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Question:
Determining Need for Crowns: How is it determined that a Dental Crown is needed?

How much of the existing tooth must be destroyed to fit the crown? Can an inlay often be fitted in place of a crown? ...Visitor from MO

Answer:
First of all: training is different at different dental schools so philosophies can differ from one dentist to another. That being said crowns are generally needed if fillings are greater than 2/3 the cheek to tongue width of the tooth.

In other words if the cusps are weakened and fracture appears likely then a crown may be suggested to prevent vertical fracture and tooth loss.

Teeth that are filled with large fillings are not candidates for inlays as inlays are conservative and if such a small (1/3 to 1/2 the cheek to tongue width to the tooth) filling is needed a direct composite or inlay will be offered to the patient.

An inlay can be gold, porcelain, or composite made in a lab. To prepare a crown generally 2 mm of tooth is reduced off the top of the tooth and 1.5 mm is removed from the front of the tooth. This can be 1mm in some instances, it depends on crown design, type of crown (gold vs. porcelain) and preparation design of the crowns margins.

Hope this helps. Bottom line you have to find a dentist you trust to suggest proper treatment based on x-rays, occlusion, current restorations, state of the mouth and financial considerations. If you can't get the right answer from your dentist that makes sense - get a second opinion.

Wisconsin Reconstructive Implant Dentistry
Richard Winter, DDS MAGD
Winter Dental Associates
5323 W. Hampton Avenue
Milwaukee Wisconsin WI 53218
(414) 464-9021

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