Are dental crowns on live teeth really a good idea?

I recently had business dealings with a dental implant specialist who during the course of chit chat indicated to me that the best thing that had happened to his business was the proliferation of crowns on live teeth. He indicated that crowns were problematic and resulted in the loss of teeth to a degree not contemplated by the Dental community. In response to my question about what he would do with his own teeth he indicated he would keep on filling them in the traditional way. My question arises out of the fact that I have had three crowns in the last 5 years and two of them are giving me trouble and on teeth that never bothered me before. I have also been around long enough to have seen many medical fads come and go. My question is: has the research been done to indicate that long term crowns actually save teeth and is there any discussion on-going in the dental community about whether crowns might not be a good idea?

[Jerome Bogin, D.D.S.]

I would not consider crowns as a fad. I have been in practice for 40 years so I guess I would have to talk from experience. In my own practice I have not seen more crowns diagnosised today than 40 years ago.If it is necessary to restore the tooth and there is not enough tooth structure present then the necessity for full coverage is apparent. I am not about to say that every tooth that has had a crown stays asymtomatic with the possibility of needing root canal treatment or even having to replace the crown at some time in the future. Full coverage should not be done unless it is absolutely necessary. In my experience a well fitting crown with proper home care will last for many many years.

[pertykitty]

lets say you have a molar. this tooth has been filled and refilled. you can only fill a tooth so much. at that point the filling is so large it acts as a wedge and with daily chewing or grinding, it can crack a tooth. it can cause the tooth to need a root canal, or worse extraction. so to place a crown on a tooth like this is a very great preventative treatment. anytime you touch a tooth, filling or crown you risk the need for root canal. there are no guarentees no matter how small the filling. so i do believe its a great treatment option. now to place a crown for esthetic reasons on a virgin tooth? id find another option first.

[mike1105]

when fillings are too large, crown are indicated. no question. I find it hard to believe that anyone with any dental training at all would suggest to keep filling teeth as long as possible. I have seen more teeth crack due to the wedging/weakening effect of large fillings than for any other reason. Perhaps there was some sort of miscommunication with your oral surgeon. Crowns, when done well, are the best way to save teeth weakened by large fillings, recurrent decy, or root canal treatment, just to mention a few reasons to place a crown.

[fromnowhere]

I agree, I am in the the process of getting 2 crowns done on teeth that had large fillings and it was very visable that it was cracking my tooth, My aunt has several crowns most of which are over 20 year sold and one is 30 years. Never given her any trouble.

[gtown08]

Thank you JB. According to my acquaintance he believes that more crowns are in fact being prescribed. In my original post I asked if there are studies being done which indicate whether this is true or not. Your post and several others from dentists seem to confirm that a crown should be used only when necessary to save the tooth. I am being asked to put on crowns simply because I have large fillings and not because the tooth has cracked. I did get a second exam done and did not recieve this advice from the second dentist who just shrugged his shoulders when I asked the question. Are there studies being done?

[Backin9]

I know this is an older thread, but I have to comment on this.  I have just been to a dentist (well known and on my dental plan) who has given me a written estimate to crown, or recrown every tooth in my mouth.  The sole purpose being cosmetic.  I visited for a tooth ache and every ploy aimed at my vanity was used to try to get me to sign a dental plan that included crowning perfectly good teeth "so they match".  Dentists don't need to be covering for each otherby denying this practice.  The reason this was a new dentist for me is because every dentist I go to tries to make me feel guilty about not spending more money on my teeth.  My teeth are mostly crowned already, done in my teens due to decay but not lack of dental care or hygiene.  I am a professional person, out in society daily and not afraid to smile.    My dental plan would never cover that, but I was offered an interest free dental loan.  I'm looking for another dentist, and looking into where I should report such goings on.

[gtown08]

The information I'm seeking is whether the studies have been done which show that it is better to put a crown on a large filling uncracked tooth as opposed to waiting to deal with the problem if the tooth should ever crack. If no study has been done we should know that as part of the decision making process. My MD is always able to get me the detailed study when he makes a recommendation. Do dentists operate from the same level of science?