A filling repairs a limited area of a tooth, usually a cavity or small chip. A crown is a cap that covers the whole visible tooth, and it is more often used when a tooth is cracked, heavily damaged or weakened. The deciding factor is usually how much healthy tooth remains. Your dentist’s exam settles which fits.
Quick verdict
- A filling usually fits a small or moderate cavity, or a minor chip or crack, with plenty of healthy tooth around it.
- A crown usually fits a cracked, broken or badly worn tooth, a tooth with too little structure left to hold a filling, or, commonly, a back tooth after a root canal.
- The cost difference: a crown can cost several times as much as a filling, and insurance often pays a smaller share.
- The catch: crowning a tooth removes enamel for good, so it is a reasonable question to ask whether a filling or onlay would also work.
Crown vs filling at a glance
| Filling | Crown | |
|---|---|---|
| What it does | Fills a limited damaged area | Covers the whole visible tooth |
| Typical US cost per tooth | About $100 to $400 for amalgam or composite | About $800 to $2,500, depending on material |
| Visits | Usually 1 | Usually 2, about 2 to 3 weeks apart; same-day at some offices |
| Tooth removed | Decay and damaged tissue | Decay, plus enamel shaped to fit the cap |
| Numbing | Local anesthetic | Used when preparing the tooth |
| Typical lifespan | About 10 to 20 years, depending on material | About 5 to 15 years, sometimes longer |
| Common insurance treatment | Often covered at some or all of the cost | Often about 50% as major work |
Costs vary by location, tooth, material and how many surfaces are involved. Our dental crown guide breaks down crown materials and prices.
Filling or crown: how dentists decide
Dentists don’t choose by cavity size alone. They look at what the remaining tooth can handle.
How much healthy tooth is left. A filling needs surrounding tooth to hold it and to take chewing force. When the remaining walls are thin, a crown may be suggested to protect the tooth from splitting.
Whether the tooth is cracked. Cleveland Clinic says fillings can fix minor chips and cracks, while a crown can protect and support a cracked tooth. How deep the crack runs matters, which is why a dentist needs to examine it.
Whether the tooth has had a root canal. Crowns are commonly placed on root canal-treated teeth, especially back teeth, as the root canal guide explains. More on the evidence below.
The state of an old filling. A large filling that has failed may leave too little tooth for a new one. That is a common moment when the question comes up.
Your own priorities. Budget, how a tooth looks, and how much natural tooth you want to keep all count. A cavity itself is often the starting point; see what a cavity looks like and how to know if you have one.
Cost
GoodRx reports average filling prices of about $160 for amalgam and $191 for composite, with most falling between $100 and $400. Gold and porcelain restorations cost much more. Crown estimates generally start around $800, and our crown guide uses a range of $1,000 to $2,500 per tooth before insurance, with material and location driving the difference.
Insurance often narrows the gap but rarely closes it. Many plans cover some or all of a basic filling. Crowns are usually treated as major work, commonly paid at about 50% after the deductible and subject to your annual maximum, which is often $1,000 to $2,000. Plans differ, so a written pre-treatment estimate is the way to learn your real share.
Time and what the appointment is like
Filling. A direct filling is placed in one visit. The dentist numbs the area, removes the damaged tissue, places the material, hardens it with a curing light if it is composite, then polishes it and checks your bite.
Crown. Usually two visits. At the first, the dentist shapes the tooth, may build it up with filling material, takes an impression or digital scan and places a temporary crown. A lab typically takes two to three weeks to make the final crown, which is cemented at the second visit. Offices with in-house milling can sometimes make a ceramic crown the same day.
Pain and recovery
Getting a filling shouldn’t hurt, because the area is numbed. Minor sensitivity and gum soreness are normal afterward and usually pass in a week or two. Crowns can also cause sensitivity, especially to heat and cold, for a couple of weeks, along with some gum soreness for a few days. In both cases, most people go back to normal activities right away unless they had sedation.
