Dental Crowns: 5 Types, Procedure & Cost

Have a dental crown procedure coming up? Understanding dental crown types, materials, and what affects the dental crown cost of care will help you feel more prepared. Plus, there are some other things you need to know about to avoid common problems with dental crowns. 

From temporary crowns to why dental crowns are necessary, being informed about the overall process will help you make smart choices about your smile. If you’re feeling especially anxious or think dental crowns are overhyped, we’ll cover all of the super-important information that you need to know.

4 Main Reasons Why A Crown Needed? 

There are usually four reasons why a crown is required:

1) Broken Or Decaying Teeth

Procedure:

The damaged portions of the tooth are removed, including any tooth decay or cracked areas. Then an impression is taken, a temporary crown is placed, and a permanent crown is designed and bonded to the tooth. One to two visits are required.

Reason For Crown: 

Without a crown, these teeth would crumble apart to the point they need to be extracted. Or existing decay might expand further into the tooth and require a root canal. The crown supplies a protective cover.

2) Dental Implants

Procedure:

The dental implant process is a multi-step procedure that spans the course of several months. Once your implant is fully integrated with the bone (meaning that it’s fused in place), your dentist will attach an abutment on top of it. It’s this abutment that will then support a fixed restoration, such as a crown. Your dentist will still need to take an impression of the abutment once it’s in your mouth to make sure the new crown lines up with all of its neighbors.

Reason For Crown:

Dental implants only make up the “root” portion of your missing tooth replacement. For proper function and aesthetics, you’ll need a crown placed on the top of the implant abutment. If you have more than one missing tooth, something longer like a bridge will probably be used (which is like a row of dental crowns fused side by side.)

3) Root Canals

Procedure: 

Endodontic therapy (aka root canals) treats the inside of teeth with dying nerves or painful abscesses. They’re a must-have if you want to preserve the tooth and avoid an extraction. Usually, you’ll get a temporary crown on the same day as your root canal treatment, then come back a couple of weeks later for the permanent crown.

Reason For Crown:

Root canal-treated teeth are no longer “alive” so to speak. And one of the side effects of being an essentially dead tooth is that the overall structure becomes more brittle. Putting a crown over your tooth after a root canal means it can keep biting and chewing practically the same as your other teeth. The crown protects your investment and extends the lifetime of your overall smile.

4) Dental Bridges

Procedure: 

Getting a dental bridge is almost identical to a dental crown procedure. The supporting teeth are “prepped”, impressions are taken, and then the permanent bridge is designed. You’ll wear temporary crowns over the abutment teeth until the final restoration is ready for placement a couple of weeks later.

Reason For Crown:

Dental bridges are used for replacing missing teeth, but they require a sort of functional crown to do so. You see, either end of the bridge is basically a dental crown built into the restoration. It’s fitted and designed nearly the same way, except that it’s fused to adjacent “pontic” (fake) dental crowns to help fill in the gap in your smile.

5 Main Types Of Dental Crowns 

1) Porcelain Fused To Metal Crowns 

This more traditional type of cosmetic dental crown blends the durability of a metal base with the customization of matching the restoration to your surrounding teeth.

2) Metal Crowns & Gold Alloys

Gold crowns are great for teeth that are used for heavy load-bearing purposes. Since gold is super resistant to biting forces, it’s an excellent material to use for dental crowns on your back teeth (where the heaviest amount of pressure is applied.)

3) Stainless Steel Dental Crowns

When it comes to dental crown cost, stainless steel is your cheapest option. These crowns are typically used for temporary purposes or for protecting primary (baby) teeth that need to last a little longer but have aggressive tooth decay or abscesses. As you might guess, the entire crown is a bright silver color. The inexpensive material is durable enough for short-term purposes and biocompatible enough that it usually doesn’t affect people with metal allergies.

Stainless steel crowns provide a cheaper, temporary crown alternative for protecting teeth while you’re waiting on a permanent crown solution. They’re also preferred for children, whose mouths are still rapidly developing. That way if the tooth falls out or erupts further, you haven’t spent unnecessary amounts of money on a more durable, cosmetic alternative.

4) Ceramic & Porcelain Crowns

There are all sorts of porcelain, ceramic, and zirconia types of dental crowns on the market these days. Between all of the varying cosmetic materials used, your dentist can select one that best matches your surrounding smile. Ceramic and porcelain crowns are usually the design of choice if you’re topping off a dental implant, restoring a tooth in your “smile zone” or just want to avoid having any potential of visible metal.

