A dental crown is a custom-made cap placed over a damaged tooth to restore its function and appearance. Dentists recommend this protective measure when a tooth is severely compromised, such as after a large filling has weakened the remaining structure, following root canal treatment, or when a tooth has suffered a crack or significant decay. The tooth is already structurally vulnerable and cannot withstand the normal forces of chewing on its own. Delaying the placement of a crown leaves this compromised tooth exposed to daily oral function, setting the stage for more severe complications.
Increased Risk of Tooth Fracture
The most immediate consequence of not getting a crown is the high risk of catastrophic tooth fracture. A tooth that has lost substantial natural structure, often due to extensive decay or a large, old filling, becomes brittle. Without the complete coverage and support of a crown, this weakened tooth is constantly subjected to the immense forces generated during chewing.
These biting forces, which can be hundreds of pounds per square inch on the back molars, cause the unsupported walls of the tooth to flex and eventually break. A minor crack can quickly propagate, extending deeper into the tooth structure. This structural failure is often sudden and unpredictable, happening while eating or during sleep from clenching or grinding.
A fracture becomes particularly problematic if the crack extends vertically below the gum line and into the root. Once a fracture travels deep into the subgingival area, the tooth is often considered unrestorable, meaning it cannot be saved. This severe structural damage necessitates the complete removal of the tooth, resulting in permanent loss.
Progression to Pain and Infection
Ignoring the need for a crown creates an opening for bacteria to invade the sensitive interior of the tooth, leading to pain and infection. When decay or a crack compromises the outer enamel and dentin, it exposes the dental pulp—the soft tissue containing the tooth’s nerves and blood vessels. This exposure causes the pulp to become inflamed, a condition known as pulpitis.
Initially, this inflammation might manifest as reversible pulpitis, causing temporary sensitivity to hot or cold temperatures that quickly fades. If the cause is not corrected, the pulpitis progresses to an irreversible stage. The pain then becomes more severe, persistent, and may be spontaneous or linger long after a hot or cold stimulus is removed.
The bacteria can then multiply and cause the death of the nerve tissue, a process called pulp necrosis. Once established, the infection can push beyond the tip of the tooth root and into the surrounding jawbone, forming a pocket of pus known as a periapical abscess. An untreated abscess is a serious health concern, potentially causing facial swelling, bone loss, or spreading the infection.
Escalation to Complex and Costly Procedures
Delaying a crown often means the eventual treatment will be significantly more complex and expensive than the initial procedure. If the infection reaches the dental pulp, a root canal procedure becomes necessary to save the tooth. This involves removing the infected tissue from the tooth’s interior, cleaning the root canals, and sealing the space, which must then be followed by the placement of a crown.
The combined cost of a root canal and a crown is substantially greater than the cost of a single crown procedure alone. A root canal can range from approximately $750 to $2,500, plus the cost of the new crown, which can add another $500 to $3,000. This financial burden results directly from allowing the problem to progress from structural damage to deep infection.
In the most severe cases, particularly if the tooth fractures below the gum line or the infection is too extensive, the tooth cannot be saved and must be extracted. Extraction is followed by the need for replacement, such as a dental implant, bridge, or partial denture. A single dental implant, the most durable replacement option, typically has a higher upfront cost, often ranging from $3,000 to $6,000, which includes the post, abutment, and final crown.