How do dentists decide between a crown and a filling? Learn what each does and when one may be the better fit for your tooth. Contact us today to find out more.
If your dentist has told you a tooth needs to be repaired, you may be wondering what comes next. Two of the most common options are fillings and crowns, and while both restore a damaged tooth, they do it in different ways. Understanding how dentists choose between them can help you feel more at ease about your treatment, whether the appointment is for you or for someone you care for.
Their staff was truly caring and respectful in everything they did. The dentist explained what they found in the initial tests, asked us questions about our 82 year old sister, then explained the options that would give the best results.
Response from the owner:Thank you for your thoughtful feedback. We’re grateful for the opportunity to provide compassionate care and appreciate you taking the time to share your experience.
My hygienist, DeLaina Joost, takes excellent care of my teeth with her advanced skills, gentle touch and great “chair side” manner. She is a consummate professional, and such a compassionate person. I look forward to my visits at DAC!
Response from the owner:Thank you for your kind words! We’re so glad to hear you had a positive experience with our team and appreciate you taking the time to share your feedback.
Devon’s has received his dental services here for several years. The staff are always pleasant. Dr. Hoffman unmatched. His bedside manner is always welcoming. Devon receives amazing care and support based on his assessed needs. Feedback and instruction is clear and detailed. Follow-up is greatly appreciated. I appreciate their acceptance of differences and assurance that Devon will be taken care of.
Response from the owner:Thank you for your kind words and continued trust in our team! We’re grateful to be part of Devon’s care and truly appreciate your thoughtful feedback.
Best Dentists in St. Louis. Really a great dental experience. I have used this office for regular dental care, cavities, crowns, and cosmetic dentistry. Teeth look great.
Response from the owner:Christopher we apologize for the belated response. We are very pleased to hear you have a great dental experience with our office! Thank you for your kind words. We look forward to seeing you at your next dental appointment!
Dr. Behl!
I cannot recommend Dr. Maris Behl enough. If you have dental anxiety, she is truly the kind of dentist you hope to find. If teeth could be wrapped in pillows and protected by flying unicorns, Dr. Behl would somehow make it happen.
I have significant anxiety around dental procedures and have needed deeper sedation for dental work in the past. From the beginning, Dr. Behl took the time to listen to my concerns and made me feel genuinely heard rather than dismissed or rushed. She created such a sense of trust and safety that I was eventually able to have my dental work done with only nitrous instead of full sedation, which is something I honestly didn’t think I would be comfortable doing.
During my crown placement, she explained what she was doing throughout the procedure, which made an enormous difference in keeping me calm. She also took the time to address a filling that had been bothering me for what felt like forever — and she actually fixed the problem.
What stands out most about Dr. Behl is how safe I feel in her care. She is compassionate, patient, communicative, and incredibly attentive to how her patients are feeling. For someone with dental anxiety, that combination is invaluable.
Finding a dentist I trust this much has completely changed my experience with dental care. I am incredibly grateful to Dr. Behl and would recommend her without hesitation, especially to anyone who has dental anxiety or has struggled to feel comfortable receiving dental treatment.
Response from the owner:Thank you for such incredibly kind words! We’ll be sure to pass this along to Dr. Behl. We’re pretty sure the flying unicorns are going to be the part she remembers most! 🦄💙 We’re so glad our team could help make your experience a more comfortable one.
Dr Thoms and his team are phenomenal. No question, the absolute best possible option for my child when he needed work done while sleeping (age based). While this option is not inexpensive, this set up of have anesthesiology in-house allowed us to get his mouth healthy when a traditional pediatric dentist could/would not. I am a parent that asks a lot of questions on behalf of my toddler’s care and at no point did I feel judged for this, nor was I rushed during my evaluation process during the consultation. Although the procedure is not one I would like to repeat for my child, my husband and I were both so pleased with how well Dr. Thoms communicated and how he clearly cared for our son’s wellbeing (both physical and emotional during a less than comfortable visit). Cannot recommend the back of house team more highly.
My one detraction is the FOH staff (not everyone) were not nearly as pleasant. I would like to communicate that while their day-to-day is very routine for them, being in that office as a parent is very scary for some people in their office and a little bit of kindness goes along way. I do recall, having a very pleasant conversation with Rebecca, but otherwise everyone else was on the apathetic side, in my personal opinion. That said you’ll notice that I still am leaving a five star review because the dental staff really just knocked out of the park, but as a parent I want to encourage you to look past any rudeness you may experience over email or on the phone because Dr. Thom’s is really that excellent.
