On rare occasions even unfilled natural teeth break due to the force of chewing, but the larger your fillings get and the more tooth that is drilled away, the more likely that your tooth can break. Dentists often notice small cracks in filled teeth and say,”gee you better watch that tooth because one day it may need a crown”. It is important not to crown a tooth without considering that it is going to cut away even more tooth, but if the tooth is already showing stress, a crown is like a helmet over the tooth and will protect it.
The following tooth presented to me with no pain and the patient hoped it could be just repaired until I showed him the X-ray. Remember no pain doesn’t mean no problems – 30 stories down when falling off a 60 story building causes no pain but you are in deep trouble.
It is quite rare to break a tooth with such a small filling, but if there are obvious cracks in a tooth and you want to reduce the load try replacing the metal filling with a bonded tooth coloured filling, or a full cover crown. My advice always is that a gold onlay or crown is the best alternative because it strengthens the tooth without needing to drill as much as a traditional crown, and gives great protection. The following is a failed tooth with a large tooth coloured filling that I saw in a teenager today – the tooth was unsavable. Also pictured is a gold onlay that has been present over 40years.
Of course if the tooth has so much filling that a crown isn’t going to cause much further tooth loss then tooth coloured porcelain crowns look better like the one I did here –