How can a dentist determine if a tooth needs a crown?

The determination of whether a tooth requires a crown typically involves a comprehensive analysis that includes both clinical examination and radiographic imaging. Extensive decay, which can be effectively assessed through radiographs, indicates that the structural integrity of the tooth may be compromised. With significant decay, there may not be enough remaining tooth structure to support a filling, making a crown a more suitable restoration to preserve the tooth's function and prevent further damage.

Clinical examination allows the dentist to assess the tooth's condition visually and through tactile means, such as testing for sensitivity or mobility. However, radiographs provide essential information about the extent of decay below the tooth surface and in the surrounding bone, which is not visible during a routine examination. Therefore, combining clinical findings with radiographic evidence leads to a more accurate assessment of the need for a crown.

While patient preferences and reported pain can inform treatment decisions, they do not provide the clinical justification needed for determining the necessity of a crown. The most reliable approach is one that includes objective data and assessments from a clinical examination and diagnostic imaging.