By: Dr. Paul KennedyA dental crown is a custom made covering placed over a damaged, weakened, or heavily restored tooth. Sometimes called a tooth cap, a crown covers the visible portion of the tooth to help restore its shape, strength, function, and appearance.
Dentists commonly recommend crowns when a tooth cannot be predictably repaired with a simple filling. They may be used for cracked teeth, large cavities, worn teeth, teeth with large fillings, or teeth that have undergone root canal treatment.
If you have a damaged, cracked, or weakened tooth, a dental examination can help determine whether a crown or another restorative treatment is appropriate.
A dental crown is a type of tooth restoration designed to fit over a natural tooth. Once placed, it becomes the tooth's new outer surface above the gumline.
The purpose of a dental crown is to protect the remaining tooth structure while allowing you to bite and chew more comfortably. Crowns can also improve the appearance of teeth that are significantly discolored, misshapen, or damaged.
Depending on your needs, a crown may be made from materials such as:
Porcelain
Ceramic
Zirconia
Metal alloys
Porcelain fused to metal
Your dentist will recommend a material based on the location of the tooth, bite forces, appearance, remaining tooth structure, and other clinical factors.
A crown surrounds and supports the visible part of a weakened tooth. Before placement, the dentist prepares the tooth so the crown can fit securely over it.
The finished crown is shaped to match your bite and neighboring teeth. Once cemented or bonded into position, it functions as part of the tooth during everyday biting and chewing.
A crown does not replace the natural tooth underneath it. Instead, it protects the remaining tooth structure.
Not every damaged tooth needs a crown. Your dentist will examine the tooth and determine whether a filling, bonding, inlay, onlay, crown, or another treatment is most appropriate.
Common reasons for getting a dental crown include:
A cracked tooth may become weaker over time, especially when chewing places additional pressure on it. A crown can help hold the remaining tooth structure together and protect it from further damage.
When tooth decay removes too much healthy tooth structure for a filling to provide adequate support, a crown may be recommended after the decay is removed.
The crown helps restore the tooth's shape while protecting the weakened structure underneath.
A tooth with a very large filling may have limited natural tooth structure remaining. If the tooth becomes weak or develops cracks, a crown may provide greater coverage and protection than replacing the filling alone.
A tooth that has undergone root canal treatment may sometimes need a crown, particularly when it is a back tooth exposed to strong chewing forces.
The crown helps protect and restore the treated tooth so it can continue functioning.
Teeth can become worn because of grinding, clenching, bite problems, erosion, or long term use. A crown may be used when significant tooth structure has been lost and needs to be rebuilt.
In some situations, a crown may be considered when a tooth has significant structural or cosmetic concerns that cannot be adequately corrected with more conservative treatments.
For smaller cosmetic imperfections, your dentist may recommend alternatives such as composite bonding or veneers instead.
A crown can also be attached to a dental implant to replace the visible portion of a missing tooth. In this situation, the crown is supported by the implant rather than a natural tooth.
Only a dental examination can determine whether a crown is necessary, but some signs may indicate that a tooth needs professional evaluation.
These can include:
A cracked or fractured tooth
Pain when biting or chewing
A large or failing filling
Significant tooth decay
A tooth that has become noticeably worn
Part of a tooth breaking away
Increased sensitivity in a damaged tooth
A recently completed root canal
These symptoms do not automatically mean you need a crown. Other treatments may be more appropriate depending on the condition of the tooth.
The dental crown procedure usually involves preparing the tooth, creating a model or digital scan, and placing a custom crown.
Your dentist first evaluates the tooth, surrounding gums, bite, and remaining tooth structure. Dental Xrays may also be taken when needed.
Any decay or damaged material must usually be addressed before the crown is placed.
The tooth is reshaped so the crown can fit over it properly. If a large amount of tooth structure is missing, restorative material may first be used to rebuild part of the tooth.
Local anesthetic is typically used during tooth preparation.
Your dentist takes an impression or digital scan of the prepared tooth and surrounding teeth. This information is used to create a crown that fits your tooth and bite.
When the permanent crown is being made by a dental laboratory, a temporary crown may be placed to protect the prepared tooth.
Temporary crowns are not as strong as permanent restorations, so patients are generally advised to avoid particularly hard or sticky foods until the final crown is placed.
Once the permanent crown is ready, your dentist checks its fit, shape, bite, and appearance.
