Crown Now or Wait?

[LotsOfWork]

Hey all,

I have a rough spot on the my bottom, back right tooth. Dentist has mentioned that the filling is large and is starting to deteriorate a bit. Wants to proactively do a crown. I’m hesitant on moving forward with a crown, because I feel like removing tooth structure should be the last resort. What are y’all’s thoughts?

(I have already retreated the tooth next to it)

 

[Dr M]

The filling should and can be replaced. I do not think a crown is warranted at this stage.

 

[LotsOfWork]

The filling should and can be replaced. I do not think a crown is warranted at this stage.

Should it be replaced based on the pictures or the roughness I described?

When should a crown be considered, I think fracturing the tooth was the risk mentioned if we don’t crown

 

[MattKW]

It's a 2nd molar with a large DO filling; you have signs of attrition. These teeth take very heavy forces and are liable to fracture without warning. I would certainly suggest a precious metal crown (gold) so you get minimal reduction needed, great marginal fit - but costly (gold has gone very expensive) - I had same tooth crowned earlier this year in gold.

 

[LotsOfWork]

It's a 2nd molar with a large DO filling; you have signs of attrition. These teeth take very heavy forces and are liable to fracture without warning. I would certainly suggest a precious metal crown (gold) so you get minimal reduction needed, great marginal fit - but costly (gold has gone very expensive) - I had same tooth crowned earlier this year in gold.

Would you proactively do this or wait until there’s an issue?

 

[MattKW]

In your case, I would be proactive because the filling takes up a large central and back (distal) portion of your tooth and it is considerably weakened. If a crack were to develop, I doubt very much if you'd simply lose a corner (still reparable) - you'd be more likely to split it from front to back like attached, and it would have to be extracted.