A crown (some people call it a “cap”) is a shell of material – porcelain, metal or both – that is made to fit over the top of a tooth to restore and strengthen it.

There are a number of possible reasons:

• A tooth has fractured.
• A heavily restored or root-treated tooth needs a crown to strengthen the remaining structure.
• A filling has fractured/failed and the tooth needs a stronger restoration.

It could be left untreated, but any damage or decay will get worse and the tooth may end up needing root canal therapy (RCT) if left unrestored.  Teeth that have already been root-treated or that are already heavily restored will likely break unless strengthened with a crown.

In these situations, a crown is the best treatment as it is strong, has the best aesthetics and excellent longevity.  It is also less likely to cause a “food-trap” that can lead to dental decay.  However, it is more expensive than a filling and more of the tooth will be removed in the process of preparing it for a crown, so it preserves less of the original structure.  Composite filling material can sometimes be used if you wish.  It is quick and relatively inexpensive.  However, it is not the best treatment option since very large fillings are prone to failure, especially where they comprise two thirds or more of the surface area of the tooth.  If the filling fails, you will still end up needing a crown – so you may just be postponing the inevitable and will have to pay for the treatment twice.

If a crown is to be placed, there are different types to choose from (see below).

Porcelain fused to metal (sometimes called PFM or Porcelain Bonded) – This is a traditional type of dental crown.  It’s slightly cheaper but has a metal base so the aesthetics are less good and the margin may begin to show in the longer term.  It’s main benefit is its strength.

All-ceramic – Is slightly more expensive but has better aesthetics – because there is no metal, the margin is less visible and the finished crown has better translucency and depth of colour, meaning that it looks even more realistic.  It is particularly suitable for anterior (front) teeth because the crowns on front teeth are very visible and need to look good.

Gold – This is the most expensive option.  Gold crowns are strong and durable so are usually the longest-lasting but they have very poor aesthetics since they don’t match the other teeth at all.

This depends on the type of crown chosen.  Current prices are given on our website and on display in reception.  Also, the cost of your crown(s) will be given on your estimate / treatment plan.

As a rough guide, an all-ceramic crown costs from £960.00 and a gold crown from £1,350.00.  There may be other charges; such as where a “core” is needed to support the crown.

Crowns are generally very durable and hard-wearing – they usually last over 10 years and we have patients whose crowns have lasted 20 or even 30 years.  We guarantee them for the first year (unless they are damaged by external force).

Many factors affect the longevity of crowns.  For example:

• How good your oral hygiene is;
• Grinding your teeth;
• Where the crown is in your mouth; and
• How heavily your teeth come together when you bite.

It’s impossible to predict with certainty how long a crown will last.  One of the reasons that crowns “fail” is de-vitalisation of the supporting tooth.  In other words, the crown is OK but the tooth itself dies off, resulting in a need for extraction or root canal treatment.  This can occur in cases where crowns are placed on vital (living) teeth.  However, crowns are often placed on teeth that have already been root-treated (so they are already “de-vitalised”).

An existing crown may need to be replaced because:

• A tooth may have secondary decay around or beneath the crown. This requires treatment to deal with the decay; also the “margins” of the crown may begin to look dark and will no longer be aesthetically acceptable.
• An old crown may have broken or chipped.
• The crown may no longer be the right shade – the other teeth may have brightened or darkened so the crown isn’t a match and looks out of place.

It could be left untreated, but any damage or decay will get worse and the tooth may end up needing root canal therapy (RCT) if left unrestored.  Any colour mismatch will also probably worsen.

If the crown is replaced, then the different types of new crown to choose from, their pros and cons, the cost and their expected longevity are the same as for a first crown (see above).

Brush your teeth with fluoride toothpaste last thing at night and at least one other time during the day and cut down on how often you have sugary foods & drinks.  Also, visit your dentist regularly – as often as they recommend.  This will help keep all your teeth in good condition.