Do I Really Need That Dental Crown?

Exploring conservative and cost-effective alternatives for a stronger, healthier smile.

Dental crowns are one of the most common procedures performed in dental offices. Many patients come to my office asking the same question: “Do I really need that crown?”

Remarkably often, the answer is no. In many cases, there are more conservative, effective, and affordable alternatives that preserve more of your natural tooth structure — and your money.

Why Are Crowns Done?

Crowns have long been used to restore broken, decayed, or discolored teeth. Before modern bonding materials existed, crowns were the main option for rebuilding teeth that had lost significant structure.

Today, however, with advanced materials that bond directly to your tooth, we have better and less invasive options.

Crowns are still frequently recommended for teeth that have undergone root canal therapy. But here’s the problem: by the time a tooth needs a root canal, it has often been hollowed out by decay, old amalgam (silver) fillings, and the root canal procedure itself. When a crown is placed, even more healthy tooth structure is removed, and the tooth is then built up with a post and core to support the crown.

This approach can leave very little of your natural tooth remaining, and unfortunately, these restorations sometimes fail within a few years — leading to extraction and the need for an implant or bridge.

What Are My Real Options?

For many patients, a crown is not the only option. A tooth-colored composite filling can often restore the tooth beautifully. These bonded restorations actually strengthen the tooth by holding it together, and they can last for many years — at a fraction of the cost of a crown.

For more severely compromised teeth, a ceramic onlay may be ideal. These restorations bond directly to your tooth, fitting like a puzzle piece to replace only the damaged portion. Onlays are strong, highly esthetic, and long-lasting. Most importantly, they allow you to keep more of your natural tooth structure intact.

I’ve been placing ceramic onlays for over 20 years, and they’ve proven to be remarkably successful. When these materials are used, even teeth with root canals can often be restored without posts or additional drilling — and in many cases, a root canal can even be avoided altogether.

Sometimes, I meet patients who were told they need a crown on a front tooth that already has a small bonded filling after a root canal. If the tooth looks good, functions well, and has no cracks — no crown is needed. My philosophy has always been simple: “If it isn’t broken, don’t fix it.”

Insurance-Based Dentistry

One pattern I’ve noticed is that many patients who were told they need multiple crowns come from large, insurance-driven dental offices. In some practices, crowns are recommended far more often than necessary — sometimes because they’re fully covered by insurance.

I once met a 26-year-old patient who came in for teeth whitening. He mentioned that his insurance would cover two crowns his previous dentist had recommended. When I examined those teeth, there was absolutely no reason for crowns — they could be easily restored with small bonded fillings.

This highlights an important point: just because insurance covers a treatment doesn’t mean it’s the best or most conservative option for your long-term dental health.

The Benefits of Conservative Dentistry

Our goal is simple: to keep dentistry as conservative as possible. By preserving more of your natural tooth structure, we help you save money, avoid unnecessary procedures, and maintain stronger, healthier teeth for years to come.

In fact, many new patients come to us after being told they need veneers or crowns to improve their smiles — only to discover that cosmetic bonding can achieve stunning, natural results at a lower cost. And if more extensive treatment is ever needed, we can always take that next step later.

Conservative dentistry keeps your options open and your smile intact.

Our Goal at the Center for Cosmetic Dentistry

At the Center for Cosmetic Dentistry, our goal is simple — to make you happy with your smile. With over 650 five-star Google reviews, our results and patient satisfaction speak for themselves.

We offer free consultations so you can meet our team, ask questions, and review any dental insurance you may have. We work with most dental plans to help you maximize your benefits.

📞 Call us today at (631) 265-2700 or visit KeepSmilingLI.com.

Your best smile is waiting — and it might not need a crown to get there.