Bottom line, the biggest advantage of ceramic or porcelain crowns is the cosmetic potential. It’s possible to have a restoration crafted from a variety of shades and hues, for optimal aesthetic appeal. Thanks to advancements in dental materials, there are more durable porcelain crowns to choose from than ever before.

5) All-Resin Crowns

Resin crowns are a sort of white temporary crown that’s prefabricated or made in the dental office during your appointment. They’re generally used for temporary purposes or for restoring baby teeth on older children, who might be self-conscious of a “silver tooth.”

Advantages

All-resin dental crowns are a cosmetic alternative to stainless steel temporary crowns when an interim restoration is required. Your dentist can place the resin crown over a tooth while you’re waiting for the permanent porcelain crown, minimizing any cosmetic concerns.

Other Types of Dental Crowns 

Temporary Crown 

A temporary crown is always required if you’re getting a traditional two-visit crown or if the treatment is being performed on a child. They provide protection and offer aesthetic support as needed. Since an uncrowned, prepped tooth is extremely susceptible to sensitivity and breakage, temporary crowns are essential if you’re waiting on the permanent crown to be made.

Stainless Steel Or Resin

Any time you have a crown that is made out of stainless steel or resin materials, you must know that it’s only going to help you out on a temporary basis. These dental crowns are not meant for (nor designed to withstand) long term use. Most dentists will only use them for a couple of weeks to a few years at most. Wearing them any longer could actually put you at risk for dental crown problems. Do not try to convince your dentist to leave it on there permanently or give into the temptation to cancel your appointment to go back for the permanent crown!

One-Day Dental Crowns 

Same-day dental crown placement like CEREC use 3D CAD/CAM imaging to digitally scan your prepped tooth and carve a permanent, custom crown while you wait. The virtual imaging equipment replaces the need for a physical impression or trip to the lab. Instead, the high-resolution information is converted into the milling equipment which will transform a solid block of ceramic into a perfectly fitting crown in about an hour.

Onlay Or 3/4 Dental Crowns 

Inlays and onlays — also called “three-quarter crowns” — are like a smaller version of a full crown. They’re usually made out of ceramic or gold. As you might guess, they cover a portion of the tooth instead of the entire surface. Inlays and onlays are preferable when there’s still a healthy amount of intact tooth structure. It’s like finding a middle ground between a traditional filling and a full “cap”. However, not all dentists offer 3/4 crowns, so be sure to ask.

Pediatric (Children’s) Dental Crowns

Dental Crown Procedure Explained

Dental crowns can be completed in one visit or two, depending on the type of crown you’re getting and the technology that’s available in your dentist’s office. Most will be a traditional two-step process.  

One of the reasons why there are so many different dental crown types is because some of them provide better advantages for unique scenarios. As such, they’re made and fitted differently.

Here’s what you can expect, depending on the one that’s recommended by your dentist:

Single-Visit Experience

Same-day dental crowns are one of two types: temporary crowns or CAD/CAM designed permanent crowns.

Step 1

The first is one that’s prefabricated or designed by hand, made out of stainless steel or resin. Depending on which type best fits your tooth, the dentist will use a special dental cement or bonding type of material to affix it directly to your enamel. Unless the crown is for a child, a temporary cement will be used.

Step 2

Now, when most people hear “same-day crowns”, they’re thinking of 3D fabricated crowns like CEREC. These single visit crowns utilize CAD/CAM technology, similar to what you’ve probably seen with 3D printing. Except instead of printing, the scanner converts the data into a virtual mold of your tooth, then carves a precisely fitting crown out of a solid block of ceramic. Your dentist can pick the color that best matches your tooth, and the entire procedure is completed in just one appointment. Plus, there aren’t any gooey impressions.

TIP: Since you’ll be numbed up and waiting a while for the crown to be made, this is a great opportunity to catch up on any other dental work you need!

Multi-Visit Experience 

Traditional dental crowns almost always require two appointments to complete.

First Visit

During the first visit, your dentist will anesthetize (numb) your tooth and then remove any damaged structure. From there, the overall shape of the tooth will be reduced — a process that’s called “prepping” — to make room for a crown to fit over it. Once it’s completely prepped, the dentist will take an extremely accurate impression of the prepared tooth which will go to the dental lab. They’ll also document what color(s) to use for any ceramics involved. In the meantime, your dentist will place a temporary crown over your prepped tooth to minimize sensitivity and protect the residual structure until your second visit.

Second Visit

It usually takes most dental labs about a two-week turnaround time to handcraft your permanent crown and deliver it back to your dentist’s office. Once it’s ready, you’ll go back to your dentist to have the temporary crown removed and then the permanent crown cemented in place. Your dentist may need to make a few small adjustments to ensure everything lines up properly. This second appointment is typically fairly short, and you may not even require any local anesthetic.

