"When do I need a crown?" When teeth get broken more than a filling can fill. 

Notice how previous patches encompass most of the back two teeth, thisis fairly obvious crown situation.  The little tooth with the blackfilling is also fracture to the right.  A split in the tooth reallyrequires something called a bonded build up... and then a crown overall else for maximum strenth, cleansability and of course beauty.

Some people think that beautiful restoration is somehow "cosmetic"only or "functional" only.  But the truth is when structures are fixedproperly they look beautiful also! 

The patient here, decided to get bonded gold (the ultimate in strength) for the furthest back tooth.  This is a 50+ year old man with a very heavy bite and strong but more beautiful bonded all ceramic crowns for the two tetth more forward of the back one, and a little composite (white) filling on the next one forward.  Nice result, don't you think? 

In any case filling or crown, veneer, or onlay.... all restorations should be BONDED, not merely glued in.  Realize that as of the classes I attended in 11-07, over 85% of practicing dentists didn't routinely bond restorations in. 

I wouldn't have anything but bonded restorations in my mouth or my family's.... remember in my office YOU ARE FAMILY TOO. 

Many dental practices are cutting fees and cutting corners to match.  A sizeable number of offices have told me about cheaper lab's in Phillipines or China that make crowns at a fraction of the cost of my custom lab in the USA.  But with the recalls of Chinease toys, dog food and drugs etc. containing toxins.... wouldn't you want something bonded permanently in you mouth to be cerfified as to content by USA regulatory agency.  All our work is made in the USA and is the best materials we have learned about.  Is the best good enough?  thought you should know. 

The other side of the coin is the question "When can I have a white filling?" 

I would advise (and most patients prefer), that when a filling can be done; a high tech white filling is what I prefer.  There are several reasons for the high tech filling being preferable.  They are a fraction of the cost, and they are far less invasive than a cap or a crown WHEN the previous damage or filling is 1/3 or less of the visible tooth.  None of the teeth shown here to the left qualify for this.  But notice the part of my website that shows composite fillings.  

 When a filling can be done they preserve far more of the original tooth than a crown; this feels better, and with great prevention can last quite nicely.

In this case, in the left photo, notice how mercury filling patches and fractures, have severely compromised the structural integrity of these teeth.  One of the most visible fractures is on the third tooth from the top... this fracture proved too deep to fill even with high tech bonded composites.  We DID get to save this tooth in time but without the ability to bond a cap or crown on this tooth, it likely would have fractured catastrophically. This would have meant unnecesary amputation of this tooth.  However, with a bonded all ceramic crown (no metal) crown this tooth looks and feels fine approximately 3 years after restoration.

Experts in dentistry estimate that we can prevent about 80% of the root canals that become neccesary just by diagnosing early and BONDING teeth together again as pictured here.

This patient had black fillings that scored positively for decay when laser tested, after a cleaning. Our patient wanted to replace these with new high tech white fillings (composite)

notice how nicely these mercury fillings can be replaced with composite fillings