A dental crown is a cap that fits over your tooth after it has been severely weakened by an injury, cavity, or dental work like a root canal.
A crown can be made from a variety of materials, including porcelain, ceramic, or metal.
Depending on the type of material that’s best suited for your needs, you may be a candidate for a same-day crown installation, or your dentist may fit your new crown over two appointments. Whether you go with a multi-day procedure or a same-day procedure, understanding how they differ may help you prepare.
The initial steps leading up to the installation of your new crown will be similar whether you get a crown in one day or you go through the multi-day procedure. Here’s what you can expect after sitting down in the dentist’s chair:
Examination of your mouth
Your dentist will examine your mouth. This will include evaluating the tooth that needs the crown and the area around it. They may take X-rays of the tooth. The X-rays will give your dentist a better view of the roots of the tooth, as well as the surrounding bone.
Anesthesia
Dentists will apply a local anesthetic during crown preparation. Your dentist can inject a temporary numbing agent into your gum so you won’t feel pain.
Some dentists also offer conscious sedation. During conscious sedation, you’ll still be awake for the procedure, but you’ll feel drowsy and relaxed. This can take the edge off any anxiety you may be having. According to the American Dental Association, two commonly used methods are nitrous oxide, which you inhale through a mask, and intravenous sedation, which is administered through a vein in your arm.
In rare cases, people with severe anxiety may need general anesthesia.
Preparation of the tooth
Your dentist will probably need to file, shave down, or remove part of the outer layer of the tooth. The amount can vary. They will use a tool to file down the top and sides of your tooth, making it smaller and smoother. There may also be some need to build up a broken-down tooth and strengthen it so it can support the crown.
This step is critically important. If the tooth isn’t filed down to the correct shape before the crown is installed, it can affect how the crown fits on top of it. An improperly prepared tooth might leave your bite misaligned. A bite that’s out of alignment can lead to wear of the enamel on your teeth, as well as pain and stress on the joints in your jaw.
The next step will depend on what kind of crown you’re getting.
For a multi-day procedure:
Tooth impressions
Your dentist will make an impression of your tooth and the surrounding area, which will be sent to a lab so a crown can be manufactured to fit the exact space.
Temporary crown placement
Next, your dentist will place a temporary crown on top of your tooth. This cap will fit over your tooth, but it’s not designed to stay there for very long. It’s meant to protect your vulnerable tooth until your dentist can install the permanent crown.
After you receive the temporary crown, you can go home. Be careful with your temporary crown, since it’s not intended to last for a long period of time.
Return to the dentist office
About 2 weeks later, you’ll return to your dentist’s office and they will remove the temporary crown.
Final crown placement
Your dentist will choose a dental cement that’s appropriate for the type of crown you’re receiving and the location, since that can affect the amount of stress the crown must withstand. For example, research suggests that resin cement is the best choice for a zirconia crown.
The dentist will apply a uniform layer of cement to the inside of the crown. Then your dentist will carefully fit the crown onto your tooth. After it’s been fitted correctly, any excess cement will be carefully removed or scraped away.
If you’re a “let’s get this over with” kind of person, here’s some good news: If your dentist offers same-day crowns, you only have to show up once to get your new crown made and installed. You just have to wait while the crown is being made.
One type of crown that’s commonly used in a same-day procedure is a crown made of very strong ceramic that’s known as a CEREC crown. This is a process designed to minimize the time spent in making and installing a crown.
It uses computer-assisted design (CAD) and computer-aided manufacturing (CAM) to scan the tooth and create a three-dimensional model that guides the creation of the crown right there in your dentist’s office. It’s a process that’s evolved and improved since it was pioneered over four decades ago.
Here’s how the process varies from the multi-day procedure in more detail:
Scanning
If you’re getting a same-day crown, your dentist will take digital scans of your mouth, focusing primarily on the tooth that needs a crown and the surrounding area. This scan is used to create a 3-D model of your mouth.
Creating the crown
Your dentist will send the specific measurements and details from the digital images to the equipment that will actually make the crown. Using the CAD/CAM software, they will create and design your crown model.
Then, they will use a milling device to sculpt the crown out of a block of ceramic, based on the model. Depending on the type used, the device will first cut away the excess ceramic, then gradually trim the piece down and refine it until it’s the right shape for your mouth.
Installing the crown
When the crown is ready, your dentist will choose a dental cement to use for the installation of the crown. Then it’s time for you to open wide again, so they can carefully place the crown onto your prepared tooth.
Prior to the installation of your same-day crown, you can also ask for anesthesia during the process. Once the numbness from the local anesthetic wears off, you should be good to go.
The preparation of the tooth involves filing or shaving down your tooth, but it shouldn’t hurt, since your dentist will numb your tooth with local anesthesic and make sure you are comfortable.
After you get your crown installed, you may have some discomfort or mild pain afterward. This should only last a little while, and you can manage it with over-the-counter pain relievers. If it lasts for more than a couple of weeks, though, call your dentist.
For a one-day appointment, you can expect the process to take anywhere from 2 to 4 hours. If you’re arranging to take some time off for the procedure, it’s probably best to err on the side of allowing more time.
For a multi-day appointment, you’ll need to block out time on your calendar for two separate appointments. Your dentist will let you know how far apart the appointments will need to be, but your second appointment will likely be at least 1 to 2 weeks after your first one. Each appointment may take 1 to 2 hours.
As with any procedure, complications can arise.
Damage to the tooth
It’s possible that your tooth may be weakened when your dentist is cleaning out the cavity and filing down the tooth. This might require a little repair work or building up the structure of the tooth, depending on how damaged the tooth is.
Damage to the root or nerve
It’s also possible that some damage to your tooth’s nerve may occur. This may result in the need for a root canal.
Bite misalignment
If a crown is not created and installed properly, it can alter your bite — and not in a good way. This can cause pain to your temporomandibular joint. You may have to have the crown removed, altered, and replaced.
Even if you’ve received a crown before, it’s a good idea to talk to your dentist in advance of your next crown installation. Make sure you know exactly what type of procedure your dentist plans to use, so you’ll know how much time to allow and how to prepare.
If you’re feeling uncertain, be sure to let your dentist know. And regardless of which type of crown you receive, be sure to take good care of it afterward so it will last as long as possible.