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Dental crown

A dental crown is a common restoration for a missing tooth. This tooth-shaped covering encases the entire visible part of a tooth. People fit dental crowns for different reasons. These reasons include the following:

  • A decayed tooth that a filing cannot fix
  • A chipped, broken or cracked tooth repair
  • To strengthen a weakened tooth, especially after a root canal
  • To improve a tooth's cosmetic appearance
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Crowns are available in different materials. They include metal-coloured crowns and some that look like your natural teeth.

Before the advancement of dental technology that made dental crowns available, removing the tooth was the only option for a heavily decayed or damaged tooth. With dental crowns, dentists can save much of the tooth structure and prevent discomfort from dental extraction.

Unlike dental fillings that repair only a part of the tooth, a tooth crown restores the whole tooth. A tooth with a dental crown will function as a natural tooth.

What is the difference between a dental crown and a tooth cap?

Many people use caps and crowns interchangeably, and you may wonder if they are different. These terms are names referring to the same thing.

A dental cap is the less technical term for a dental crown, but it refers to a covering placed on a shaved down tooth. Some people say a dental crown is metal-coloured and a cap is tooth-coloured, but dentists do not differentiate them this way.

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What are the benefits of dental crowns?

A dental crown helps restore and enhance a damaged tooth or replace a missing tooth. Crowns strengthen the tooth and improve its shape, alignment and appearance. A temporary crown can also help preserve the tooth structure before a permanent crown is available. However, a temporary crown is more prone to breaking, so be extra careful when flossing, brushing or eating.

Full crowns vs partial crowns

Full crowns are the most common dental crown, but you can also fit a partial crown called an onlay. Instead of completely covering the tooth structure, a partial crown covers only a part of the crown, leaving some of the enamel visible.

A partial crown, like the regular dental crown, is custom-made in the lab and fitted on the tooth in-office. Your dentist may recommend an onlay instead of a full crown if a substantial part of your remaining tooth structure is healthy after removing the decayed area.

What dental crown materials are available?

The most common dental crown materials include:

  • Dental ceramic such as zirconia or porcelain that match the surrounding teeth
  • Silver-coloured metal alloys, often made from non-precious metals, usually available in the public healthcare service
  • Gold alloys are often chosen for their distinctive appearance

If you want a temporary crown fitted before the permanent crown is available, it will be with a composite or acrylic material.

Gold dental crowns are not pure gold because gold in its pure form is too soft to make a dental crown. Gold is combined with other metals to make a stronger gold alloy. The gold content of a gold dental crown is between 20 – 77%.

Since gold is a precious metal, dental crowns made with gold have a cost than crowns made from non-precious metal alloys such as cobalt, nickel and chromium.

If you get a crown from the public healthcare service for your back tooth, your only option may be a silver-coloured material and a white crown for a front tooth. Other aesthetic options are available in private dental practices.

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Choosing the right crown material

Each material for dental crowns has its advantages and disadvantages. The right material for your dental crown will depend on which teeth you want to cover, your desired aesthetic result and how long you want the crown to last.

Ceramic crowns are custom-made in the lab and built up in layers. This gives ceramic crowns the slightly translucent appearance of the natural teeth, making them a popular option for front teeth. However, ceramic materials are more brittle than metal, so porcelain crowns are more likely to chip or crack and may need a replacement sooner.

Emax dental crowns are also ceramic but from a brand called Ivoclar Vivadent. They are made from a block of lithium disilicate, making them more durable than other all-ceramic crowns.

Gold dental crowns and crowns made from other metal alloys are often more durable and biocompatible with the teeth, meaning your capped teeth shouldn't cause any wear or damage to the teeth.

The main downside of metal crowns is the colour. Many people do not want a silver-coloured or gold-coloured tooth to show, even if it is on the back teeth.

For some people, gold dental crowns are appealing, and they can have their gold crown studded or engraved with gemstones.

Porcelain fused to metal (PFM) crowns offer some strength of metal and porcelain crowns' aesthetics. However, they do not usually look like our natural teeth because of how they are layered. The ceramic coating can crack while the metal underneath remains intact.

How much is a dental crown in the UK?

A dental crown in the UK costs between £300 and £800. The exact cost depends on the material used and, sometimes, the tooth's position that requires the crown. Most times, crowns for front teeth are slightly more expensive than the back teeth because they usually require more time in the lab to make them look natural.

Like any dental treatment, the cost of a dental crown varies significantly depending on location and the dental clinic. You may consider checking different dental practices near you and comparing their prices, especially if you want to fit dental crowns on more than one tooth.

Other considerations besides cost are vital as each type of dental crown has pros and cons. You can ask your dentist about the cost of dental crowns and the options available to you privately and on the public healthcare service.

This table provides a summary of the types of crowns, including their cost.

