Dental Crowns

Where it may be suitable

• A tooth that has lost structure to a large filling, where each new filling leaves less of the tooth
• A fracture or crack that runs below the gum or towards the root, once the extent of the crack and whether the tooth can be repaired have been assessed
• Teeth that have had root canal treatment, especially back teeth that carry chewing load
• Teeth that will support a bridge
• Severely worn teeth, once the cause of the wear (for example grinding, or acidic food and drink) has been assessed, or teeth with developmental defects
• Restorations that keep breaking, once the cause of the fracture, the remaining tooth structure and the existing restoration have been assessed. A crown is considered only if the loss of tissue calls for it; clenching is managed as a separate part of the plan

Where an option that removes less may be enough

• If enough sound tissue remains, a filling or an onlay, which covers one or more of the tooth's cusps (the raised points of the chewing surface), may be enough; root canal treatment or a large filling does not on its own mean a crown is needed.
• A complaint about colour only: depending on the cause of the discolouration, whitening first, where suitable.
• A small chip or a flaw in shape: bonding.
• Colour and shape on a front tooth, where the tooth is healthy: a veneer. More detail: our "Crown or veneer?" page.

Where another treatment comes first

• Active decay or gum disease: this is treated first; no crown is made while the disease is active.
• A fracture that reaches the root, or loss of most of the tooth: whether the tooth can be saved is assessed. Some teeth cannot be saved with a crown, and extraction followed by an implant or a bridge then comes into consideration.
• Teeth that are still developing: in young patients, a permanent crown is usually postponed.

Suitability is decided by an examination, a review of any existing X-rays and, where needed, new imaging.

The first decision is whether the tooth needs a crown at all; the material comes second. It is chosen for the tooth's position, your bite, the opposing teeth, any clenching habit and what you expect of its appearance.

• Lithium disilicate (e.max). Lets light through in a way close to a natural tooth; often chosen for front teeth and single crowns.
• Zirconia (often called zirconium). Its strength varies with the type and design; suitable types are preferred for back teeth, bridges and people who clench. It is made as a single piece (monolithic) or with porcelain layered on top.
• Metal-ceramic (porcelain fused to metal). The type of crown studied over the longest periods; if the gum recedes, metal may show at its edge. People allergic to base metals such as nickel and chromium may react to it; tell your dentist about any metal allergy you know of.
• Full metal (gold alloy). Still an option for back teeth that do not show and for bites with very little space; because of its appearance it is rarely chosen.

The steps depend on how the crown is made. A laboratory-made crown takes two or three appointments; a crown made at the clinic with CAD/CAM can, in suitable cases, be done in one. The number of appointments and whether a temporary crown is needed vary accordingly.

Risks

• Loss of tissue that cannot be undone. The tooth is reduced on every surface; the enamel and dentine removed do not grow back. The tooth will always depend on a restoration, and the crown may need replacing over time.
• The tooth's nerve. The pooled results of 37 studies cover teeth that were alive at the start and were then treated with indirect restorations such as crowns. In about 5 in every 100 of these teeth¹, the nerve lost its vitality; in studies with more than ten years of follow-up, the figure was about 7. The certainty of this evidence is low, and the rate cannot be put down to the preparation alone: earlier decay and fillings also play a part. If it happens, root canal treatment is needed to keep the tooth; sometimes this shows up years later.
• Sensitivity. Temporary sensitivity to cold and heat after preparation is common; if it lasts or gets worse, it is assessed.
• Decay. A crown does not protect the tooth from decay; new decay can develop at its edge or underneath it, and it is one of the main causes of crowns being lost in the long term.
• Gums. A crown whose edge does not fit the gum well can cause gum inflammation and recession; receding gum makes the edge of the crown visible.
• Fracture and chipping. On porcelain-layered crowns, the porcelain on top can chip; this has been reported less often with single-piece crowns². Clenching increases the risk.
• Wear of the opposing tooth. Ceramic crowns can wear down the natural tooth they bite against. In studies of monolithic zirconia lasting 6 to 24 months, the deepest wear measured on the opposing tooth averaged about 0.1 mm³. Polishing and adjustment of the bite affect this.
• Coming loose. If the cement bond weakens, the crown can come off. The dentist checks why it came off and examines the crown and the tooth; it can be cemented back only if both are sound and the crown still fits.

Benefits

• It protects a weakened tooth from breaking and can delay an extraction.
• It restores chewing and the shape of the tooth.

Until the anaesthetic wears off, take care not to bite your cheek or lip. There may be sensitivity to cold and heat in the first days; avoid hard and sticky foods. If a temporary crown is in place, sticky foods and pulling floss upwards can dislodge it; slide the floss out sideways instead.

Daily care

• Brush twice a day with a fluoride toothpaste; clean carefully along the line where the crown meets the gum.
• Use floss or interdental brushes every day; under a bridge you need special floss.
• Do not bite on hard objects such as ice, pens or your nails.
• If you clench or grind your teeth, a night guard may be advised.
• Keep up regular check-ups; the edge of the crown, the gums and the bite are checked, and an X-ray of the tooth under the crown is taken when needed.

The rates below are what studies observed; they are not a promise of how long your crown will last. What happens in your case depends on how much of the tooth remains, your bite, your habits and your care.

• Single crowns. A 2026 review reported five-year survival for single crowns on natural teeth in the four material groups below; these figures do not cover other crown materials. For single-piece lithium disilicate, about 98 to 99 in every 100² were still in the mouth after five years; for porcelain-layered zirconia, metal-ceramic and single-piece zirconia, the figure was about 97. The same review reported fewer fractures and chips on single-piece crowns than on porcelain-layered ones. These estimates cannot be applied directly to bridges or implant crowns.
• Metal-ceramic, over the long term. In a single practice, 2,211 crowns were judged to be in a favourable condition when they were cemented. Of every 100 of them, about 97 were still in the mouth after 10 years and 85 after 25 years⁴. This series used a high-gold alloy, and the crowns were made by one dentist.
• Our sources contain no data showing that zirconia lasts longer. Claims such as "lasts 20 percent longer" have no basis.

Staying in the mouth does not mean staying free of complications. Some crowns need their edges adjusted, polishing, a repair or re-cementing. These are not routine maintenance: the cause of the problem (decay, a poorly fitting edge, a fracture) is assessed first, and the crown is replaced if needed.

If you have a crown, contact your dentist if any of the following happens:

• Sensitivity that lasts more than a week or keeps getting worse; pain that starts with heat and lingers
• Pain when you bite, or a feeling that the crown is high
• A crack, a fracture or movement in the crown
• Bleeding, receding gum or a dark line at the edge of the crown
• The crown comes off: keep it, and do not glue it back yourself
• A temporary crown comes off: see your dentist without waiting, to protect the tooth

Emergencies. Throbbing pain, facial swelling or a fever are not expected after a crown; see a dentist without waiting. If you have difficulty breathing or swallowing, swelling in the mouth and neck that spreads quickly, or swelling around the eye, go to an emergency department or call 112.

Fees are not given on this page. The main factors that shape a plan are: how many teeth need crowns, the material and how the crown is made, the treatment needed before the crown (decay, root canal treatment, a post and core, gum treatment), the temporary crown and the review appointments. Ask for your plan to state in writing why a crown is recommended for each tooth, and why an option that removes less is not enough.