After Procedure Care

Recovering from a dental crown procedure is a little different than a routine filling. For the first few days, you may have some tooth sensitivity, fears about the crown falling off, or concerns about what you can eat. Essentially, you can go “back to normal” with your typical diet and hygiene routine after a few days. But at the very beginning, there will be some special steps you need to take.

Pain Management

Some mild to moderate discomfort after dental treatment is normal. It’s no different with a dental crown procedure. Except in this case, you may notice some discomfort as your nerve reacts/responds over the course of days to weeks. Anti-inflammatory medication like ibuprofen or Motrin is ideal for pain management. Take it as directed, as needed. If symptoms persist for more than a couple of weeks, let your dentist know. In rare situations, the dentist may need to go back and apply a desensitizer or perform a root canal on your tooth.  

Eating

Give yourself a few hours for any numbing medications to wear off before you try to eat anything. Chewing while the local anesthetic is still working typically leads to accidentally biting into your lips, tongue, or cheeks, no matter what type of dental work you’ve had.

After the local anesthetic wears off and for the first few days after a dental crown procedure, try to chew on the other side of your mouth. As you transition into chewing on your crown, avoid sticky or especially crunchy foods until you’re certain that the bonding is completely secure. Once the cement has had time to cure, you can eat like normal (but we would still recommend avoiding biting straight into something like caramel or taffy.)

Cleaning Your Dental Crowns

If there’s one thing you take away from this post, it’s that you need to clean your crown religiously, every single day. Most dental crown problems develop over time because of poor cleaning practices. For the first couple of days, you can use an irrigator, water flosser, and toothbrush. After a few days, continue water flossing or use your traditional dental floss. Just make sure you’re cleaning around the edges of it daily!

Temporary Crown Care

Temporary crowns are just that: temporary. They don’t have as strong or tight of a seal against your tooth as a permanent crown does. That’s why you’ll need to care for them differently, as they’ll be easier to pull out. you can brush a temporary crown normally but consider using a water flosser to clean around the edges, since regular floss may shred or get stuck (which is different than permanent crowns.)

If the temporary crown is on a baby tooth, use a gentle hand with traditional floss or a floss pick to clean each side of the tooth daily.

How Should I Care For Dental Crown?

The better you take care of your dental crown, the longer it’s able to last. Like other dental work, it needs to be cleaned thoroughly every day to prevent bacteria from affecting the edges (margins) and seeping underneath your restoration. Here are some important things to keep in mind:

Right After the Procedure

You’ll need to be delicate with your crown for a day or two as the cement underneath it completely hardens. Do your best to avoid chewing in that area, don’t eat anything sticky, and don’t use string floss (or a floss pick) to prevent pulling it off. Just keep in mind you will want to start flossing it after everything is finally firmed up.

Routine Care

Once you’ve had time for the bonding agent to completely cure, it’s important to get into a daily routine of brushing and flossing your crown tooth. Like other teeth, gently wrap the floss around the crown and slide it up and down each side, as well as just below the gumlines. If something gets stuck, don’t force it out. A water flosser can be helpful if you feel nervous flossing around a crown. But whatever you do, don’t avoid flossing! It will cause you way more harm than good.

While we’re on the topic of routine care, there’s an elephant in the room that we need to discuss. A lot of people assume that string floss is going to pull off their crown if they use it too tightly. Here’s the truth: You’re more likely to have a crown fall off from not flossing than you are for floss to actually dislodge your crown. The seal underneath it is that strong. And if the floss does pull your crown off, there’s a pretty good chance it was going to come off anyway - better to have it happen while you’re paying attention than during a meal or something like that.

Problems That Could Develop With Dental Crowns

Knowing about potential dental crown problems, even if temporary, can help you be better equipped for a dental crown procedure. Here are some potential issues that might pop up.

Discomfort Or Sensitivity 

It’s totally normal to experience some tooth sensitivity for the first several days (or even weeks) after a crown treatment. Why? Because your dentist is essentially reducing the thickness of the tooth structure around the nerve. So, your nerve is going to potentially be on “high alert” as it responds to the change in your tooth’s anatomy. Fortunately, there are desensitizers and similar products your dentist can use underneath the crown to help prevent this common side effect.

