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What are Dental Crowns?
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, your dentist will consider the following factors:
- Location and function of the tooth
- The position of your gum tissue and gum line
- How much of the tooth shows when smiling
- The colors and shades of surrounding teeth
- Any signs of clenching or teeth grinding, which determines the crown material used
Pros and Cons of Dental Crowns
Crowns are effective and popular tooth restorations.
However, as with every dental procedure, they come with pros and cons:
Pros
- Natural-looking
- Enhance your smile and oral hygiene
- Can fix severely damaged or decaying teeth
- Protect teeth after a root canal or dental implant placement
- Replace worn out or large fillings
- Cost-effective
- Simple and relatively painless procedure
- Five types of materials to choose from to fit every budget, need, and lifestyle
- Quick recovery time
- Can last up to 15 to 30 years with proper care
- Low risk of fracture
Cons
- Permanent removal of natural tooth structure is necessary before placement
- Has to be replaced eventually
- Poorly-fitted crowns can loosen and fall out
- Fracture and damage is possible
- Increased risk of tooth sensitivity after placement (specific toothpaste can help reduce this)
5 Types of Dental Crowns
There are five types of dental crowns available:
1. Porcelain-Fused-to-Metal Crowns
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.
2. Metal & Gold Crowns
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. Metal-based crowns require the least amount of removal, making them a more conservative option.
3. Stainless Steel Crowns (SSCs)
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.
4. Cosmetic Crowns (Ceramic)
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.
5. All-Resin Crowns
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.
When is a Dental Crown Needed?
40 million Americans (1 in 3 adults) need to replace one or more teeth.
Dental crowns are commonly used to restore:
- Weak teeth — crowns protect weak teeth, typically caused by severe decay
- Cracked teeth — crowns hold together parts of cracked teeth and restore their natural shape, function, and look
- Worn down teeth — crowns restore broken or severely worn down teeth, typically caused by bruxism (teeth grinding) or dental erosion
- Large fillings — crowns cover and support teeth with large fillings that have little remaining tooth structure left
- Tooth discoloration — if teeth are severely discolored, tooth-colored crowns are often used to cover the discoloration. Other options include veneers or teeth whitening
Crowns also play a critical role in dental prosthetics and more invasive dental treatments, including root canals, dental bridges, and dental implants:
Dental Implants
Crown placement is the last step of a dental implant procedure. Implants (artificial tooth roots) take a few months to heal.
A dental implant replaces an entire missing tooth that was lost due to severe tooth decay, trauma, or periodontal disease.
Implant Procedure
A dentist drills holes into the 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.
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. They should last forever in healthy patients who prioritize dental care.
Root Canal Treatment
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 places a temporary filling on top of your tooth.
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.
Dental Bridges
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.
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.
In a bridge, crowns are placed 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.
Dental Crown Procedure & Aftercare
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 Visit — X-Ray, Tooth Reshaping, and Temporary Crown Installation
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.
Second Visit — Permanent Crown
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.
Pain Maintenance
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.
Foods to Avoid With a Temporary Crown
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:
- Chewy or sticky foods, such as candy and gum
- Hard foods, such as chips, bagels, and nuts
- You should also chew on the opposite side of your mouth and avoid flossing with a temporary crown
Potential Complications
Some potential complications that can occur after crown placement include:
- An allergic reaction to the crown material or anesthetic used during the procedure
- Sensitivity and discomfort
- Poor-fitted crown
- Tooth decay at the margin where the crown and tooth meet (this is why oral hygiene is still very important, even with a crown)
- Nerve problems
- A dark line at the gum line
- Mouth injury
- Loose or fractured crown
How Much Do Dental Crowns Cost?
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:
- Porcelain-Fused-to-Metal Crowns — $875-$1,400 (per tooth)
- Ceramic (Porcelain) Crowns — $800-$3,000 (per tooth)
- Metal and Gold Crowns — $800-$1,400 (per tooth)
- Stainless Steel Crowns — $300-$500 (per tooth)
- All-Resin Crowns — $600-$1,300 (per tooth
Frequently Asked Questions (FAQs)
Here are some frequently asked questions about dental crowns:
Does an HSA cover dental crowns?
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.
Do dental crowns hurt?
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.
How long does a crown last?
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.
What types of crowns are available?
There are five main types of crowns available, including porcelain-fused-to-metal crowns, ceramic crowns, stainless steel crowns, metal crowns, and all-resin crowns.
What is an alternative to a dental crown?
The most common crown alternative is a porcelain onlay. Onlays restore the surface of a tooth but not the entire crown. Other alternatives include inlays and porcelain veneers.
Does a dental crown require special care?
Once healed, a dental crown does not require special care. However, oral hygiene is essential because decay and disease can still form.
