I have a cavity under an existing porcelain veneer, the dentist says I need a crown. Can’t I just get a filling?
Ah, the dental compromise: “Doc, can’t we just do a filling instead of a crown? I mean, it’s
cheaper, quicker, and, hey, I’ve got plans tonight!” Sure, it sounds like a good idea—until it
doesn’t.
Filling a tooth that needs a crown is like duct-taping a leaky boat. It might float for a while, but
when it sinks, you’ll wish you’d invested in the yacht. That small filling is no match for a tooth
teetering on the edge of disaster. It’s only a matter of time before it cracks, breaks, or turns
into the Titanic of dental emergencies—on a holiday weekend, no less.
And let’s not forget the awkward call to your dentist when it all goes south: “Uh, remember
how I insisted on the filling? Yeah… the tooth broke. And, uh, I swallowed part of it. Cool,
right?”
Crowns may cost more upfront, but they’re the VIP section of dental care. And trust me, your
tooth deserves it. Allow me to let my partner in crime (mostly traffic violations) explain why
fillings may not work in this case.
Dr Jonathan Josephs:
If a patient develops a cavity behind a veneer the best treatment is usually replacing the veneer or crowning the tooth. The problem with putting a large filling behind the veneer is that the filling material only weakly bonds to porcelain. After this type of repair there will be less adhesive force keeping the veneer in place and it could become more likely to fall off.
I get nails in my tires pretty often and when the nail is too close to the sidewall most good tire shops will insist I replace the whole tire to avoid a blowout. Yes, if I visit enough tire shops I’m sure someone will agree to just plug the hole, but that would still not be an appropriate repair. Sometimes when a dentist suggests replacing a faulty veneer with a crown, it’s to avoid a catastrophic failure down the road.