A dental crown is a custom-made "cap" that fits over a damaged tooth, restoring its shape, strength, and appearance. But when is one actually needed? Crowns aren't used for every dental problem—they're reserved for situations where a tooth needs significant protection or structural support. Here are the most common reasons your dentist might recommend a crown, and what to expect.
After a Root Canal
Teeth that have had root canal therapy are more brittle than healthy teeth. They're also no longer vital—no blood supply or nerves inside. A crown is typically placed over a root-canaled tooth to protect it from fracture and restore function. Without a crown, the tooth is at high risk of breaking. In most cases, a crown is an essential part of root canal treatment, not optional.
A Large or Failing Filling
When a cavity is large, a simple filling may not be enough. The remaining tooth structure can be weak and prone to cracking. A crown provides full coverage and distributes chewing forces more evenly, reducing the risk of fracture. Similarly, when an existing filling is failing—recurrent decay, cracks, or breakdown—a crown may be the best way to restore the tooth for the long term.
A Cracked or Fractured Tooth
Cracks can range from superficial craze lines to deep fractures that threaten the tooth's survival. When a tooth is cracked or fractured, a crown can hold it together and prevent the crack from propagating. The sooner a cracked tooth is treated, the better the chance of saving it. Delaying treatment can lead to a split tooth that may need extraction.
Significant Wear or Erosion
Teeth that have been worn down by grinding, acid erosion, or attrition may need crowns to restore their shape and function. This is especially true when the wear has compromised the tooth's structure or caused sensitivity. Crowns can rebuild the tooth to its proper dimensions and protect what remains.
Cosmetic Improvement
Sometimes crowns are used for primarily cosmetic reasons—to improve the shape, color, or alignment of a tooth. This is less common than structural indications, but it's an option when veneers or bonding aren't sufficient. Your dentist can explain when a crown is the right cosmetic choice.
To Support a Bridge
When replacing a missing tooth with a bridge, the teeth on either side of the gap are crowned to support the false tooth (pontic) in between. The crowns act as anchors for the bridge.
The Bottom Line
Crowns are recommended when a tooth needs protection, structural support, or significant restoration. If your dentist suggests one, it's typically because the tooth's long-term health depends on it. Ask questions, understand your options, and move forward with confidence.