A dental crown is a custom-made restoration that covers a damaged or weakened tooth to restore its shape, strength, function and, when appropriate, appearance. Crowns are also used on top of dental implants to replace the visible part of a missing tooth.
Medically reviewed by Dr. Walter Kostrzewski, DMD
Dr. Kostrzewski has more than two decades of experience in dentistry and reviews the dental information published by ACE Dental Resource.
A crown is different from a filling or bonding because it covers much more of the tooth. That can make it useful when a tooth has lost substantial structure, but it also means removing some healthy tooth structure to create space for the restoration. The goal is to use the least invasive restoration that can reliably meet the tooth’s needs.
When Is a Dental Crown Needed?
A crown may be considered when a tooth is too damaged, weakened or heavily restored for a more conservative restoration to provide adequate protection. Common situations include:
| Situation | Why a crown may be considered |
|---|---|
| Large fracture or loss of tooth structure | A crown can cover and protect the remaining tooth when a filling or bonding is not sufficient. |
| After root canal treatment | Some root-filled teeth, particularly those with substantial loss of tooth structure, need cuspal protection. The decision depends on the individual tooth. |
| Large or failing restoration | A crown may replace a restoration when too little sound tooth remains for another conservative repair. |
| Severely worn or misshapen tooth | A crown can restore form and function when other options are unsuitable. |
| Dental implant | An implant crown is the visible restoration attached to the implant and abutment or implant connection. |
| Bridge abutment | Crowns can sometimes cover the teeth that support a traditional fixed dental bridge. |
Not every cracked, discolored or root-filled tooth needs a crown. Your dentist should assess the remaining tooth structure, decay, cracks, periodontal health, bite and available alternatives before recommending full coverage.
Dental Crown Materials
Modern crowns can be made from several materials. There is no single material that is best for every tooth. The choice depends on location in the mouth, available tooth structure, bite forces, esthetic requirements, space, bonding requirements and the dentist’s clinical plan.
| Material | Common considerations |
|---|---|
| Metal alloys | Strong and durable, with a long history of clinical use. Their metallic appearance makes them less suitable when visible tooth color is the priority. |
| Porcelain-fused-to-metal | Combines a metal substructure with a tooth-colored ceramic surface. It remains a well-established option, although ceramic chipping can occur. |
| Zirconia | A strong ceramic available in different formulations and designs. Monolithic zirconia can reduce some chipping concerns associated with veneered designs. |
| Lithium disilicate and other glass ceramics | Can provide excellent esthetics and are used for selected anterior and posterior crowns when the material and preparation are appropriate. |
The American Dental Association notes that indirect restorative materials differ in mechanical properties, processing and clinical indications. [1] Stronger newer ceramics have expanded the options for combining esthetics and durability, but material selection still needs to be case-specific. ADA guidance on indirect restorative materials. [1]
Dental Crown Procedure: Step by Step
1. Examination and treatment planning
Your dentist examines the tooth, gums, bite and surrounding structures. X-rays or other imaging may be appropriate when the condition of the roots, bone or previous restorations needs to be assessed. If decay, infection or periodontal disease is present, it may need to be treated before the definitive crown.
2. Tooth preparation
The dentist reshapes the tooth to create enough space for the chosen crown material while preserving as much sound tooth structure as the clinical situation allows. The amount and design of preparation vary with the tooth, restoration and material.
3. Digital scan or impression
The prepared tooth and surrounding teeth are recorded using either a conventional impression or an intraoral digital scan. The information is used to design and fabricate the crown.
4. Temporary protection
When the definitive crown is being made outside the mouth, a temporary restoration may protect the prepared tooth between appointments. Not every digital workflow requires the same sequence.
5. Try-in and final placement
Before final cementation or bonding, the dentist checks the crown’s fit, contacts, bite, color and appearance. Adjustments may be made before the restoration is permanently placed.
Can a Dental Crown Be Done in One Visit?
Yes, some dental practices use chairside CAD/CAM systems to design and fabricate certain crowns during a single appointment. Digital scanning and milling can reduce laboratory turnaround time, but a same-day workflow is not automatically appropriate for every tooth or material.
The important issue is not whether a crown was made in one visit or two. The restoration still needs appropriate diagnosis, tooth preparation, material selection, fit, occlusion and finishing. Digital dentistry is a tool within the treatment process, not a guarantee of a better clinical outcome.
Does Getting a Crown Hurt?
The tooth is normally anesthetized during preparation, so you should not expect significant pain during the procedure. It is common to have some temporary sensitivity or gum soreness afterward. Persistent, severe or worsening pain should be assessed by your dentist because it can indicate a problem with the tooth, pulp, bite or restoration.
How Long Do Dental Crowns Last?
There is no single guaranteed lifespan for a crown. Longevity depends on the material and design, the tooth underneath, oral hygiene, periodontal health, bite forces, grinding or clenching, diet, smoking and the quality of the preparation and placement.
Clinical research shows that several modern crown materials can have high medium-term survival, but different studies evaluate different materials, tooth locations and types of complications. A 2026 systematic review and meta-analysis reported five-year survival rates ranging from about 90% to 98.5% among several tooth-supported single-crown material/design groups, with monolithic lithium-disilicate and zirconia showing fewer fractures or chipping than some veneered alternatives. These figures should not be treated as a personal prediction for an individual crown. [2].
