6 factors to consider when picking out the best kind of crown for your tooth. -
Crown selection checklist:
#1 - There is no single "best" type of crown.
No one type of dental crown offers the best solution for all applications. So before you make a final decision, quiz your dentist about all of the different types of crowns. Especially if up to this point they've only mentioned placing one kind.
Hopefully they'll outline the same general issues our page does. If not, quiz them some more. Because if you're after superior aesthetics, or great strength, or the right combination of the two, it really does matter which is placed.
(This page gives a basic run down of what types of crowns are generally preferred for different kinds of teeth.)
#2 - At least consider a gold crown. They make an excellent choice for back teeth.
If cosmetic appearance is not a factor, nothing can beat a gold crown, period.
- They provide excellent service. - All-metal crowns are the strongest, most durable type of dental cap. Because they are solid metal, there is nothing to chip off. Likewise, they don't crack or break.
- They're very biocompatible. - While exceptionally durable, gold crowns won't wear down opposing teeth (like porcelain-surfaced crowns can).
A gold dental crown.
The only disadvantage of a gold cap is its color. But if it won't show (like when placed on teeth way in the back) this isn't a drawback.
Need more details? Visit our Gold Crowns page.
#3 - The great advantage of all-porcelain crowns is their beauty.
The big advantage of having porcelain (all-ceramic) dental crowns placed is that they create an exceedingly life-like end result. So, in those situations where cosmetic considerations are of great concern, all-porcelain crowns make an excellent choice.
a) The trade-off of all-ceramics is one of strength and cost.
An all-ceramic dental crown.
Even though modern ceramics have been developed that are much stronger than dental porcelains of the past, no type of all-ceramic can boast of having a service track record that comes close to matching that of all-metal or porcelain-fused-to-metal crowns. And they usually cost around 10 to 20% more.
b) All-porcelain dental crowns can make an excellent choice, but only in selected situations.
Ceramic crowns can make a great choice for upper front teeth, where cosmetic appearance is a major concern. However, when considered for molars, bicuspids, or lower front teeth, their risk of fracture and higher cost may make other types of crowns a better choice.
Need more details? Visit our Porcelain Crowns page.
#4 - Porcelain-fused-to-metal crowns are a middle ground between all-metal and all-ceramic caps.
The construction of porcelain-fused-to-metal crowns (PFM's) is one where an overlying surface of porcelain is fused onto an underlying thimble of metal.
A porcelain-fused-to-metal dental crown.
This makeup allows PFM's to offer many of the benefits of both all-metal and all-ceramic crowns.
- Porcelain-fused-to-metal crowns are very strong. - While not as strong as all-metal crowns, dentist's routinely place PFM caps on back teeth.
- Porcelain-fused-to-metal crowns can produce pleasing aesthetics. - While not as translucent, the cosmetic appearance of PFM's can often approach, and possibly equal, those of all-porcelain caps.
PFM's do have some disadvantages.
Porcelain-fused-to-metal crowns do have some shortcomings that may come into play in some situations:
- If the tooth's gum line recedes, the crown's underlying metal edge may show and spoil the tooth's appearance. (An important concern with front teeth.)
- Unless proper protocol is followed when the bite of a PFM crown is adjusted, its porcelain surface may wear opposing teeth.
- It's possible for portions of the crown's porcelain covering to fracture off.
The new type of porcelain-metal crown.
In recent years a new type of porcelain covered restoration has been developed. It's called the pressed-to-metal (PTM) or pressed-over-metal (POM) crown.
To look at one of these restorations, you'd think it was a PFM. But what's different about it is its method of fabrication and that a stronger, possibly more esthetic, type of ceramic is used.
- On the upside, PTM/POM's address all of the limitations of PFM's stated above.
- Their biggest downside is that they don't yet have a time-tested track record of use.
Need more details about PFM and PTM/POM's? Visit our Porcelain-fused-to-metal Crowns page.
#5 - Make sure to compare costs.
You can expect a PFM or all-metal crown to cost around 10 to 20% less than an all-ceramic. (Cost estimates for different types of dental caps.)
a) If dental insurance is involved ...
It's common for a dental plan to cover 50% of the cost of a crown, minus the plan's deductible.
As an example, for crown that costs $1000, and a plan that has a $100 deductible, insurance would pay $400.
[If you're concerned about costs, have your dentist file a "predetermination of benefits." In response, the insurance company will report the amount of benefits they will provide for your planned work.]
Common dental plan exclusions:
- No benefits for replacing crowns (that the plan previously paid toward) that are less than 5 years old.
- No coverage for crowns that are placed just for purely cosmetic purposes. However, ask your dentist on this point. The crown you think is strictly cosmetic in nature may serve other (covered) purposes as well.
b) If you're paying for your crown out-of-pocket and its cost is a bit of an expense ...
Ask if you can arrange to pay half of your crown's cost now and half later, possibly even stretching the second half over a couple of payments. This arrangement can provide a way where your dentist can cover their immediate costs, yet help to accommodate your financial needs too.
Need more details? Visit our Dental Crown Costs page.
#6 - Make sure you understand why your dentist has recommended a crown.
Dental crowns serve many important functions. But if your tooth does not require one then other types of dental restorations make a better choice.
a) There are other ways to rebuild teeth.
- Your dentist might be able to place a dental filling as opposed to a crown.
- And although one is often placed after root canal treatment, not all teeth receiving this procedure require one.
- If a tooth truly needs a crown, there are no good alternatives. But there are some alternative approaches to having one placed.
b) There are other ways to improve the cosmetic appearance of teeth.
If it's just a change in appearance that's needed, porcelain veneers may provide a less invasive way to accomplish the same cosmetic end result. In some situations, just placing tooth bonding may suffice.
c) In some situations, a second opinion can be a good idea.
If your new dentist suggests several crowns (while your previous dentist never did), or if your current dentist seems to solve every problem by placing one, a second opinion may be in order.
It's expected that dentists' opinions will vary. However, over-diagnosing the need for crowns can be hard on your pocketbook and bad for your teeth. When in doubt, consider seeking a second opinion.
Would you like to avoid the hassle of getting crowns on other teeth?
Anyone can have a tooth that needs to be capped as a result of an accident. But beyond that, there are some basic steps you can take that may help you to avoid being placed in a position where you ever need to have a tooth crowned again. Use this link to read our page that explains what to do.
Full menu for topic Dental Crowns -
- Dental crown FAQ's.
- What are crowns (caps)? When is one needed?
- Applications -
- The dental crown procedure.
- The single-appointment, one-hour crowning procedure.
- Common problems and complications.
- How to sell old crowns.
- Reference sources for this page.