A crown is a cover that fits over a tooth and takes the place of its outer surface. It is used when there is not enough sound tooth left to hold a filling, after a root canal on a back tooth, or when a tooth has cracked and needs holding together.
The appointment is longer than a filling but not more uncomfortable, and it is done with the tooth numb. Here is what actually happens, in order, and what to expect between the visits.
The tooth gets reduced so the crown has somewhere to sit
A crown has to have thickness to be strong, and that thickness has to come from somewhere. The dentist numbs the tooth, removes any decay or old filling material, and shapes what is left into a smaller, tapered shape. If too much tooth is missing, a core is built up first so the crown has a solid foundation.
You will feel pressure and vibration and hear the handpiece, but not pain, and it is entirely reasonable to say so if you do feel something. Most people find the length of the appointment harder than the procedure. Around an hour to ninety minutes is typical for a single tooth.
Two visits with a lab, or one visit with a milling machine
In the traditional route, the dentist records the shape of the prepared tooth with a scanner or an impression, the record goes to a dental laboratory, and a technician makes the crown. That takes a couple of weeks, so you leave with a temporary crown and come back to have the permanent one fitted.
Some offices have a milling unit on site and can design and make a ceramic crown while you wait, usually in a single appointment of two to three hours. Same day crowns are convenient and suit many cases well. A lab technician still has the edge for complicated shades and appearance on front teeth, so ask what your dentist would choose for your particular tooth and why.
- Visit one: numbing, shaping, scan or impression, temporary crown fitted
- Between visits: the lab makes the crown, usually one to three weeks
- Visit two: temporary removed, fit and bite checked, crown cemented
- Same day option: designed and milled in the office in one longer visit
The temporary crown is the part that needs care
A temporary is held on with soft cement so it can be taken off easily later, which also means it can come off early. Sticky food is the usual culprit, so avoid chewing gum, caramel and hard candy on that side, and when you floss, pull the floss out sideways rather than snapping it back up past the edge.
Some sensitivity to cold and some tenderness in the gum around the temporary are normal. If the temporary comes off, keep it, avoid chewing on that side and call the office, because the prepared tooth can drift and become sensitive if it is left uncovered. Most offices will re cement it quickly.
Materials change the price and the appearance
All ceramic and zirconia crowns are the usual choice now. Zirconia is very strong and suits back teeth that take heavy load. Layered ceramics such as lithium disilicate look better on front teeth. Porcelain fused to metal is still used and can show a dark line at the gum over the years. Gold is rarely requested but wears kindly against the opposing tooth.
In the United States, a single crown commonly runs somewhere in the range of nine hundred to two thousand five hundred dollars before insurance, and prices vary a lot by city, by practice and by case. Many dental plans treat crowns as major work and pay around half, subject to a deductible, a waiting period and an annual maximum. Ask for a pre treatment estimate rather than a verbal number.
The fit appointment is where you should speak up
At the second visit the dentist tries the crown in, checks the contact with the neighboring teeth and the way it meets the tooth above or below, then adjusts it before cementing. A crown that is slightly tall feels wrong immediately, and adjusting it takes a minute at the chair. It is much less trouble than living with it.
Say something if the bite feels high, if floss shreds between the crown and the tooth next to it, or if the shade looks off on a front tooth. Once it is cemented these things are harder to change, so the few minutes before that point are worth using.
- Tell them straight away if the bite feels high or uneven
- Check the shade in daylight for a front tooth before it is cemented
- Mention any catching or shredding when you floss around it
- Mild cold sensitivity for a few weeks afterwards is common
How long a crown lasts depends mostly on what is under it
A well made crown often lasts a decade or more, and many last considerably longer. What usually ends a crown is not the crown itself but the tooth beneath it: new decay at the margin where the crown meets the tooth, or a fracture in a tooth that was already weakened. Grinding at night shortens the life of anything in the mouth, and a night guard is worth discussing if you grind.
Look after the edge. That margin sits at the gum line, and it needs brushing and cleaning between the teeth exactly like a natural tooth. Pain on biting, a bad taste around the tooth or swelling near the gum means it should be looked at rather than waited out. If swelling is spreading toward your eye or neck, or you have a fever with facial swelling, or trouble breathing or swallowing, go to an emergency room now rather than waiting for a dental appointment. If you do not currently have a dentist, the directory searches every dental practice in the United States by town or ZIP code and shows the closest first, free and with no account.
The short version
- A crown covers a tooth that no longer has enough structure for a filling.
- The tooth is shaped under numbing, then a lab or an in office mill makes the crown.
- Temporary crowns come off if provoked, so avoid sticky food and floss out sideways.
- Crowns commonly run around nine hundred to two thousand five hundred dollars, varying widely by area and case.
- Say something at the fit appointment if the bite feels high, before it is cemented.
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Frequently asked
Does getting a crown hurt?
The tooth is numbed, so the appointment itself should not hurt, though you will feel pressure and vibration. Afterwards the tooth and gum can be tender for a few days and respond to ordinary painkillers you would take for a headache. Pain that builds rather than settles is worth reporting to the office.
How long does a crown take from start to finish?
With a laboratory, expect two appointments about one to three weeks apart, the first around an hour to ninety minutes and the second shorter. With an in office milling unit it can be a single visit of roughly two to three hours. Complex cases with a build up or a root canal take longer.
Can a crowned tooth still get a cavity?
Yes. The crown itself cannot decay, but the natural tooth at its margin can, and that margin sits right at the gum line. Brushing along the gum and cleaning between the teeth daily is what protects it. Decay under a crown is often found on a routine x ray before you feel anything.
What if my crown falls off?
Keep it, do not try to glue it back with household adhesive, and call the office. Avoid chewing on that side and keep the exposed tooth clean, since it will often be sensitive. Depending on the state of the tooth underneath, the same crown can frequently be re cemented.
This is general information to help you ask better questions, not a diagnosis. Anything happening in your own mouth needs a dentist who can look at it.