Dental crowns are a common solution for restoring damaged, weakened, or decayed teeth, helping to improve both function and appearance. However, in some cases, there may not be enough tooth structure left to support a crown effectively. Whether due to severe decay, fractures, or excessive wear, insufficient tooth structure poses challenges in achieving a stable and long-lasting restoration.
If you or your dentist discover that your tooth is too small or compromised to hold a crown, several treatment options are available to build up the tooth and ensure a secure fit.
Why Would a Tooth Not Have Enough Structure for a Crown?
For a dental crown to function correctly, it needs a strong foundation. Several factors can contribute to a tooth not having enough structure to support a crown:
Severe Tooth Decay
Extensive cavities can erode a significant portion of the tooth, leaving too little healthy enamel and dentin to support a crown. Even after removing decay, the remaining structure might be too weak or too small to hold the restoration securely.
Fractured or Broken Teeth
A tooth that has suffered a serious break or fracture may not have enough structure left above the gumline to support a crown. In some cases, a break may extend below the gumline, complicating the restoration process.
Excessive Wear and Erosion
Teeth can become worn down over time due to conditions such as bruxism (teeth grinding), acid erosion, or improper bite alignment. This can result in a shortened or flattened tooth, making it difficult for a crown to fit properly.
Root Canal Treatment
Teeth that have undergone root canal therapy are often more brittle and prone to breakage. If a significant portion of the tooth was removed during treatment, the remaining structure may not provide enough support for a crown.
Failed Previous Restorations
A tooth that has previously been restored with large fillings, crowns, or onlays may no longer have sufficient natural tooth material to securely support another crown.
What Happens If There’s Not Enough Tooth for a Crown?
If your dentist determines that there isn’t enough tooth structure for a crown, they will recommend one or more procedures to rebuild or reinforce the tooth. The goal is to create a strong foundation that can securely support a crown while preserving as much natural tooth as possible.
Core Buildup
A core buildup is one of the most common solutions when a tooth lacks enough structure for a crown. This procedure involves adding material to the tooth with composite resin or dental cement, effectively rebuilding its shape.
The dentist cleans and preps the tooth, removing any decay or weak areas.
A strong bonding material is used to rebuild the core of the tooth.
Once hardened, the dentist shapes the buildup to resemble the original tooth structure, ensuring a stable base for the crown.
Core buildups are particularly effective for teeth with moderate structural loss that still has a healthy root and surrounding gum tissue.
Post and Core for Root Canal Treated Teeth
For teeth that have undergone a root canal, a post and core buildup may be necessary. Since root canal-treated teeth often become fragile, a post is placed inside the tooth’s root canal to reinforce stability.
A small metal or fiber post is inserted into the cleaned root canal.
A core buildup material is placed around the post to rebuild the tooth structure.
The prepared tooth is then shaped for crown placement.
This method helps strengthen severely compromised teeth while ensuring the crown remains securely in place.
Crown Lengthening
If there is not enough exposed tooth above the gumline, a crown lengthening procedure may be required. This involves removing excess gum tissue and/or bone to expose more of the tooth’s surface, creating a larger area for the crown to grip onto.
The dentist or periodontist reshapes the gum and bone around the affected tooth.
The area is given time to heal, typically for a few weeks.
Once healed, the dentist proceeds with the crown placement.
Crown lengthening is particularly beneficial when a tooth has broken below the gumline or when there is insufficient height for the crown to bond to the tooth securely.
Extraction and Tooth Replacement
In cases where the tooth is too damaged or too weak to support a crown, extraction, and tooth replacement may be the best option. Some alternatives to replacing the missing tooth include:
Dental Implants – A permanent solution that involves placing a titanium post into the jawbone, followed by a crown, to restore function and aesthetics.
Dental Bridges – A restoration that uses adjacent teeth for support, filling the gap left by the extracted tooth.
Partial Dentures – A removable option for replacing multiple missing teeth.
While extraction is typically a last resort, it may be necessary if the tooth cannot be salvaged through other procedures.
How to Prevent Tooth Damage That May Require These Procedures
The best way to avoid the need for extensive dental restorations is through preventative care and good oral hygiene. Here are some steps to maintain strong teeth and minimize the risk of needing a crown buildup or replacement:
Brush and floss daily to prevent decay and gum disease.
Visit your dentist regularly for check-ups and professional cleanings.
Wear a nightguard if you grind your teeth to prevent excessive wear.
Avoid hard foods and chewing ice, which can lead to fractures.
Treat dental issues early—delaying treatment for cavities or cracks can lead to more extensive damage.
By prioritizing oral health, you can reduce the likelihood of needing complex restorative procedures in the future.
Restoring Teeth for a Stronger, Healthier Smile
If your tooth does not have enough structure to support a crown, there are several practical solutions available. Whether through core buildups, post and core reinforcement, crown lengthening, or tooth replacement, modern dental techniques allow for strong, long-lasting restorations.
Your dentist will assess the condition of your tooth and recommend the best course of action to restore function and aesthetics. By taking proactive steps to maintain oral health, you can ensure long-term success with your dental restorations and preserve your natural smile for years to come.