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  Metal crown Ceramic or porcelain crown Porcelain fused to metal (PFM) crown One-day CEREC crown
Cost £300 - £600 £350 - £950 £325 – £850 £385 - £800
Durability/strength Long-lasting Least durable and prone to breaking Although the metal inside is strong, the porcelain outside can break Can chip like the porcelain crown
Aesthetics Silver or gold-coloured, making it easily noticeable Look like natural teeth Tooth-coloured but does not usually have the natural teeth translucency Its fast production process makes  it harder to achieve a natural look
Others Will not wear down other teeth May gradually wear away other teeth it bites against May gradually wear away other teeth it bites against May gradually wear away other teeth it bites against

If you fit multiple crowns, your dentist may reduce the cost per crown. However, the cost of the material and a fitting time for each crown is usually fixed regardless of how many crowns you need.

How much is a dental crown on the public healthcare service?

Dental crowns are under the public healthcare service Band 3 treatment charge, which costs up to £282.80. This cost is fixed regardless of how many crowns you need, provided they are part of the same treatment.

You can get one crown around this price at private dental practices, but if you need several crowns, the cost of the public healthcare service is significantly lower.

Can I get a porcelain crown on the public healthcare service?

Dental crowns on the public healthcare service for the back teeth are metal, but you can get tooth-coloured white crowns (PFM) for the visible front teeth.

Due to its higher cost, you are unlikely to get an all-porcelain crown on the public healthcare service.

Private vs public healthcare service crowns

A high-quality dental crown at a private practice can cost about three times more than public healthcare crowns. Besides costs, there are a few things to consider between private and public healthcare crowns.

  • Eligibility

You can only get a public healthcare crown if the tooth restoration is medically necessary. You will need private treatment if you need the crown for cosmetic reasons, such as making your uneven teeth straighter.

  • Appearance

The public healthcare service has a limited choice of material for a crown. Even if you get a white front tooth crown, it's likely the porcelain fused to a metal crown. This crown doesn't look like your natural tooth, like all-porcelain crowns. If you want a more natural look, you will have to pay for it at a private dental practice.

  • Waiting times

Getting treatment at a private dentist is faster, both with the initial appointment and making the crown. With modern milling technology, you can have your dental crown made by the dentist while waiting, so you will not need a temporary crown. However, you will pay for premium service.

Public healthcare crowns are medically sufficient to restore the tooth's function. However, private treatment may be worth paying for, especially for the front teeth.

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Reducing the dental crown cost

Private dental insurance may cover part or all of your dental treatment costs. Ensure you check the insurance policy's waiting periods and your annual limits, as these may restrict when you can claim insurance and how much you will pay out-of-pocket. If a root canal is necessary before getting a crown, check if the policy covers it.

You may consider veneers if you only need cosmetic improvements, but most insurance policies do not cover them. You can discuss with your dentist the best choice for you. Dental financing options are also available to help you pay for your treatment.

Getting cheap dental crowns abroad

Travelling abroad for dental crowns may be cost-effective, depending on the number of teeth that needs treatment. Dental tourism has become quite popular because many people cannot pay for dental work at home.

Excellent standards of treatment and care are available in some countries like Spain, Hungary and Turkey at a lesser cost than in the UK. For example, depending on the material used, a dental crown costs between £150 and £400 in these countries.

Dental crown procedure

A dental crown procedure requires a few steps. They include:

Visit 1 –preparing the teeth

Fitting a dental crown requires removing a significant amount or all of the existing tooth enamel for the crown to stay in place.

Before this, the dentist may take an X-ray to ensure your tooth can support the crown and check for any underlying issues. If the tooth can support the crown, the dentist will use an anaesthetic to numb the tooth and surrounding gums.

A root canal may also be necessary, and the dentist may surgically remove some of the gum tissues to create more base for the crown. Most crowns are a minimum of 2mm thick to give them the strength to last long. This means you will have your teeth trimmed by at least 2mm on all sides.

The dentist will remove decayed areas and any previous filling material. If this leaves only a small tooth structure, the dentist may have to build it up with a metal post or filling material. After this, the dentist will shape the tooth stump to be slightly thinner on the top, so the crown can easily slip over it.

The next step is taking an impression of the tooth to create a crown that fits perfectly. It can take 2 – 3 weeks to have a crown made in a lab with professional dental tools. The dentist may fit a temporary crown (made from acrylic or composite) to prevent tooth sensitivity.

The colour of the temporary crown should match your natural teeth but isn't the same quality as the permanent crown. The dentist will choose the crown shade you will get if you need a tooth-coloured crown.

This first dental visit often takes between 45 – 60 minutes.

Visit 2 – fitting the crown

When the permanent crowns are available, you will revisit the dentist for their fitting. The dentist will remove your temporary tooth cap and numb the tooth again to avoid any sensitivity.

