Cracked Tooth? When You Need a Crown vs. an Onlay

The Moment You Feel That “Zing”

You’re biting into a baguette or sipping something cold when a sharp twinge shoots through a tooth. That “zing” could be a crack or a weakened cusp. Now comes the key question: Do you need a full dental crown or a conservative onlay? While both strengthen a damaged tooth, they differ in how much structure they cover and how much enamel they preserve.

How Teeth Crack (And Why It Matters)

Cracks often form from a mix of heavy chewing forces, older large fillings, clenching or grinding, and temperature stress. Because cracks can spread unpredictably, choosing the right restoration early protects the tooth from a catastrophic split. Therefore, diagnosis is critical: we evaluate symptoms, take X-rays, and sometimes use bite tests or transillumination to visualize the fracture.

What Is a Crown?

A crown is a custom cap that covers the entire tooth above the gumline. It wraps and protects all cusps, creating a single, strong unit. Crowns are excellent when:

• There’s extensive cracking or multiple weakened cusps
  
  
• A large portion of the tooth is missing or restored
  
  
• You’ve had root canal therapy and the tooth needs reinforcement
  
  
• The bite forces are high and the tooth acts as a primary chewing surface
  
  

What Is an Onlay?

An onlay is a lab-made restoration that replaces only the damaged portion—usually one or more cusps—while keeping as much healthy enamel as possible. Think of it as a “partial crown.” Onlays are ideal when:

• Damage is localized to one side or a couple of cusps
  
  
• Healthy tooth structure remains around the rest of the tooth
  
  
• You want maximal conservation without sacrificing strength
  
  

Crown vs. Onlay: Head-to-Head

• Tooth Preservation: Onlays remove less tooth structure; crowns cover everything for broad protection.
  
  
• Strength: Both can be very strong; however, crowns distribute forces across the entire tooth, which is important for extensive cracks.
  
  
• Aesthetics: Modern ceramics allow natural color and translucency for both.
  
  
• Longevity: With proper fit, bonding, and bite balance, either can last many years.
  
  
• Cost & Visits: In many cases the costs are comparable; both typically take one or two visits depending on the technology used.
  
  

How We Decide in the Chair

We map the crack: its direction, depth, and whether it reaches the pulp or splits the root. We also consider your symptoms—lingering cold sensitivity, pain on release after biting, and history of grinding. If the crack threatens multiple cusps or extends under old fillings, a crown may be safest. If it’s confined to a single area with strong surrounding enamel, an onlay can be the conservative winner.

Materials That Make a Difference

Today’s ceramics (like lithium disilicate) deliver excellent strength and lifelike translucency. Composite resin onlays are sometimes used for small or temporary situations, but for long-term durability, ceramic is often preferred. Meanwhile, bonding protocols have improved, enabling secure adhesion that supports the remaining tooth.

Life After the Restoration

Whether you receive a crown or onlay, you’ll care for the tooth much like a natural one:

• Brush twice daily and floss around the margins
  
  
• Wear a night guard if you clench or grind
  
  
• Avoid using teeth to open packages or bite very hard objects
  
  
• Schedule regular checkups so we can monitor bite and contact points
  
  

When a Root Canal Is Part of the Plan

If a crack reaches the pulp or you have spontaneous lingering pain, root canal therapy may be necessary before placing the final restoration. Although that sounds daunting, the goal is simple: remove the inflamed tissue, relieve pain, and create a stable foundation for a long-lasting crown or onlay.

Benefits Section

Choosing the right restoration at the right time prevents deeper cracks, reduces sensitivity, and restores comfortable chewing. Furthermore, conservative options like onlays preserve healthy enamel, while full crowns provide comprehensive protection for heavily compromised teeth. Either way, you regain confidence to enjoy food without fear of that next “zing.”

Annapolis Patient Tips

• Don’t Delay: Small cracks are easier to treat predictably.
  
  
• Mind the Grind: If mornings bring jaw fatigue, ask about a guard.
  
  
• Temporary Care: If you leave with a temporary, avoid sticky foods on that side.
  
  
• Follow-Up: Return promptly if sensitivity worsens; adjustments or additional care may be needed.
  
  

Find the Right Fix

If a tooth hurts on bite or you see a visible line, let’s assess it before it spreads. Call Aria Dental of Annapolis at (410) 280-5370 to Schedule a Consultation in Annapolis, MD.