The main difference between a crown and a filling comes down to how much of your tooth is damaged. Fillings are great for small cavities where most of the tooth is still healthy. But if a big portion of the tooth is broken, decayed, or too weak to hold a filling, a crown is the better option.
In some cases, your dentist may rebuild part of the tooth with a core material before placing the crown. A root canal is only needed if the nerve is infected or exposed—not just because you’re getting a crown. So how do you know which one you’ll need?
Let’s walk through what dentists look for when choosing between a crown and a filling.
When Will You Need a Crown or a Filling
Knowing whether you need a crown or a filling depends on how much tooth structure is left, whether the damage reaches the nerve, and how well the tooth can hold up long-term.
That’s also why regular dental cleanings are so important—they allow your dentist to catch small problems early, often before they turn into something more serious. A small cavity spotted during a cleaning might only need a simple filling. But if left untreated, that same cavity could eventually require a crown—or even a root canal.
Dentists will recommend a filling when:
- The cavity or damage is small to moderate
- Most of your natural tooth structure is still intact
- There are no cracks or fractures that compromise the tooth’s strength
- You’re not experiencing nerve pain or sensitivity deep in the tooth
Dentist will recommend a crown when:
- A large portion of the tooth is missing, broken, or decayed
- You’ve had multiple fillings in the same tooth over the years
- There’s a crack or the tooth is at risk of fracturing
- You’ve had a root canal, and the tooth needs full coverage for protection
Think of your crown like a protective cap. It’s used to restore the tooth’s shape, strength, and function—all while protecting what’s left of your tooth underneath.
Cost Comparison for Crown vs. Filling
Without insurance, a dental filling costs between $100 and $300 per tooth, while a crown can range from $400 to over $2,000 depending on the type of filling material. With private insurance, most plans cover around 80% of a filling and about 50% of a crown, as long as it’s medically necessary.
If you’re on Apple Health (Washington State Medicaid), you may have even better coverage—fillings and some crowns are often covered in full, as long as the treatment falls within your benefit limit and is considered medically necessary. Let’s break it all down:
Filling Costs
- Composite (tooth-colored) fillings: $100–$300
- Silver amalgam fillings: $75–$200
- With private insurance: You typically pay 20% out of pocket
- With Apple Health (WA Medicaid): Fillings are fully covered if you’re eligible
Crown Costs by Material
- Composite resin (least expensive): $400–$600
- Porcelain-fused-to-metal: $800–$1,500
- All-ceramic or zirconia: $1,000–$2,000+
- Gold or metal alloy crowns: $900–$2,500+
- With private insurance: Usually 50% coverage, depending on your plan
- With Apple Health:
- Stainless steel crowns are covered for adults
- Porcelain or cosmetic crowns are not covered unless you’re under 21 or in a special program
- Some exceptions apply for people with developmental disabilities
Medicaid Coverage in Washington (Apple Health)
For eligible adults, Apple Health covers:
- Fillings, exams, X-rays, cleanings, extractions, and stainless steel crowns
- Root canals on front teeth only
- Partial and full dentures
- Oral surgery when medically necessary
For children under 21:
- More comprehensive benefits, including crowns and orthodontics (with approval)
Note: Cosmetic crowns (like porcelain) and implants are not covered for adults. You can learn more or find a Medicaid-approved dentist through DentistLink or the WA HCA website.
Crown vs. Filling Cost Comparison Table
Coverage and limits vary based on your plan, provider, or medical need. Always confirm with your dental office or Apple Health provider. But on average, here’s the cost of crowns or fillings.
| Treatment Type | Typical Cost (No Insurance) | Private Insurance Coverage | Apple Health (WA Medicaid) |
| Filling (Composite) | $100–$300 | ~80% covered | ✅ Fully covered if eligible |
| Filling (Amalgam) | $75–$200 | ~80% covered | ✅ Fully covered if eligible |
| Crown (Composite Resin) | $400–$600 | ~50% covered | ❌ Not covered for adults |
| (Porcelain-Fused-to-Metal) | $800–$1,500 | ~50% covered | ❌ Not covered for adults |
| Crown (Zirconia/All-Ceramic) | $1,000–$2,000+ | ~50% covered | ❌ Not covered for adults |
| Crown (Stainless Steel) | ~$400–$800 | ~50% covered | ✅ Covered for adults and children |
| Root Canal (Front Tooth) | $300–$1,200 | ~50–80% covered | ✅ Covered on front teeth only |
What the Procedure Looks Like: Filling vs. Crown
Knowing what to expect can make your dental visit feel a whole lot less intimidating. Here’s how each procedure typically goes:
Filling Procedure: Quick and Simple
Fillings are usually done in a single visit and take about 30 to 60 minutes per tooth.
Step-by-step:
- Numbing — The dentist numbs the area around the tooth.
- Cleaning the cavity — The decayed portion of the tooth is removed.
- Filling the space — The cleaned-out space is filled with composite (tooth-colored) material or amalgam.
- Shaping and polishing — The dentist shapes the filling to match your bite and smooths it out.
That’s it! You’ll be in and out quickly, and the tooth is ready to use almost right away—just avoid chewing hard foods until the numbness wears off.
Crown Procedure: A Two-Visit Process (Usually)
- Numbing — Local anesthesia is applied.
- Tooth shaping — The dentist trims the tooth down so the crown will fit over it.
- Impression or scan — A mold or digital scan is taken and sent to the lab.
- Temporary crown placed — You’ll wear this for 1–2 weeks while the final crown is made.
FAQ: Crowns vs. Fillings
Can I choose between a crown or a filling myself?
You can always ask for options, but your dentist will usually recommend one based on how much of your tooth is damaged. If there’s not enough healthy structure left to support a filling, a crown will likely be the better—and longer-lasting—choice.
Do crowns last longer than fillings?
Yes. Fillings typically last 5–10 years, while crowns can last 10–15 years or more with good care. Crowns are more durable because they cover the entire tooth and can handle more bite pressure.
Do I always need a root canal before getting a crown?
Not always. A root canal is only needed if the pulp (the inner nerve of your tooth) is infected or exposed. If the nerve is healthy, your dentist can place a crown without doing a root canal.
Are crowns or fillings covered by insurance or Medicaid?
Yes, but coverage varies:
- Private insurance usually covers fillings at 80% and crowns at 50%.
- Apple Health (WA Medicaid) covers fillings and stainless steel crowns for adults, and more options for children under 21.
Can I get a crown or filling in one visit?
- Fillings are almost always done in one appointment.
- Crowns usually take two visits, but some clinics offer same-day crowns using digital scanning and 3D printing.
Is it bad to wait too long for a crown or filling?
Yes—waiting can lead to more serious damage, pain, or even tooth loss. If your dentist recommends a filling or crown, it’s best to take care of it before the problem gets worse (and more expensive to fix).
Key Takeaways
Whether you’re dealing with a cavity or need full coverage with a crown, btyDENTAL is here to help you take the next step toward a smile that’s better than yesterday.
We combine cutting-edge technology with compassionate care to make sure your treatment is smooth, comfortable, and built to last. Book a dental crown appointment today!