The crown is then cemented or bonded securely over the prepared tooth.
There is no single crown material that is best for every patient.
The right option depends on factors such as the tooth being restored, how visible it is when you smile, bite pressure, existing dental work, and personal preferences.
Porcelain and ceramic crowns can closely resemble natural tooth enamel, making them popular for visible areas of the smile.
Zirconia is a strong ceramic material commonly used for both front and back teeth. It can provide a combination of durability and natural looking appearance.
Metal crowns are highly durable and can withstand significant chewing forces, although their metallic appearance makes them less commonly chosen for visible teeth.
These crowns combine a metal base with a tooth-colored porcelain exterior. They can provide strength while offering a more natural appearance than a fully metal crown.
Your dentist can explain the advantages and limitations of each option before recommending a material.
When appropriately recommended, dental crowns can:
Protect a weakened tooth
Restore a damaged or broken tooth
Improve chewing function
Support a tooth with a large filling
Restore the shape of a worn tooth
Cover significantly damaged or discolored teeth
Complete a dental implant restoration
The main goal is usually to preserve as much usable tooth structure as possible while restoring normal function.
The tooth is typically numbed with local anesthetic during crown preparation, so patients should not normally feel sharp pain while the tooth is being treated.
Some temporary sensitivity or mild gum tenderness can occur after treatment. This usually improves as the area settles.
Persistent pain, worsening sensitivity, swelling, or discomfort when biting should be evaluated by your dentist.
Your natural tooth remains underneath the crown.
During the procedure, part of the tooth's outer structure is reshaped so the crown can fit properly. The crown is then placed over the remaining tooth.
Because the natural tooth is still present, good oral hygiene remains important. Decay can still develop around the edge of a crown if plaque accumulates in the area.
The lifespan of a dental crown varies from person to person.
Factors that can affect its longevity include:
Oral hygiene
Tooth grinding or clenching
Bite forces
Crown material
Diet and chewing habits
Condition of the underlying tooth
Regular dental care
A crown can last for many years, but it is not considered permanent for life. Your dentist should continue checking the crown during routine examinations.
A crowned tooth should generally be cared for like your natural teeth.
Brush twice daily with fluoride toothpaste and clean between your teeth every day using floss or another recommended interdental cleaner.
You should also avoid habits that can damage both crowns and natural teeth, such as chewing ice, biting fingernails, or using your teeth to open packaging.
If you grind or clench your teeth, your dentist may recommend a nightguard to reduce excessive pressure on your teeth and restorations.
Schedule a dental examination if you have a cracked tooth, broken filling, persistent tooth sensitivity, pain while chewing, or visible damage to a tooth.
Early evaluation may provide more treatment options and help prevent existing damage from becoming more extensive.
If your dentist determines that the tooth needs additional protection, a dental crown may be one option for restoring its strength and function.
A crown may be recommended when a tooth is significantly weakened, cracked, broken, heavily filled, worn, or damaged by decay. Crowns are also commonly used in certain cases after root canal treatment or as part of a dental implant restoration.
Local anesthetic is normally used while the tooth is being prepared, which helps keep the procedure comfortable. Some mild sensitivity or tenderness may occur afterward.
The natural tooth remains in place but is reshaped so the crown can fit over it. The crown then covers and protects the remaining tooth structure.
A crown may be necessary when a tooth no longer has enough healthy structure to be predictably restored with a filling or another more conservative restoration. Your dentist can determine this after examining the tooth.
Yes, but treatment depends on how much decay is present and the condition of the tooth. In some cases, the existing crown may need to be removed and replaced.
Once a permanent crown has been securely placed and your dentist confirms that your bite is comfortable, you can generally eat normally. Avoiding excessively hard foods and habits such as chewing ice can help protect the restoration.
A crown can occasionally loosen or come off because of cement failure, decay, damage, or excessive biting forces. If this happens, keep the crown if possible and contact your dentist rather than attempting to permanently reattach it yourself.
Neither treatment is automatically better. Fillings are generally suitable when enough healthy tooth structure remains, while crowns provide greater coverage when a tooth has been significantly weakened or damaged.
Not necessarily. Whether a crown is recommended depends on the location of the tooth, how much structure remains, and the forces placed on it. Back teeth are more commonly restored with crowns after root canal treatment because they experience greater chewing pressure.
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