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1. We were taught in dental school that if a filling or cavity was more than 1/2 the width of the tooth ,tongue to cheek, that the tooth was weak and needed the protection of a crown.
2. Insurance companies do not play fair with dentists and refuse to cover the costs to run a dental practice for a very well done direct bonded resin restorations (fillings) placed under a rubber dam therefore when the decayed part of the tooth even approaches 1/2 the width of the tooth, the dentist most often decides that a crown is the better restoration.
Do I believe that most teeth that have crowns NEED crowns? A resounding "NO!"
My reasons:
1. With the introduction of adhesive dentinal bonding in 1992 , teeth that are restored with a well bonded direct resin placed under a rubber dam ARE NO LONGER WEAK.
2. I have not placed a silver mercury filling in almost a quarter of a century and well done bonded resins do extremely well long term AND DO NOT LEAK and ARE NOT SIGNIFICANTLY WEAKER THAN MERCURY FILLINGS.
There are a relatively few dentists in the world that would consider placing a direct resin restoration for this tooth...I am one of them. It takes a lot of education and some talent to place a bonded resin restoration with 75% of the tooth missing.
Remember that a crown could cost almost $1500 while the patient paid approximately $400 to restore her tooth and not a millimeter of healthy tooth structure was removed..And people will tell you that Dr. Benjamin is very expensive. Let me see $1500 or $400. Which would YOU rather spend?
By the way..How bout all that ugly bacteria (tooth decay is bacteria) under that old filling? Most of YOUR old mercury fillings look exactly like this one.
