A dental crown is a tooth-shaped cap that covers a damaged or weakened tooth

A dental crown is a hollow cap made of ceramic, porcelain, metal, or a combination of materials that fits over a tooth that has been filed down. The dentist removes decay or damage, shapes what remains, and cements the crown in place. It restores the tooth's shape, size, strength, and appearance. Once cemented, the crown becomes the visible part of the tooth you see and use to chew.

Crowns are different from fillings because they cover the entire tooth rather than filling a cavity. They are also different from veneers, which cover only the front surface. A crown wraps around the whole tooth and extends slightly below the gum line.

The process typically takes two to three weeks from start to finish. At the first appointment, the dentist prepares the tooth and takes an impression or digital scan. You wear a temporary crown while the permanent one is made in a lab. At the second appointment, the dentist removes the temporary crown and cements the permanent one in place.

Key Takeaways

  • A crown covers a tooth that is cracked, decayed, or weakened, and it usually lasts 5 to 15 years depending on the material and how well you care for it.
  • The cost varies widely by material (metal crowns are often cheapest, all-ceramic crowns are more expensive) and by region, ranging from several hundred to over a thousand dollars per tooth.
  • Dental insurance often covers 50 percent of the cost if the crown is medically necessary, but coverage rules and limits vary by plan.
  • A crown requires the tooth to be filed down, which is permanent, so dentists recommend it only when the tooth cannot be saved by a filling or root canal alone.
  • After the crown is placed, you care for it like a natural tooth—brushing, flossing, and avoiding chewing on hard objects—but it cannot get a cavity because it is not a living tooth.

Why a dentist might recommend a crown

A crown is recommended when a tooth has damage or decay that is too large for a filling to repair. Common reasons include a tooth that is cracked or broken, a tooth that has had a root canal and needs reinforcement, a tooth with a very large filling that is failing, or a tooth that is severely discolored or misshapen and cannot be fixed with whitening or bonding.

Crowns are also used to support a bridge (a false tooth anchored to neighboring teeth), to cover a dental implant, or to protect a tooth that is at high risk of breaking. If you grind your teeth at night, a crown on a worn tooth can prevent further damage.

A dentist will not recommend a crown if the tooth can be saved with a smaller, less invasive treatment. Fillings, bonding, and root canals all preserve more of the natural tooth structure, so they are tried first when possible.

Materials and how they differ in cost and durability

Crowns are made from several materials, and the choice affects both how long the crown lasts and what you pay. Metal crowns (usually gold or a gold alloy) are the most durable, lasting 20 years or longer, and are often the least expensive option. They are very strong and require less tooth removal. The downside is that they are visible and most people do not want them on front teeth.

Porcelain-fused-to-metal (PFM) crowns have a metal base with a porcelain coating, so they look like a natural tooth while keeping much of the strength of metal. They last 5 to 15 years and cost less than all-ceramic crowns. Over time, the porcelain can chip or the metal can show at the gum line.

All-ceramic or all-porcelain crowns look the most natural and are a good choice for front teeth. They last 5 to 15 years and cost more than metal or PFM crowns. They are not as strong as metal and can crack if you chew on hard objects or grind your teeth.

Zirconia crowns are a newer ceramic material that is very strong and looks natural. They last as long as metal crowns and cost more than PFM but similar to or slightly more than all-ceramic. They are a good middle ground if you want durability and appearance.

What the crown process costs and what insurance may cover

The cost of a crown varies by material, location, and whether the tooth needs additional work before the crown is placed. A metal crown might cost $500 to $900. A PFM crown typically costs $800 to $1,200. An all-ceramic crown usually costs $1,000 to $1,500. Zirconia crowns often cost $1,200 to $1,600. These are general ranges; your dentist can give you a specific quote.

If the tooth needs a root canal before the crown, that is an additional cost, usually $800 to $1,500 depending on which tooth and how complex the canal is. If the tooth needs a buildup (a core of material to support the crown), that adds $100 to $300.

