush twice a day with fluoride toothpaste, floss daily and keep your six-month checkups, where we look closely at every restoration you have.

If you grind or clench, a custom nightguard protects your crowns and fillings along with your natural teeth. Chewing ice, opening packages with your teeth and biting pens are hard on everything. With good care, many crowns last ten years or more.

Why it's worth fixing a cavity early

Small cavities don't usually hurt, which makes them easy to put off. The trouble is that decay keeps going. A spot that needs a small filling today can need a crown next year, or a root canal once it reaches the nerve. Catching it early is the simplest and least expensive route.

If a tooth already hurts, stays sensitive to hot or cold for more than a few seconds, or you broke a piece off, call us. Same-day emergency visits when we can, during office hours.