Dental crowns: Alternatives and options.

If your dentist recommends a crown, do you have any other options?

There is no other type of dental restoration that cups over a tooth in the same way that a dental crown does,* and for this reason there really is no perfectly equivalent alternative treatment.

Depending upon your specific circumstances, however, there are choices that might be made as a suitable alternative to the immediate placement of a crown. However, each of them usually involves at least some degree of risk.

It is your dentist's obligation to discuss each available option with you. You should never make a treatment decision unilaterally. Both you and your dentist, together, need to determine which alternative might be considered to be a reasonable approach for your situation.

Options / alternatives to the immediate placement of a dental crown.

[*There are variations on the technique of placing a dental crown. These are termed onlays and 3/4 crowns. The premise associated with each of these is identical to that of a full crown, they just cover over a tooth less completely. For the purposes of our discussion here, we consider each of these restorations to be essentially the same.]

A) Have a filling placed instead of a crown.

While there are a number of factors that must be taken into consideration before selecting this option, having your dentist place a dental filling instead of a crown can prove to be a workable solution.

Fillings vs Crowns.

Placing a filling instead of a crown, especially one that will need to be quite large, isn't typically considered to be ideal treatment. You cannot expect a filling to give the same type of longevity or create the perfect shape and anatomy like a crown can.

A big cavity repaired by a big dental filling.

Additionally, fillings do not provide the same level of protection from fracture. Without a crown a tooth may crack or break sometime in the future, possibly irreparably. However, despite these tradeoffs, a filling approach often works out just fine.

A crown can still be placed at a later date.

Certainly, having a filling placed now does not preclude the placement of a dental crown later. And, in fact, in most cases even if a filling has been placed, it would still be prudent to go ahead and have a dental crown made for the tooth whenever circumstances (financial or time) permit.

B) Delay the placement of the dental crown.

Delaying a crown can provide an appropriate alternative in some situations. At other times, it might make the absolute worst choice. For this reason, you should never choose this option without the advice and concurring opinion of your dentist.

In the case where a relatively serviceable, although less than ideal, filling already exists, postponing a crown may make a reasonable approach.

But in cases where decay is already present, or the tooth has broken in a fashion where it traps food and plaque easily and therefore decay is likely to form, delaying your treatment could very well lead to more serious complications and even tooth loss.

C) Temporize the tooth so crown placement can be delayed.

In those cases where a tooth that needs a crown has some type of immediate issue that needs to be addressed, it might be possible for a dentist to temporize the tooth, thus allowing for an extended time frame before a crown is finally placed.

As examples, if a tooth has decay, a dentist can probably remove it and then place some type of temporary filling. Or, if the tooth has broken, the dentist might go ahead and place a temporary crown. The crowning process could then be resumed at a later date.

While this approach may provide an adequate option, it's not exactly ideal. Temporary dental restorations don't have the strength, longevity or retentiveness of their permanent counterparts. This can place your tooth at some degree of risk. It also places you at risk for at least some level of inconvenience, if not worse.

If this alternative is chosen, you should ask over what time frame it would be expected that this temporization should remain stable. You'll also need to ask about what precautions you should take while the temporary restoration is in place.

D) Ask what financial arrangements can be made.

For many people, it's the cost of a dental crown that creates the barrier to having their work performed. And since this is such a common obstacle, it's likely that your dentist will have some type of financial arrangement or credit plan available so your crown can be placed now and paid for over time.

E) Confirm the need for the crown with a second opinion.

A missing tooth allows the neighboring teeth to shift.

Different dentists have different skills and abilities and also different training and clinical experiences. A second dentist may have varying views or insights regarding what they feel can be an appropriate treatment approach for your tooth.

No one can predict the future. There isn't always one right solution to every problem. Hear each dentist out and see whose approach makes the most sense to you.

F) Have the tooth extracted.

This seemingly cheapest and simplest solution is often the most expensive and worst choice in the long run.

When a tooth is extracted its neighboring teeth will tend to shift position, possibly significantly so. The resulting misalignment can have a major impact on a person's dental health. Even the removal of a single tooth can lead to problems with chewing ability, jaw joint function, or create a situation that makes remaining teeth harder to keep clean (and therefore at greater risk for tooth decay or gum disease).

So to avoid these types of complications, your dentist will probably recommend to you that you replace any tooth that has been extracted with an artificial one. Replacing a missing tooth (using a dental implant, bridge, removable partial denture) can easily cost more than simply having a crown placed.

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