Gumline Dark (Exposed Metal)

Another normal “problem” (if you want to call it that) with crown treatments is that depending on the materials and dental crown types, you run the risk of a dark grey line right at your gumline, near the edge of the crown. This scenario really only applies to “PFM” or porcelain fused to metal crown designs. Since the porcelain coats a metal crown base, it tapers off right at the edge. When it’s on your tooth, the margin of the crown sets as close to your gums as possible without actually going under them. If you look closely, you might see a dark line. This potential concern is one reason why so many dentists are now getting away from using PFM crowns when it comes to treating teeth toward the front of the mouth.

Chipped Dental Crown

Just like teeth, crowns can chip. They’re not invincible. Accidents or bruxism (clenching and grinding) can lead to chipped porcelain on your new “cap”. The bad news is that you can’t simply patch over the chip with more porcelain; the entire crown would need to be replaced if you want to repair it. Depending on how severe the chip is and where the crown is in your mouth, your dentist could potentially just smooth it out. If you have a porcelain fused to metal crown, the metal base will likely become exposed.

If you know you’re prone to grinding your teeth, it’s worth your time and money to go ahead and invest in a protective nightguard to sleep it. It’s better (and cheaper) to have to replace a bite splint every few years than it is to change out a crown.

Loose Crown/Crown Falls Out

Crowns are attached to your tooth with a special type of dental cement. If that bonding agent is compromised, your crown can fall off your tooth. Eating super-sticky foods may create enough suction to pull your crown out. Or perhaps you haven’t been flossing as you should, and bacteria have seeped up around the edges of your crown, causing decay underneath it. If your tooth is shorter, it might need pins or a buildup to provide an added base to prevent your crown from falling out. In some situations, the crown can be re-cemented, in others they need to be replaced altogether.  

Allergic Reaction

If you have extreme metal sensitivity, be sure to let your dentist know. This would include someone who breaks out easily to certain jewelry, like non-precious metal earrings and necklaces. An allergic reaction to a dental crown is extremely rare. So rare that most dentists never even see it during their years of practice. But it’s still something you need to discuss so that your provider can select a non-metal crown or one made out of a precious metal like gold if you’re genuinely concerned about the risk.

Gum Disease 

Without healthy gums, you run the risk of losing both your crown and the tooth it’s attached to. A lot of people get nervous about flossing around their crowns, thinking the floss will pull it off. This scenario can lead to gum infections and bone loss around those teeth, compromising their integrity, and putting you at a greater risk of tooth loss. It’s better to floss around your crown each day than not to. And if you’re still nervous about it, a water flosser is an excellent alternative!

Since dental crowns have a thin margin (edge) directly alongside your gums, there’s a tiny surface area that plaque can adhere to. It’s really important to make sure you’re angling your toothbrush toward these spaces in order to remove the plaque before it calcifies into tartar. Chronic plaque buildup along that tiny edge can predispose you to gingivitis around your crown. And gingivitis is the first stage of gum disease.

How Long Do Dental Crowns Last? 

Some dental crown types last longer than others. Specifically, when it comes to comparing stainless steel crowns to the other designs. Stainless steel or resin crowns should only be used on a temporary basis. On the other hand, your other permanent crowns should last at least 5-10 years, as long as you care for them properly. They might last even longer. But dental crown problems such as recurring tooth decay around them (from not flossing or dietary habits) could cause your permanent crown to fail prematurely.

With super good oral hygiene, daily flossing or water flossing, regular checkups, and wearing a nightguard (if you’re prone to clenching and grinding) you can help to ensure that you get the best possible outcome from a dental crown procedure.

How Much Does A Dental Crown Cost?

One of the biggest factors that affect whether people actually go through with their recommended treatment is the dental crown cost. Since there are a variety of materials on the market, dental crown types or designs directly impact the charge for the procedure.

Dental crown cost totals will vary depending on where you live and which dental crown types you, dental insurance,  and your dentist choose. Here’s an estimated breakdown of the fee structure when it comes to one design to the next (cost is per tooth.)

Keep in mind that any additional steps, such as possible buildups or pins, or getting sedation during your procedure, will get coded out as a separate cost. If you are having a root canal or dental implant as well, here is the associated pricing with a root canal and dental implant. Dental insurance covers around 50% of a dental crown procedure. But remember most dental insurance companies only pays out $1,500 per year. You can actually save more with a dental discount plan. 

Dental Crowns Overview

Getting a dental crown helps you save your natural tooth and smile, both functionally and aesthetically. They’re used for adults and children alike. Now that you know everything about a dental crown procedure, including dental crown types, dental crown costs, and common dental crown problems…what are you waiting for? Avoiding treatment could risk sacrificing your tooth altogether. If you have hesitations about treatment, be sure to talk to your dentist one-on-one, or even seek out a second opinion.