After checking if the crown fits, the dentist will apply dental cement inside the crown and press it down over the tooth.

If you are concerned about the shape or colour of your permanent crown, especially for a front tooth, inform the dentist before it is cemented. Making any changes after fitting the crown in place is difficult, and you may have to live with it.

The second visit lasts for 30 – 60 minutes, on average, depending on the number of adjustments you need. Your newly capped tooth may initially feel strange since it isn't the same as your original teeth. Provided the tooth isn't interfering with your bite, you should gradually get used to it in a few weeks.

One-day CEREC crown fitting

This type of crown allows you to avoid multiple visits and weeks or months of using a temporary crown.

With CEREC technology, the dentist can make your crowns on-site in about one hour from digital scans of your mouth. This option is more convenient for patients as they also do not need unpleasant dental impressions.

CEREC crowns are relatively new, so there isn't much data on their long-term performance. However, dentists say they are aesthetically pleasing and string for back teeth but can't match the natural look of a hand-crafted porcelain crown for the front teeth.

CEREC dental crowns cost about the same as traditional crowns because while they don't require lab work and the process is faster, the dentist will pay a lot for the machine used to make them. This option isn't available in the public healthcare service.

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When you've regained normal feeling in your mouth, carefully test the bite of the crown in all directions. If it feels odd, inform your dentist. The dentist may refine the crown's shape so it doesn't interfere with other teeth.

After fitting a crown, you may experience pain or soreness in the crowned tooth or the surrounding gum. This is normal, and your dentist will advise you on how to manage tooth crown pain.

Some people experience pain in the crowned tooth from biting down, which should gradually stop. Contact your dentist if you experience severe pain or have concerns after your crown fitting.

How long can a dental crown last?

While dental crowns are a long-term fix for restoring damaged teeth, they do not last forever. Some crown materials are more durable than others, but they can all last at least ten years.

Your dentist may tell you to expect the crown to last for 5 – 15 years, but many last longer than this. A study assessing 2340 gold-based PFM crowns found that 97% of the crowns lasted longer than ten years, and 85% were still strong past the 25-year mark.

Your crown will need replacement if:

  • It wears down (metal) or causes excessive wear to other teeth (ceramic)
  • It becomes broken or cracked (ceramic)
  • The cosmetic appearance deteriorates (the front tooth crown)
  • Inside the tooth becomes decayed

Gold tooth crowns are usually the strongest but wear down if the patient grinds their teeth. This condition may be an issue for those with porcelain crowns because this material is more prone to wearing down other teeth that bite against it.

Caring for a dental crown

  • Temporary crowns

Avoid sticky or chewy foods, like soft sweets or chewing gums, while wearing temporary dental crowns. You should also avoid hard foods like apples and carrots. Try biting and chewing on the side of your mouth where you don't have a crown, or use the crowned tooth to only bite on soft foods.

Instead of pulling your floss back out between the teeth, slide the floss out sideways. If you lift your floss normally, it may catch on the crown's side and dislodge it.

  • Permanent dental crowns

Your dentist will advise you to avoid chewy or hard foods the first day after fitting the crown to allow the cement time to set.

In the long term, you can care for your crowned teeth like your natural teeth by brushing two times a day and flossing. If you are concerned about your dental floss catching on the side of the crown, consider getting a water flosser.

The Waterpik WP-600UK Ultra is a high-quality water flosser in the UK with different speed settings and a big water tank that makes cleaning around crowns convenient and easy,

If your gums are receding, sensitivity or pain may occur in the crowned tooth. This makes reducing the risk of gum disease by getting your teethed cleaned regularly by a hygienist important.

People with PFM crowns may notice a dark line along the gum line over time. This is from the ceramic material eroding or gum recession. Depending on where you have the crown, you may consider replacing it at this point.

If your dental crown chips or comes off, contact your dentist as soon as possible to assess the damage. Your dentist can temporarily fill the chip with composite resin, but replacing the entire crown is the only permanent solution. You can re-cement the crown, provided it isn't damaged.

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Alternatives to dental crowns

Dental crowns are usually an option when the damage is too extensive to fix with an onlay or filling. If you are concerned about preserving your natural tooth structure, your dentist may recommend a partial crown.

If you don't want to refit a crown on your tooth or have problems with a dental crown, you can have it removed and replaced with a dental implant. An implant is placed in the jawbone, making it a permanent option for replacing a missing tooth.

If you want to get a crown for cosmetic reasons, you may consider veneers which are less invasive than crowns.

If you have a damaged or decayed tooth and you want to protect or preserve your remaining tooth structure, visit McKennell Dental Practice at 21 Churton Street London SW1V 2LY to have our experienced dentist fit a dental crown.

Call us on 020 7834 8802 to book an appointment with our dentist.