Dental crowns
Dental caps; Porcelain crowns; Lab-fabricated restoration; Porcelain fused to metal crown, Gold crown; PFM
A crown is a tooth-shaped cap that replaces your normal tooth above the gum line. You may need a crown to support a weak tooth or to make your tooth look better.
The structure of the tooth includes dentin, pulp and other tissues, blood vessels and nerves imbedded in the bony jaw. Above the gum line, the tooth is protected by the hard enamel covering.
A tooth can be chipped or fractured during an accident or a bad fall. A tooth that is chipped or not badly fractured can usually be handled on a nonemergency basis. A tooth that is badly fractured may have exposed nerve tissue inside the tooth. In this case, immediate attention is needed to avoid infection, abscess, and pain.
Description
Getting a dental crown usually takes two dental visits.
At the first visit, the dentist will:
- Numb the tooth and neighboring teeth and gums around the tooth that is getting the crown so you do not feel anything.
- Remove any old or failing restorations (fillings) or decay from the tooth.
- Reshape your tooth to prepare it for a crown.
- Take an impression of your tooth to send to the dental lab where they make the permanent crown. Some dentists can digitally scan the tooth and make the crown in their office. Sometimes, the impression is taken at a second visit instead of the initial visit.
- Make and fit your tooth with a temporary crown.
At the second visit, the dentist will:
- Remove the temporary crown.
- Fit your permanent crown. Your dentist may take an x-ray to make sure the crown fits well.
- Cement the crown in place.
Why the Procedure Is Performed
A crown can be used to:
- Attach a bridge, which fills a gap created by missing teeth
- Repair a weak tooth and keep it from breaking
- Support and cover a tooth
- Replace a misshapen tooth or restore a dental implant
- Correct a misaligned tooth
- Improve the appearance of an existing tooth
Talk to your dentist if you need a crown. You may need a crown because you have a:
- Large cavity with too little of the natural tooth left to hold a filling
- Chipped or broken tooth
- Worn down or cracked tooth from grinding your teeth
- Discolored or stained tooth
- Badly shaped tooth that does not match your other teeth
Risks
Several problems can occur with a crown:
- Your tooth under the crown can still get a cavity. To prevent cavities, be sure to brush your teeth twice a day and floss once a day.
- The crown could fall off. This can happen if the core of the tooth that holds the crown in place is too weak. If the nerve of the tooth is affected, you may need a root canal procedure to save the tooth. Or, you may need to have the tooth pulled and replaced with a dental implant.
- Your crown could chip or crack. If you grind your teeth or clench your jaw, you may need to wear a bite splint or mouth guard at night to protect your crown when you sleep.
- The nerve of your tooth could become extra sensitive to cold and hot temperatures. It may be painful. In this case, you may need a root canal procedure.
Before the Procedure
There are several types of crowns, and each has pros and cons. Talk to your dentist about the type of crown that works best for you. There are different types of crowns.
Stainless steel crowns:
- Are pre-made.
- Work well as temporary crowns, especially for young children. The crown falls out when the child loses the baby tooth.
Metal crowns:
- Hold up to chewing and teeth grinding
- Rarely chip
- Last the longest
- Do not look natural in color
Resin crowns:
- Cost less than other crowns
- Wear down more quickly and may need to be replaced sooner than other crowns
- Are weaker and prone to cracking
Ceramic or porcelain crowns:
- Wear down opposing teeth more than metal crowns
- Match the color of other teeth
- May be a good choice if you have a metal allergy
Porcelain fused to metal crowns:
- Are made from porcelain covering a metal coping
- The porcelain part is more prone to fracture than crowns made of all porcelain
After the Procedure
While you have the temporary crown in place, you may need to:
- Slide your floss out, rather than lifting it up, which can pull the crown off the tooth.
- Avoid sticky foods, such as gummy bears, caramels, bagels, nutrition bars, and gum.
- Try to chew on the other side of your mouth.
Contact your dentist if you:
- Have swelling that is getting worse.
- Feel that your bite is not right.
- Lose your temporary crown.
- Feel as if your tooth is out of place.
- Have pain in the tooth that is not relieved with over-the-counter pain medicine.
Once the permanent crown is in place:
- If your tooth still has its nerve, you may have some sensitivity to heat or cold. This should go away over time.
- Expect that it will take a few days to get used to the new crown in your mouth.
- Take care of your crown the same way you take care of your normal teeth.
- If you have a porcelain crown, you may want to avoid chewing on hard candy or ice to avoid chipping your crown.
Outlook (Prognosis)
When you have a crown, you should be more comfortable chewing, and it should look good.
Most crowns should last at least 5 years and can last as long as 15 to 20 years.
References
American Dental Association website. Crowns.
Celenza V, Livers HN. Porcelain-full coverage and partial coverage restorations. In: Aschheim KW, ed. Esthetic Dentistry: A Clinical Approach to Techniques and Materials. 3rd ed. St Louis, MO: Elsevier Mosby; 2015:chap 8.
Melnick PR, Takei HH. Preparation of periodontium for restorative dentistry. In: Newman MG, Klokkevold PR, Elangovan S, Hernandez-Kapila YL, eds. Newman and Carranza's Clinical Periodontology and Implantology. 14th ed. Philadelphia, PA: Elsevier; 2023:chap 66.
Version Info
Last reviewed on: 10/14/2024
Reviewed by: Michael Kapner, DDS, General Dentistry, Norwalk Medical Center, Norwalk CT. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