Response from the owner:Thank you for taking the time to share such thoughtful feedback. We’re grateful to hear that our team provided compassionate, attentive care and took the time to answer your questions throughout the process. We also appreciate your comments regarding your experience with our front office team and will certainly share your feedback. Your kind words mean so much to us!
I have Autism. I had my caregiver call ahead to give them a heads up. It was ignored. The building sits on the highway with major traffic next to building. The building is under construction and the inside of building was a mess with workers, trash and construction equipment everywhere. I tried to use restroom but it was filled with loud workers from building hanging out. I sat in waiting room for 45 minutes while another mentally challenged individual was very loud next to me the entire time I waited. The waiting room had debris all over the floor as if somebody spent hours moving ceiling tiles. When I was finally taken back it was by a person in training. They led me to a back area of office and asked me to sit in a seat. The building is completely open. They have nothing deviding you from seeing, hearing and being in the way of other patients. Just walking through the office I almost bumped into patients having work done. They have absolutely no privacy in this building. The floor of this dental practice was littered with trash. I took photos.Clients be warned! This is not set up for patients with anxiety. This is not set up for people with autism . This dentist is not set up for any sort of privacy at all. This is not a dentist for you if you like things clean. When I explained to staff I needed to leave, I explained to them why. Yet, they made me sit and wait for an office manager. After waiting 30 minutes I got up and left on my own. On my way out I could not find the exit. I walked around office while patients were getting work done. I almost bumped into numerous objects, dentist helpers and patients. This place is UNSAFE! Never have I seen somewhere that advertises for autistic patients and they have the office SET UP Like this. BEWARE! STAY AWAY IF YOU WANT PRIVACY! STAY AWAY IF YOU HAVE ANXIETY! STAY AWAY IF YOU ATE AUTISTIC! YOU HAVE BEEN WARNED!!!
Response from the owner:Thank you for taking the time to share this feedback. Privacy laws prevent us from discussing any individual's experience, but we want to speak to the concerns raised. Our office is set up as a surgery center, and our open layout is intentional. It allows our clinical team to maintain clear visibility and respond quickly, which is essential for patient safety. Our building is currently undergoing renovation, and we know the construction has created noise and conditions that do not reflect the environment we work hard to provide. That work is expected to be complete by the end of the year. We proudly care for patients with special healthcare needs and high anxiety, and every patient is welcome in our office. Anyone with concerns is welcome to contact our office manager, Marie, at 314-862-7844.
Very nice very convenient for me great people working
Response from the owner:Thank you for your kind words! We’re so glad you had a positive experience with our team. We truly appreciate your 5-star review!
The staff is always compassionate and explain all the steps of the procedure. This office has been a God send for me because otherwise I would have let my teeth fall into further disrepair. I highly recommend this office!!!!!
Response from the owner:Thank you for your kind words and recommendation! We’re so glad our team could help make your experience feel comfortable and supportive. We truly appreciate your 5-star review!
Searching for a new dental clinic is challenging for someone who has
dental anxiety, fear, and traumatic experiences in a dental chair. The staff and doctors at the Dental Anesthesia Center were immediately very welcoming. Dr. Thoms put together a very detailed plan to repair and replace the previous work that I had in the past that was now causing problems. Putting my faith in him was the best thing that I could have done for my situation. I am more than completely satisfied with all of the extensive dental work that I’ve had with Dr.Thoms. I had my fourth sleep dentistry experience yesterday and I’m very happy with my results. I highly recommend this practice and truly want to give them more than five stars! Thank you for giving me back my health and confidence.
I adding to this post because of my visit today with the best dental hygienist Delaina and my exam with Dr. Biehl. I have truly never been to such a caring and supportive dental group. Everyone is always conscientious of my needs and knows that I have issues with anxiety. I am always calm when I am sitting in the chair because of their kindness. I am so pleased with the Dental anesthesia center. There needs to be more than five stars. Thank you, everyone.
Response from the owner:We know it isn’t always easy to find a dental office where you feel at ease, so your words mean the world to us. We’re so glad you feel comfortable with our team and truly appreciate your trust and recommendation!
I am unusually tense about my appointments. However, from the moment I checked in I relaxed. The staff was welcoming and assuring, and helped me to relax completely. Dr. Hofmann is superb. He is by far the best dentist and dental surgeon I have ever ever experienced.
Response from the owner:Thank you for your kind words! We’re so glad our team helped create a welcoming and comforting experience. We appreciate you sharing your feedback!
