Crown or Filling? How We Decide the Best Way to Repair Your Tooth

When a tooth is damaged — whether by decay, a crack, or wear — one of the most common questions we hear at Norman, Obeck, & Foy Dentistry is: “Will I need a filling or a crown?” It’s a reasonable question. Both treatments restore a tooth, but they do so in different ways and for different situations. Choosing the right option isn’t guesswork — it comes down to assessing how much healthy tooth remains, how the tooth functions in your bite, and creating a solution that lasts.

Let’s break down how we approach this decision for your smile.

Understanding the Difference Between Crowns and Fillings

A filling is a repair. It replaces a small to moderate area of tooth structure that’s been lost to decay or minor damage. Modern filling materials — especially tooth‑colored composites — bond directly to your tooth and restore its shape and function with minimal alteration of the remaining healthy structure.

A crown, on the other hand, is a full‑coverage restoration. It encases the entire visible portion of the tooth above the gumline. This makes crowns ideal for cases where the tooth is weakened, has a large area of decay, or has already had extensive dental work.

Both options can restore your tooth and help you chew comfortably again. The question is: which one offers the most reliable outcome for your specific situation?

How We Evaluate Your Tooth

When you come in with a cavity, crack, or old dental work that needs attention, we consider several factors before recommending a filling or a crown.

First, we look at how much healthy tooth structure is left. If only a small portion of the tooth is affected, and most of the enamel and dentin are intact, a filling is often sufficient. The cavity can be cleaned out, and the resulting space filled and sealed. This preserves as much of your natural tooth as possible — which is always a priority.

But if the damage is larger — for example, a big cavity that extends deep into the chewing surface, or an old filling that’s failing — there may not be enough healthy tooth left to support a filling that will last. In those cases, a crown can provide a stronger, more protective restoration.

We also consider how the tooth fits into your bite. Back teeth (molars and premolars) take a lot of chewing force every day. If a tooth is significantly weakened, placing a crown helps distribute biting pressure more evenly and reduces the risk of fracture. A filling in that scenario might repair the hole, but it won’t reinforce the overall structure as effectively.

Cracks and Root Canal History

Cracks are another important consideration. Minor surface cracks that don’t extend deep into the tooth may be managed with a filling. But deeper cracks — especially those that approach the root — leave the tooth vulnerable to splitting under pressure. A crown, in those situations, acts like a protective shell that helps hold the tooth together.

If a tooth has had a root canal, it tends to become more brittle over time. In these cases, we often recommend a crown even if the remaining structure looks sufficient. The goal is to minimize the chances of the tooth breaking later, which can lead to more complex treatment down the road.

What to Expect With a Filling

Placing a filling is typically a straightforward process. After removing the decay or damaged area, we clean and shape the space to ensure the filling will bond securely. A tooth‑colored composite material is applied in layers and cured with a special light. Once complete, the tooth looks natural and functions normally.

After a filling, it’s common to experience mild sensitivity to temperature or pressure for a few days. This usually resolves quickly. If the bite ever feels slightly off after the appointment, a small adjustment can make a big difference.

What to Expect With a Crown

A crown usually requires two visits: one to prepare the tooth and take impressions or a digital scan, and another to place the finished restoration. During the first visit, the tooth is shaped so the crown will fit snugly and align properly with neighboring teeth. A temporary crown protects the tooth while your custom crown is being made.

At the second appointment, we remove the temporary and cement the permanent crown in place. A well‑made crown restores strength, function, and appearance. It’s designed to look like a natural tooth and blend seamlessly with your smile.

After the final crown is placed, you may notice a little sensitivity or slight change in how the tooth feels — especially as your bite settles — but most patients adapt quickly.

Choosing What’s Best for Your Smile

At Norman, Obeck, & Foy Dentistry, our goal is always to recommend the restorative treatment that offers the best mix of durability, comfort, and preservation of natural tooth structure. When a filling will restore the tooth reliably, we embrace that conservative option. When a crown will help protect the tooth and improve its long‑term function, we recommend that route.

We believe it’s important for patients to understand the why behind their treatment. That’s why we’ll walk you through our findings, explain the pros and cons of each option, and give you space to ask questions. You deserve clarity and confidence about your dental care — and we’re here to provide it.

If you’re facing a decision between a filling and a crown, call our Richmond, VA office. We’ll evaluate your tooth, talk through your options, and help you choose the approach that keeps your smile strong for years to come.

Categorized in: Dental Crowns, Dental Fillings, Restorative Dentistry