Dental insurance plans vary widely in what they cover. Many plans cover 50 percent of the cost of a crown if it is deemed medically necessary (not cosmetic). Some plans cover only 30 percent. Others have an annual maximum, so if you have already used your benefit on other work, a crown might not be covered that year. Some plans require you to wait six months or a year after a filling before covering a crown on the same tooth. Check your plan documents or call your insurance company to learn your specific coverage and any waiting periods.

Temporary crowns and what to expect between appointments

After the first appointment, you wear a temporary crown while the permanent one is being made in a lab. The temporary crown is usually made of acrylic or composite material and is held in place with temporary cement. It protects the prepared tooth and keeps it from shifting.

Temporary crowns are not as strong as permanent ones, so you should avoid chewing on that side of your mouth if possible. Do not chew sticky foods like gum or caramel, which can pull the crown off. If the temporary crown comes loose or falls off, call your dentist right away so it can be reattached or replaced.

The temporary crown may feel slightly different or uncomfortable at first. If it feels too high when you bite down, call your dentist to have it adjusted. Small gaps between the temporary crown and the tooth are normal and do not mean something is wrong.

How long a crown lasts and when it might need to be replaced

A dental crown typically lasts 5 to 15 years, depending on the material, how well you care for it, and how much stress you put on it. Metal crowns often last 20 years or longer. Ceramic crowns are more likely to chip or crack and may need replacement sooner, especially if you grind your teeth or chew on hard objects.

A crown can fail if the tooth underneath decays (though the crown itself cannot get a cavity), if the cement washes out and bacteria get underneath, if the crown cracks or chips, or if the tooth breaks at the gum line. If any of these happen, the crown will need to be replaced.

To extend the life of your crown, brush and floss daily, avoid chewing on hard objects like ice or hard candy, and wear a night guard if you grind your teeth. If you play contact sports, wear a mouthguard. Regular dental checkups allow your dentist to spot problems early.

Crowns versus other options for a damaged tooth

Before recommending a crown, your dentist will consider whether a smaller treatment would work. A filling is less invasive and less expensive but works only if the decay or damage is small and the tooth structure is still strong. A bonded restoration uses tooth-colored resin to rebuild part of the tooth and costs less than a crown, but it does not last as long and is not as strong.

A root canal removes the nerve and pulp from inside the tooth if it is infected or dying. After a root canal, the tooth is often weaker and more brittle, so a crown is usually recommended to protect it. A root canal plus crown costs more than a crown alone but saves the natural tooth.

An extraction (removing the tooth) is an option if the tooth cannot be saved, but it is usually the last choice because it leads to bone loss and shifting of neighboring teeth. Replacing an extracted tooth with an implant or bridge is more expensive and more involved than a crown.

Frequently Asked Questions

Does a crown hurt?

The tooth is numbed before the dentist prepares it, so you should not feel pain during the procedure, only pressure and vibration. After the anesthetic wears off, the tooth may be sensitive to temperature or pressure for a few days. Over-the-counter pain relievers usually help. If pain lasts more than a week or is severe, contact your dentist.

Can I eat normally with a crown?

Once the permanent crown is cemented, you can eat normally. Avoid chewing on very hard objects like ice, hard candy, or bones, which can crack the crown. While wearing the temporary crown, stick to soft foods and chew on the other side of your mouth if possible.

What happens if the crown falls off?

If your permanent crown comes off, call your dentist right away. Do not wait—the prepared tooth underneath is vulnerable to decay and damage. If you cannot reach your dentist, a temporary fix is to clean the crown and tooth and use over-the-counter dental cement to reattach it, but you still need to see your dentist as soon as possible.

Will my crown look like my natural teeth?

Ceramic and zirconia crowns are designed to match the color and shape of your natural teeth. Your dentist will work with the lab to match the shade. Metal crowns are visible and do not look like natural teeth. PFM crowns look natural from the front but may show a metal line at the gum line over time.

How do I care for a crown?

Brush and floss your crown like a natural tooth. Use a soft-bristled toothbrush and non-abrasive toothpaste. Floss gently around the crown, especially at the gum line. Avoid sticky foods and do not chew on hard objects. If you grind your teeth, wear a night guard to protect the crown.