How long each one lasts
Cleveland Clinic gives 10 to 20 years for fillings depending on material, and 5 to 15 years on average for crowns, with some lasting up to 30 years. Those ranges don’t tell you which is stronger, since teeth getting crowns are often more damaged to begin with.
Research on large back-tooth restorations gives a more direct look, though it is imperfect:
- A 2020 network meta-analysis in JADA of 43 studies reported annual failure rates of 0.29% for gold crowns, 0.52% for metal-ceramic crowns and 2.19% for direct composite. Even so, its authors concluded that standard materials other than glass ionomer can all be used for large cavities.
- A 2024 meta-analysis of five trials compared direct composite with lab-made composite restorations and found fewer failures with direct ones. It rated the evidence very low, with a high risk of bias, and it did not study porcelain or metal crowns.
The fair reading: crowns made of metal or metal-ceramic have strong track records, composite fillings hold up reasonably well even in large cavities, and no single answer applies to every tooth.
After a root canal: crown or filling?
This is the most common version of the question, and the evidence is less settled than many people assume.
A large US study of 71,283 root canal-treated teeth in general practices linked a crown to about 5.3 years longer median survival. Teeth with a filling followed by a crown lasted longest, at a median of 20.1 years, compared with 11.4 years for a crown alone, 11.2 for a filling alone and 6.5 for neither. Because this study was observational, it can’t prove the crown caused the difference. Teeth and patients may have differed in other ways.
Randomized evidence is scarce. A Cochrane review found just one eligible trial, of 117 people with root-filled premolars, and called the evidence insufficient. A 2023 review found low-quality evidence of no difference in survival over 2.5 to 3 years. Our post on root canal vs extraction covers what comes before this decision.
The options in between
Inlays and onlays are lab-made pieces that fit into or over part of a tooth. Cleveland Clinic describes them as an option when a tooth has too much damage for a filling but not enough to need a crown. They usually take two visits, or one if the office has in-house milling.
Extraction and an implant may come up if a tooth is so badly decayed or broken that a crown wouldn’t offer a predictable result.
Questions to ask your dentist
- How much healthy tooth is left, and what makes you recommend this option?
- Would a filling or onlay work here, and what are the risks if I choose it?
- What happens if I wait, and what signs should I watch for?
- What will my insurance pay, and can I see that in writing?
If a crown is recommended on a tooth that doesn’t hurt, it is reasonable to ask why, and to get a second opinion when the cost is significant.
When to see a dentist
Book a visit if you have a cavity you suspect, a chipped or cracked tooth, a lost or broken filling or crown, or pain when biting. Call right away for severe pain that doesn’t respond to medication, a swollen face or jaw, or fever or chills, since these can be signs of infection.
Frequently asked questions
Is a crown better than a filling?
Not automatically. A crown covers and protects more of a tooth, which helps when a tooth is cracked or badly weakened. A filling keeps more natural tooth and costs much less, and it is often all a smaller cavity needs. The better choice depends on how much healthy tooth remains, which a dentist can assess.
Why would a dentist recommend a crown instead of a filling?
Common reasons are a large cavity or failing filling that has left thin tooth walls, a cracked or broken tooth, heavy wear, or a back tooth that has had a root canal. If the remaining tooth can’t support a filling, a crown can hold it together. Asking your dentist to show you the X-ray or photos can help you understand the reasoning.
Can I get a filling instead of a crown?
Sometimes. Reviews suggest direct fillings can work even in some large back-tooth cavities, and onlays are another middle option. A filling isn’t always suitable, though, especially if the tooth is cracked or has little structure left. Ask your dentist what the risks would be for that particular tooth.
How much more does a crown cost than a filling?
A typical filling costs about $100 to $400 before insurance, while a crown runs about $800 to $2,500 depending on material and location. That makes a crown several times more expensive. Insurance usually covers crowns at a lower rate than fillings, so the difference in what you pay can remain large.
Does getting a crown hurt more than a filling?
Neither should hurt during treatment, since the area is numbed. A crown involves more shaping of the tooth and usually a second visit. Afterward, both can cause temporary sensitivity, usually for a week or two. Severe or lingering pain after either one is a reason to call your dentist.
