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In dentistry, a crown is the surface of a tooth that is covered by enamel. When a tooth's surface breaks, chips, or fractures, an artificial dental crown is placed to prevent further damage.
Dental crowns are tooth-colored, gold, silver, or metal caps that fit over damaged teeth to restore their natural function, shape, and look. They consist of metals, ceramics, porcelain, or composite resin.
Most commonly, a dental crown is placed after a root canal or dental implant procedure.
Dental technicians make custom crowns to ensure they blend in with a patient's surrounding, natural teeth. To determine the best option, a dentist considers the following factors:
40 million Americans (1 in 3 adults) need to replace one or more teeth.
Dental crowns are commonly used to restore:
Crowns also play a critical role in dental prosthetic procedures and more invasive dental treatments, including root canals, dental bridges, and dental implants:
Crown placement is the last step of a dental implant procedure. Implants (artificial tooth roots) take a few months to heal fully.
A dental implant replaces an entire missing tooth that was lost due to severe tooth decay, trauma, or periodontal disease.
Implant Procedure: First, a dentist drills holes into your jawbone and positions the implant (post) into the socket. Implants mirror the shape of a screw and consist of materials that bond naturally with the bone. Then, the dentist places an abutment after several months of healing. A temporary cap is placed on top of the post for a few months until the healing process is complete.
Role of Crowns: A dental crown sits on top of the abutment (in replacement of the temporary cap) and is the only visible part of the implant. Crowns are completely custom and restore the shape, look, and function of natural teeth. Dental implants last longer than traditional crowns because they cannot get recurrent decay. For healthy patients who prioritize dental care, they should last forever.
Crown placement is the last step of a root canal (endodontic treatment).
Endodontic treatment restores infected dental pulp in a damaged or decayed tooth’s root, eliminating the need for extraction.
The process is different from a dental implant because the tooth’s root is restored rather than replaced with an artificial root and abutment.
Root Canal Procedure: During the procedure, an endodontist or general dentist makes an opening through the natural crown, removes the dental pulp using small instruments, and then places a temporary filling on top of your tooth.
Role of Crowns: After treatment is complete, you'll visit your dentist to have the tooth properly restored. The most common restorative treatment option is a dental crown. Fillings are also used if the natural crown has enough healthy tooth structure remaining.
Retainers (crown look-alikes) fit on each end of a dental bridge and act as an anchor.
There are four different types of bridges available, including traditional, cantilever, Maryland, and implant-supported bridges.
Dental Bridge Procedure: Traditional bridges consist of one or more fake teeth (pontics) that are held in place by crowns. They typically fill in the gap between one or more natural teeth on both sides. Dental bridges are very durable and can also replace molars.
Role of Crowns: Dentists bond retainer crowns onto the abutment teeth, adjacent to the missing tooth. In order to support the force of chewing on the fake tooth in between them, crowns always cover traditional and cantilever bridges.
There are five types of dental crowns available, including:
The most common restorative material for dental crowns and bridges is a mixture of porcelain and metal. When porcelain and metal are heated together, the porcelain chemically fuses to the oxides on the metal, which creates a durable bond.
Porcelain-fused-to-metal crowns are stronger than regular porcelain because they are supported by a metal structure. They also blend in well with the shape, look, and function of your natural teeth.
Metal crowns come in a few different forms and colors. They provide a strong bond, are fracture-resistant, and do not wear away teeth. These crowns typically consist of gold, copper, and other metals. Some metal crowns are made of non-noble metals, which are very strong and corrosion-resistant.
Crowns require the removal of tooth structure before placement. Although, metal-based crowns require the least amount of removal, making them a more conservative option.
Stainless steel crowns are only used to restore primary (baby) teeth. SSCs are placed after pulpotomy treatment or when normal cavity fillings, such as amalgam fillings, are likely to fail.
Ceramic crowns are made of porcelain. In dentistry, porcelain is used to create tooth-colored dental materials, such as cosmetic crowns, that mimic the look, shape, and function of natural teeth.
Cosmetic crowns restore anterior (front) teeth and blend in with your natural tooth color. They are strong, durable, and do not chip or break easily. the most common alternative to all-ceramic crowns is “zirconia,” which is actually a metal.
All-resin restorations are less expensive than metal, ceramic, gold, and porcelain crowns. However, dentists do not normally recommend resin crowns because they are more vulnerable to fractures, wear and tear, and do not last as long.
Resin is a thinner and more fragile material than other dental restorations, such as metal and porcelain. Resin restorations are only used on decayed baby teeth, rather than permanent teeth.
About 2.3 million implant-supported crowns are placed annually.
A crown is placed after a root canal or dental implant procedure. Most dental crown procedures take one day to complete.
Many offices also use CAD/CAM machines to create same-day crowns, eliminating the need for a second visit.
First, a dentist takes an x-ray of the patient’s jaw and tooth. Then they reshape and contour the tooth, depending on the type of crown. Since metal crowns are thinner, they require the least amount of tooth removal.
After successful tooth preparation, a temporary crown is placed over the tooth while the permanent crown is being created in a dental laboratory.
After about three weeks, the temporary crown is removed and the permanent crown is placed. Your dentist will make sure the color of the dental crown matches your surrounding teeth and fits in your mouth.
A local anesthetic is administered before crown placement (only if the patient requests it). This medication numbs the treated area during the procedure, which ensures you do not feel any discomfort. Then a special dental cement is placed to keep the crown in place.
Once the anesthesia wears off, your jaw may be sore for a few days. Gum and tooth sensitivity are also common. Dentists recommend simple analgesic medications, such as ibuprofen, to manage the pain. These medications help reduce discomfort during the healing process.
If symptoms are severe and last longer than a few weeks, you should visit your dentist to make sure there isn’t a more serious underlying condition.
While your permanent crown is being made, a temporary crown will be placed to protect the abutment tooth. During this transition period, avoid eating foods that could dislodge or break the temporary crown, including:
You should also chew on the opposite side of your mouth and avoid flossing with a temporary crown.
You can return to normal eating habits after positioning of the permanent crown is complete. However, it is important to avoid sticky foods for another 24 hours following the procedure.
The cost of a dental crown depends on the type needed. Most PPO plans pay 50% to an in-network dentist for a crown.
The prices below reflect the cost of a dental crown without insurance:
Patients can use their Health Savings Account (HSA) to pay for many dental treatments and procedures. This includes preventive services like x-rays, teeth cleanings, and dental exams. An HSA can also be used to pay for root canals, crowns, implants, cavity fillings, and bridges.
Dentists administer a local anesthetic before all dental crown procedures to ensure patients do not feel any pain. However, you may experience minor discomfort and mouth dryness during the procedure. After the anesthesia wears off, your jaw and the treated tooth may become sore. This pain should diminish after a few days.
Depending on the type of crown, they can last up to 15 years. In some cases, they can last up to 30 years when taken care of properly. To ensure your crown lasts a long time, you should practice good oral care at home and get professional teeth cleanings every six months. Stainless steel crowns do not last as long and are only placed on baby (primary) teeth.
Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.
Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.