Crowning Moment: Why Childhood Cavities Become Crowns in Adulthood

Some people make it to old age without a single cavity or filling. Others have spent time in the dentist’s chair since they were kids and have a mouth full of fillings to show for it.

If you’re in the second group, you may not have been told that fillings don’t last forever. At some point, you’ll need a crown.

What is a Dental Crown?

Crowns are one of the most common types of dental restoration. A crown is essentially a cover placed on top of a tooth. They’re great because they preserve a portion of the natural tooth structure while keeping it protected and maintaining the integrity of the bite. Crowns can be used when a tooth has serious decay or damage, to improve the appearance of the teeth, or to help hold a dental bridge in place.

Depending on the material used, they can also look completely natural. Ceramic crowns are popular because they’re easier to blend in with the rest of the teeth, but crowns can also be made out of resin, porcelain, and even gold.

I Have a Filling, So Why Is a Crown Necessary?

The process starts with decay. The dentist drills away the decay, wearing away some of the permanent structure of the tooth, and puts in a filling. After a number of years, the filling has reached the end of its life and the filling must be removed, and the tooth again needs to be drilled and filled.

When this next filling has reached the end of the road, it needs to come out. But  this time, there may not be enough natural tooth structure left to withstand more drilling, or the tooth might show some cracks and structural weakness. This is where a crown comes in.

A typical timeline goes like this: A cavity is first filled in your teenage years. It’s then redone in your early 30s. In ten to fifteen years, it’s time for a crown. In general, I’d say that most fillings from early adulthood will have run their course by the time the patient is between 40 and 60. The timeline depends on the material used in the fillings (certain types of materials last longer than others) and on the size of the cavity. Larger cavities will likely require a crown sooner.

Getting a Crown

Having a permanent crown put in place is usually  a two-appointment process. At the first appointment, the tooth is numbed with a local anesthetic and shaved down just enough to allow for a temporary crown to be placed. The dentist also makes an impression of the affected tooth so the crown can be made to match the tooth, most of the time, by an outside dental lab. At the second appointment, which is usually a few weeks later, the temporary crown is taken off and the permanent crown is placed on the tooth and put in place permanently with cement or dental glue.  

Though having a crown placed is more extensive than getting a filling, they do last a long time – an average of 10 years.  They can last anywhere from 5 to 20 years, or even longer, when properly fabricated and in a patient that takes adequate care of his dentition.

Preparing for Your Crowning Moment

If you have had large fillings for a long time and haven’t yet had a crown, now you know what to expect if (when) the time comes. Take good care of your crown and the rest of your teeth, and it will be with you for a long time.