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Treatment guide

Dental Crowns

A crown is a custom-made cap that covers a weakened tooth, restoring its strength. Our durability-first comparison — including why the proven metal-based options outlast the fashionable ones.

What is a crown?

When a tooth is too damaged for a filling — after a large cavity, a fracture, or a root canal — a crown covers and protects what remains. It is custom-made to fit your tooth and bite exactly.

As with fillings, we rank crown materials by how long they keep your tooth trouble-free: metal-based first. For molars and premolars that means full metal — gold if you can afford it. For visible teeth we recommend porcelain fused to metal (PFM): metal strength underneath, a tooth-colored surface on top. We recommend PFM over full zirconia — zirconia is a capable modern ceramic, but PFM has the longer track record and a repairable, metal-backed design.

Make the right choice: your options

Ranked by durability. Which is best depends on whether the tooth shows when you smile and how hard you bite.

OptionBest forProsConsTypical lifespanRelative cost
Our pickFull metal (gold alloy)Molars and premolars — the best for those who can afford itIt cannot crack, chip or shatter — gold is ductile, so it simply does not fracture the way ceramic does; the longest-lasting crown there is; wears at the same rate as natural enamel and expands with temperature like natural tooth; among the most biocompatible materials in medicine; kindest to opposing teeth; thinnest possible preparation (preserves tooth)Gold color — for teeth that don’t show; price follows the gold market15–20+ years, often lifelong$$$$
White gold or other full metal alloysMolars and premolars — gold-class performance in a silver colorCannot fracture like ceramic; white gold gives near-identical durability and biocompatibility to yellow gold; other alloys offer strong value; minimal tooth removalMetal color15–20 years$$
Porcelain fused to metal (PFM)Visible teeth — our recommendation over full zirconiaMetal core cannot fracture, so the crown cannot split in two; tooth-colored surface on top; 50+ years of documented performance; the honest sweet spot of looks, longevity and priceA dark metal line can show at the gum after many years; porcelain surface can chip10–15+ years$$
ZirconiaWhen metal-based options are declinedExtremely strong ceramic; good aestheticsFar harder than enamel: it can crack opposing teeth or existing dental work it bites against, and abrades the teeth it touches — wear of opposing and neighbouring teeth continues even when the crown is well polished. Ceramic does not bend, so when it fails it fractures suddenly, and the tooth underneath often fractures with it — sometimes badly enough that the tooth cannot be saved. Shorter track record than PFM; being one solid block, chips and margins are hard to repair. Not the biocompatibility benchmark gold is: the ceramic itself is inert, but all-ceramic crowns must be bonded with resin cements — the same monomer chemistry, including BPA-related compounds, that we warn about in white fillings10–15 years$$$
E-max (lithium disilicate)Front teeth where looks are everythingThe most natural, translucent appearance availableBrittle: it can chip or fracture outright under heavy chewing, and the tooth beneath can crack with it; harder than enamel, so it can also wear or damage opposing teeth. Bonded with resin cements, so it carries the same monomer/BPA-related chemistry as white fillings — not the inert, fully biocompatible option gold is. Aesthetics-first, not durability-first10–15 years (front teeth)$$$

Costs vary hugely by country — the same crown can differ 5–10x in price between clinics in different countries. Relative cost also shifts locally: gold depends on metal prices, zirconia on lab technology.

How the treatment works

  1. Preparation
    Under local anesthetic, the dentist shapes the tooth so the crown can fit over it like a thimble. Metal crowns need the least tooth removed — another durability advantage.
  2. Impression or scan
    A mold or digital 3D scan of the prepared tooth is taken and sent to a dental lab.
  3. Temporary crown
    You wear a temporary crown while the lab makes the real one (usually 3–10 days).
  4. Fitting
    The dentist checks the fit, color and bite of the new crown, adjusting as needed.
  5. Cementation
    The crown is permanently cemented. Avoid very sticky food for 24 hours.

Aftercare

  • Mild sensitivity around the tooth for a few days is normal.
  • Brush and floss the crown like a natural tooth — the margin at the gum line is where new decay can start.
  • Avoid chewing ice or very hard objects, especially with ceramic surfaces.
  • If you grind your teeth at night, ask about a night guard to protect your investment.
  • A well-made crown can last decades — regular check-ups let the dentist spot problems early.

Frequently asked questions

Why PFM instead of full zirconia for visible teeth?

Track record, and a smarter failure mode. PFM crowns have 50+ years of documented performance: a metal core that almost never fractures, with a tooth-colored porcelain surface. Full zirconia is impressively strong but newer, extremely hard on opposing teeth if not perfectly polished, and being one solid ceramic block, problems are harder to fix. For most people PFM is the honest sweet spot of looks, longevity and price — which is why it is what we specify in our own collaboration contracts.

Can a ceramic crown damage my other teeth — or take a tooth with it when it breaks?

Yes, and these are the two risks that get talked about least when a white crown is sold to you.

It is harder than your teeth. Zirconia and other modern ceramics are far harder than natural enamel. Every time you bite, that crown is grinding against a natural tooth or an existing restoration. It can abrade the tooth opposite and the neighbours it contacts, and in a heavy bite or a grinder it can crack them. Polishing the ceramic reduces the wear, but it does not remove the underlying mismatch: hard material against soft material wears the softer one. Gold is the opposite — it is close to enamel in hardness and wears at roughly the same rate as the teeth around it, which is why it is the kindest material in the mouth.

When ceramic fails, it fails suddenly. Metal is ductile: under extreme force it gives slightly rather than breaking. A gold crown cannot crack, chip or shatter — that failure mode simply does not exist for it. Ceramic is brittle — it has no give, so it chips or splits without warning. And because the crown is bonded to the tooth, the fracture often runs on into the tooth itself. A cracked tooth under a broken ceramic crown may be restorable — or may have to be extracted. That is a bad outcome for what began as a cosmetic preference on a tooth nobody sees.

There is one more thing worth knowing: an all-ceramic crown is not pure ceramic in your mouth. It has to be bonded in place with resin cement — the same monomer chemistry, including BPA-related compounds, that we warn about in white fillings. Gold needs no such bonding: it is cemented conventionally and is one of the most biologically inert materials known to medicine.

On a molar or premolar, this trade is not worth making. Gold cannot break, does not chew up the teeth around it, cannot take a tooth with it when it fails, and puts nothing questionable in your mouth.

Is a gold crown really worth it?

If you can afford it, yes — for back teeth it is the best crown dentistry knows: it cannot crack, chip or shatter — the failure mode that ends ceramic crowns does not apply to it; the longest documented lifespans, wear at the same rate as your own enamel, thermal behavior like natural tooth, and it needs the least healthy tooth removed. Its only real drawback is the color, which is why we recommend it for molars and premolars, not for your smile line.

Does the tooth die when it gets a crown?

No. Most crowned teeth stay alive and healthy. A small percentage develop nerve problems years later — if that happens, a root canal can usually be done through the crown.

What if my crown comes loose or falls out?

Keep the crown and see a dentist soon. Often it can simply be cleaned and re-cemented if the tooth underneath is healthy.

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This guide is general information, not personal medical advice. Every mouth is different — always discuss your situation with a dentist before deciding on treatment.