I cannot thank this clinic enough for their amazing care. They completely accommodated my individual needs by letting him wait in the hallway where he had more room for his feet and space to pace. Instead of forcing him into a tiny exam room, the dentist came out to the hallway to check his mouth. It made the entire visit so much easier for him. Fantastic service!
Response from the owner:Thanks so much for your kind words! We're grateful for the opportunity to provide compassionate, individualized care and appreciate you taking the time to share your experience. Wishing you all the best!
Great experience! The staff went above and beyond to make my individual comfortable. They let him wait in the hallway so he could pace instead of staying in the crowded waiting room. The dentist even examined him right there. Highly recommend this accommodating team! Fantastic service!
Response from the owner:Thank you for your thoughtful review! We're honored by your recommendation and are committed to providing compassionate, individualized care for every person we serve. We truly appreciate your kind words!
Response from the owner:Thank you for your kind review! We appreciate your thoughtful words and are grateful you took the time to share your experience with our team.
These guys are fantastic! If you are not going to the dentist because of a bad or painful experience this is the place to go.I was one of those people not going for way too long out of fear and anxiety. One day I had a horrible tooth ache, I put it off too long, the pain was unbearable and I didn`t have a dentist.Thank God I found The Dental Anesthesia Center. Don`t wait for this to happen. I have been a patient now for last fifteen years and I highly recommend you going here. You will be glad you did. The whole staff is the best. .
Response from the owner:Mike,
We are so glad you found us and to hear that our team is able to make you feel completely comfortable at the dentist. 🙂 Its our pleasure to have you as a patient! Thank you so much for your kind review! See you at your next dental appointment!
Response from the owner:Thank you so much for the 5 star review!
What a Filling Does
A filling repairs a small to moderate area of damage, most often a cavity. The dentist removes the decayed portion of the tooth, cleans the area, and fills the space with a durable material such as tooth-colored composite. The rest of the natural tooth stays intact and continues to do most of the work when you bite and chew. Fillings are often the right choice when:
The surrounding tooth structure is still strong and healthy
The damage has not reached deep into the tooth
The tooth does not show cracks or significant wear
Because a filling preserves more of the natural tooth, dentists generally prefer it when the damage is limited. It is usually a shorter procedure as well, which can matter for patients who find dental visits stressful.
What a Crown Does
A crown, sometimes called a cap, covers the entire visible portion of the tooth. Instead of filling one damaged area, it wraps the whole tooth in a protective layer of porcelain, ceramic, or another strong material. The dentist reshapes the tooth so the crown fits securely, then cements the crown in place. Crowns are often recommended when:
Decay or damage covers a large portion of the tooth
A previous large filling has failed or weakened the tooth
The tooth has had a root canal, which can leave it more fragile
The tooth needs reinforcement to handle normal chewing forces
In these situations, a filling alone may not provide enough support. A tooth with too little healthy structure left can break around a filling, while a crown holds the remaining tooth together and distributes biting pressure more evenly.
How Dentists Make the Call
The decision usually comes down to how much healthy tooth remains. As a general rule, when most of the tooth is still sound, a filling can restore it. When damage involves a large portion of the tooth, a crown is often the more reliable long-term option. Dentists weigh several factors during the exam:
Extent of decay or damage. X-rays and a visual exam show how deep and wide the problem goes.
Location of the tooth. Back teeth absorb heavy chewing forces and may need the added strength of a crown sooner than front teeth.
History of the tooth. A tooth that has been filled several times may have little natural structure left to support another filling.
Cracks and fractures. Even a small crack can spread under pressure, and a crown may help protect the tooth from splitting further.
There are also in-between cases. Some teeth fall into a gray area where either option could work for a time, and your dentist can walk you through the trade-offs so you can make an informed choice together.
Comfort Matters, Too
For some patients, the procedure itself is the biggest concern. Patients with dental anxiety, strong gag reflexes, or special healthcare needs may find longer appointments difficult, and caregivers often worry about how a loved one will handle treatment. Sedation and general anesthesia options can allow needed dental work, including crowns and fillings, to be completed comfortably, sometimes in a single visit. If this is a concern for you or someone you care for, it is worth discussing before treatment begins.
The Dental Anesthesia Center is a doctor-owned, privately owned practice serving patients of all ages, including those with dental anxiety and special healthcare needs. If you have questions about crowns, fillings, or sedation options for your care, we are happy to help. Call us at (314) 862-7844 or request an appointment through the contact form on our website.
