My first premolar cracked, and I wonder if I get a veneer for it instead of a crown. The tooth has a filling, so my dentist referred me to an endodontist to remove the filling and assess the tooth. However, the specialist didn’t remove the filling; she just recommended a crown. So, when I returned to my dentist last Tuesday, he tried to mend the crack. I asked my dentist about a porcelain veneer instead of grinding down the tooth for a crown, but he said I needed a crown or an onlay. Is a crown or an onlay the only way to repair a crack? I don’t want my tooth ground down to a peg if it’s unnecessary. Thanks. Helena from Spokane, WA
Unfortunately, without seeing an X-ray, we cannot answer the question about your tooth. Tooth cracks vary from affecting the tooth’s surface and enamel only to extending beneath the enamel and into the tooth pulp. The crack location on a tooth and whether it is horizontal or vertical also determine your treatment options. However, a tooth crack is not a fracture. A dentist or specialist must treat a tooth to prevent it from fracturing into pieces that move independently.
What Is the Treatment for a Cracked Tooth?
Dentists treat an extensively cracked tooth with an onlay or a dental crown. If a tooth crack is minor, depending on which tooth cracked, a cosmetic dentist may use dental bonding or a porcelain veneer to conceal the crack. However, a dentist or endodontist must ensure a cracked tooth is healthy enough for restoration. Internal tooth damage needs root canal treatment.
Ceramic onlay for a cracked tooth
An onlay is a custom ceramic, composite, or gold restoration covering most of a tooth’s chewing surface. Only dentists with advanced cosmetic dentistry training can provide a comfortable onlay that fits snugly on your tooth and looks completely natural. Depending on the tooth’s condition and the location of the crack, a cosmetic dentist will explain your options for an onlay.
Dental crown for a cracked tooth
A dentist must grind down your tooth to accommodate a dental crown. Tooth preparation can further weaken the tooth. Many skilled cosmetic dentists prefer restoring your tooth with an only rather than a crown whenever possible.
We recommend scheduling a consultation with an accredited cosmetic dentist to examine your tooth and X-ray. The dentist will discuss how to treat the tooth, preserving as much structure as possible. Get tips for selecting a cosmetic dentist who can give predictable results with porcelain veneers or other treatment options.
Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.