Crown, bridge or another restoration?
| What needs attention? | Starting point |
|---|---|
| A weakened natural tooth is still present | Assess whether a crown, onlay or filling can restore it |
| A tooth is missing | Compare a dental bridge with an implant or denture |
| Mainly the colour or shape of a tooth | Assess bonding, whitening or veneers before considering extensive preparation |
| Several teeth are worn or damaged | Consider a full mouth rehabilitation assessment |
A crown on a natural tooth and a crown supported by an implant have different foundations. This page mainly covers crowns fitted over natural teeth.
When a crown is the right choice
A filling replaces a small part of a tooth. When a large part is missing, a filling has too little tooth around it to hold on to, and the remaining walls can split. A crown covers the whole tooth and holds it together.
You may need a crown if:
- a tooth has broken, or has a large old filling that keeps failing
- a back tooth has had root canal treatment
- a tooth is cracked and hurts when you bite on something
- teeth are badly worn from grinding or acid erosion
- a tooth is badly discoloured and whitening hasn’t helped
A crown isn’t always necessary. If a smaller restoration, such as an onlay or a bonded filling, would do the job with less drilling, we will say so.
Types of crown, compared
| Material | Strength | Appearance | Best suited to |
|---|---|---|---|
| Zirconia | Very high | Good; modern layered zirconia looks natural | Back teeth, grinders, bridges |
| E-max (lithium disilicate) | High | Excellent translucency | Front teeth, premolars |
| Metal-ceramic (PFM) | High | Good, but a dark line can show at the gum | Back teeth where cost matters |
| Full metal | Highest | Metal coloured | Back molars with very little space |
What happens
- Assessment. We check the tooth, the nerve and the bite, and take an X-ray. If the nerve is inflamed or infected, it is treated first.
- Preparing the tooth. Under local anaesthetic, the tooth is shaped to make room for the crown. We take an impression or digital scan and choose the shade with you in daylight.
- Temporary crown. You wear a temporary crown for about a week. Avoid sticky foods on that side.
- Fitting. We check the fit at the edges, the contacts with neighbouring teeth and your bite, then cement or bond the crown.
A good fit at the gum edge, a comfortable bite and daily cleaning all contribute to crown maintenance. The tooth underneath can still develop decay, so the crown needs regular dental review.
Aftercare
- Chew carefully until the numbness wears off.
- If the bite feels high once the anaesthetic has worn off, come back. Even a small high spot can make the tooth ache.
- Brush twice a day and clean between teeth daily, paying attention to the gum line around the crown.
- If you grind your teeth, wear a night guard to protect the crown.
What affects the cost
The material is the biggest factor, followed by whether the tooth needs a core build-up or root canal first, and whether it’s a front tooth needing careful shade matching. We give a written estimate before starting and include the temporary crown in it.
Risks and limitations
- Removing tooth structure is permanent, which is why we only recommend a crown when it is genuinely needed.
- Nerve problems. A heavily filled tooth may later need root canal treatment, even after a crown. The risk is higher for teeth that were already deeply damaged.
- Sensitivity, chipping or loosening can happen and are usually fixable.
- Decay at the edge years later if plaque collects there.
The alternatives are a large filling or onlay, root canal treatment and a post if much of the tooth is missing, or, if the tooth can’t be saved, an implant or bridge.
Questions patients ask us
Is a dental crown permanent?
It is cemented or bonded on and isn't meant to come off, but it isn't forever. Crowns commonly last 10–15 years or more. The usual reasons for replacing one are decay at the edge where it meets the tooth, gum recession, or wear and chipping.
Is getting a crown painful?
The tooth is numbed for the preparation visit, so you shouldn't feel pain. Afterwards the gum around the tooth can be tender for a day or two. Fitting the final crown is usually done without an injection unless the tooth is still sensitive.
How do zirconia, E-max and metal-ceramic crowns differ?
Zirconia and E-max are both types of ceramic. Zirconia is very strong and suits back teeth and people who grind. E-max (a glass ceramic) is a little less strong but more translucent, so it often looks better on front teeth. Metal-ceramic crowns are strong and lower in cost, but a grey line can show at the gum over time. We recommend a material per tooth, not one for everybody.
Do I need a crown after root canal treatment?
For back teeth, usually yes. A tooth that has had a root canal is often weakened by the decay and the access hole, and molars and premolars are prone to cracking under chewing force. Front teeth with little damage can sometimes be restored with a filling alone.
What are common problems with crowns?
Sensitivity for a few weeks after fitting, a high bite that feels "wrong" (easily adjusted), a crown coming loose, chipping of porcelain, and decay at the edge years later if cleaning is poor. Most are preventable with good fit and care.
Why is my new crown sensitive to cold?
Mild sensitivity for a few weeks is common, especially on a tooth that still has its nerve. If it lasts more than a few weeks, gets worse, or turns into a throbbing ache, come back. The bite may need adjusting or the nerve may need checking.
Can a crown be done in one visit?
Most crowns need two visits because a lab makes the final crown. You wear a temporary crown in between.
Sources
Leeds Teaching Hospitals NHS: crowns ↗ADA MouthHealthy: crowns ↗Leeds Teaching Hospitals NHS: crowns ↗Manchester University NHS: risks of crowns, veneers and bridges ↗Last updated 24 October 2026. This page explains options in general terms; your own plan comes from an examination.