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Dental crowns

  • Definition
    • 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.

  • Alternative Names
    • Dental caps; Porcelain crowns; Lab-fabricated restoration

  • Description
    • Getting a dental crown usually takes two dental visits.

      At the first visit, the dentist will:

      • Numb the neighboring teeth and gum area around the tooth that is getting the crown so you do not feel anything.
      • Remove any old and failing restorations or decay from the tooth.
      • File down your tooth to prepare it for a crown.
      • Fill any cavities.
      • Take an impression of your tooth to send to the dental lab where they make the permanent crown. Some dentists can make a crown in their office.
      • 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 dental implant
      • Correct a misaligned 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. You may need a root canal to save the tooth. Or, you may need to have the tooth pulled and replaced with a tooth implant.
      • Your crown could chip or crack: If you grind your teeth or clench your jaw, you may need to wear a night mouth guard 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.
  • 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. The different types of crowns include:

      Stainless steel crowns:

      • Are pre-made
      • Work well as temporary crowns, especially for young children. The crown falls off 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

      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 crown
      • Metal makes the crown stronger
  • 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 of the other side of your mouth.

      Call 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

      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 can last at least 5 years and as long at 15 to 20 years.

  • References
    • Academy of General Dentistry. What Are Crowns? Available at: Accessed 10/29/14.

      American Dental Association. Crowns. Available at: Accessed 10/29/14.

      Amsterdam, AT. Oral medicine. In:  Marx JA, Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 70.