Restorative Dentistry |4 min read

What You Must Know about Fillings vs. Crowns

Were you told you need to treat a cavity with a dental crown, not a filling?

Or you need to replace a filling with a crown?

Even though fillings and crowns are both used to repair decayed teeth, they’re NOT the same.

To help you avoid unnecessary treatment (including costs and drilling!):

Our Waldorf dentist wrote this quick guide on fillings vs. crowns.

After reading this, you’ll feel empowered with the knowledge to make an informed decision about your oral health.

The difference between a crown and filling

Quick definitions:

A crown is a tooth-shaped cap cemented over your tooth. It requires removing a decent portion of your tooth’s enamel. This allows the crown to fit securely and look natural.

A filling is a dental material bonded into your tooth. Materials include gold, silver (amalgam), porcelain, and tooth-colored composite. It replaces the damaged or decayed tooth structure.

The difference?

Typically, a crown is used to treat severely damaged or decayed teeth. Whereas a filling is used to treat minor decay and damage.

Crowns are best for large and deep cavities. Fillings are best for small cavities.

When do you need a crown vs. filling?

You need a filling if:

  • The decayed or damaged area is small. Fillings are less invasive, only removing the afflicted area. This saves your healthy tooth structure, which helps keep your tooth strong and makes you eligible for other treatments (like if you need a crown years later).
  • The tooth is in good condition (no cracks). Crowns add strength and protect weak teeth, but you may not need that if your tooth is structurally sound.
  • You need a quick, affordable fix. Fillings usually take one appointment and cost less than crowns upfront.

You need a crown when:

  • The decayed or damaged area is large or deep.
  • The tooth is weak.
  • The tooth already has a filling(s). Adding another filling may negatively impact the tooth’s durability.
  • Your tooth needs structural support after a root canal procedure.
  • You want to enhance the tooth’s appearance (covering a discolored or misshapen tooth).

Do all cavities need to be filled?

It depends on the size of the cavity.

If your dentist notices early signs of tooth decay, it’s possible to stop it before it becomes a cavity. Methods include fluoride treatment, lowering acid and sugar in your diet, and enamel dental products.

If your cavity is tiny, it likely won’t need a filling yet. However, your dentist must closely monitor the cavity at your routine visits every six months.

As the decay slowly progresses, a filling will be required. Treating it at this stage will prevent it from spreading, causing damage, and inflicting painful symptoms.

If you avoid getting a filling, the cavity will grow in size and depth. Then your treatment options will become more invasive and costly, like a crown, root canal, or tooth extraction.

Do fillings need to be replaced?

Quick answer:

Yes. Fillings don’t last forever. 

Unfortunately though:

It’s not uncommon to visit a new dentist, only to be told you need to replace your fillings simply because they’re old. This is a red flag.

When this happens, you should:

  • Ask to see pictures and x-rays that prove a filling needs to be replaced
  • Seek another dentist’s second opinion

Discover More Red Flags at the Dentist

How often should you replace a filling?

You should only replace a filling when it's ineffective, damaged, or causing problems.

On average, dental fillings last 10 to 15 years.


You only need to replace a filling when it’s ineffective, damaged, or causing problems.

Signs you need to replace a filling include:

  • Tooth sensitivity to hot, cold, sweet, or spicy foods and drinks.
  • A lost filling.
  • Visible damage like a crack.
  • Floss thread getting torn to pieces or getting caught on a tooth with a filling.
  • Further decay. This may require a larger filling or crown.

5 key takeaways

  1. Crowns are best for large and deep cavities.
  2. Fillings are best for small cavities.
  3. Replace fillings when they’re ineffective, not based on “age.”
  4. Practice good oral hygiene and visit your dentist for routine exams and cleanings to prevent tooth decay.
  5. Don’t avoid treatment, or the cavity will worsen and require a more extensive procedure.

When in doubt, get a second opinion from another dentist.

Need a dentist’s second opinion in Waldorf, MD?

At The Silberman Dental Group, we recommend you do one of two things if you want a second opinion. Either:

  1. Come in with your treatment plan and directly ask our opinion. If we agree with your dentist, we’ll encourage you to return to them for treatment.
  2. Don’t show us your treatment plan. Hang onto what was suggested at another office and compare it to what our treatment plan is. Then you decide once you have compared and asked questions.

We’ll give you our honest, unbiased recommendation free of charge. We simply want to help you make confident and informed decisions about your oral health.

Request an Appointment

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Our dentists are located in Waldorf, MD and see patients from across the state, including Charlotte Hall, White Plains, La Plata, Brandywine, Accokeek, and Mechanicsville.

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