What Can Cause a Crown to Fail?
| Problem | What it can mean |
|---|---|
| Secondary decay | Decay can develop at the crown margin or elsewhere on the tooth. |
| Loss of retention | The crown can become loose if the cementation, tooth structure or forces on the restoration compromise retention. |
| Fracture or chipping | Ceramic materials can fracture or chip, especially under high functional or parafunctional forces. |
| Pulp problems | A tooth can develop inflammation or other pulpal problems before or after crown treatment. |
| Gum or periodontal problems | Plaque accumulation and poor oral hygiene can affect the tissues around a crown. |
| Wear or bite problems | Incorrect contacts or heavy grinding can contribute to discomfort, wear or restoration damage. |
A crown does not make the underlying tooth immune to decay or periodontal disease. The tooth and surrounding gums still need routine professional care and daily cleaning.
Zirconia vs. Porcelain vs. Metal Crowns
Material comparisons need context. Evidence from recent systematic reviews shows that modern zirconia and other all-ceramic crowns can perform well, but outcomes vary by material design and whether the ceramic is monolithic or veneered. A 2024 systematic review and meta-analysis of zirconia-based tooth-supported fixed dental prostheses found higher failure and ceramic-chipping rates for the specific bilayer zirconia designs studied compared with metal-ceramic prostheses, while newer evidence on single crowns shows strong five-year survival for several monolithic zirconia and lithium-disilicate designs. [3].
For implant-supported crowns, evidence also differs from evidence for crowns on natural teeth. A systematic review found high five-year survival for both metal-ceramic and zirconia implant-supported single crowns, while technical complications differed by material and design. [4].
Dental Crowns vs. Other Restorations
| Restoration | Typical role | Main consideration |
|---|---|---|
| Composite bonding | Small to moderate cosmetic or structural changes | More conservative, but generally less suitable for heavily weakened teeth. |
| Filling | Repairing localized tooth decay or defects | Preserves more tooth structure when adequate tooth remains. |
| Inlay or onlay | Selected larger defects that do not require a full crown | Can preserve more tooth structure than full coverage in appropriate cases. |
| Veneer | Primarily selected visible-surface esthetic changes | Usually does not provide the same full-coverage protection as a crown. |
| Crown | Teeth requiring substantial structural coverage | Requires preparation of the tooth and careful long-term maintenance. |
For information about related treatments, see our guides to dental inlays and onlays, dental bonding, veneers and dental implants.
Dental Crown Cost
The price of a crown varies substantially by country and region, dentist, laboratory or digital workflow, material, tooth location, complexity and whether additional treatment is required first. Older online articles often quote fixed prices that quickly become outdated, so a historical price should not be treated as a current quote.
| Cost factor | Why it matters |
|---|---|
| Crown material | Different materials and laboratory workflows have different costs. |
| Tooth preparation | Extensive damage may require additional restorative treatment. |
| Root canal or other treatment | Infection or pulpal disease may need treatment before the crown. |
| Temporary restoration | Some treatment plans include an interim crown between appointments. |
| Core buildup or post | Some teeth need additional support before a crown; this is case-dependent. |
| Location and dentist | Professional fees and laboratory costs vary considerably by market. |
Ask for a written estimate that separates the crown itself from examinations, imaging, buildup, root canal treatment, temporary restorations and other necessary procedures. For broader information, see our dental prices guide.
How to Care for a Dental Crown
- Brush twice daily with fluoride toothpaste and clean between your teeth every day.
- Continue regular dental examinations and professional cleanings as recommended.
- Do not use the crown as a tool to open packages or bite hard non-food objects.
- If you grind or clench your teeth, ask your dentist whether a protective night guard is appropriate.
- Report a loose crown, persistent sensitivity, pain when biting, fracture or changes around the gumline promptly.
Questions to Ask Before Getting a Crown
| Question | Why ask it? |
|---|---|
| Why does this tooth need a crown? | Helps you understand the diagnosis and whether a more conservative option is reasonable. |
| How much sound tooth structure remains? | Provides context for the proposed preparation and restoration. |
| What materials are appropriate? | Different materials have different esthetic, mechanical and clinical considerations. |
| Do I need a root canal or buildup first? | Clarifies whether additional treatment is needed before the crown. |
| What happens if I delay treatment? | Helps you understand the risks of waiting. |
| How will the crown be checked for fit and bite? | Fit and occlusion are important parts of final placement. |
| What is included in the total cost? | Avoids surprises from separate diagnostic or preparatory procedures. |
Bottom Line
Dental crowns can restore teeth that have lost substantial structure, protect selected weakened teeth and provide the visible restoration for dental implants. The best crown is not determined by material name alone. A sound diagnosis, preservation of healthy tooth structure, appropriate material and design, accurate fit, good oral hygiene and regular follow-up all contribute to long-term results.
Research and Sources
- American Dental Association. Materials for Indirect Restorations. ADA.
- A Systematic Review and Meta-analysis Evaluating the Survival, Failure, and Complication Rates of Metal-Ceramic, Veneered, and Monolithic All-Ceramic Tooth-Supported Single Crowns-Part 1. International Journal of Prosthodontics. 2026. PubMed.
- Chen H, et al. Clinical performance of zirconia-based tooth-supported fixed dental prostheses: A systematic review and meta-analysis. Journal of Dentistry. 2024. PubMed.
- Pjetursson BE, et al. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clinical Oral Implants Research. 2018. PubMed.
Editorial note: This page provides general dental information and is not a diagnosis or substitute for an examination by a dentist. Crown treatment should be planned for the individual tooth and patient.