Dental crowns ("caps") - What are they? When is one needed? -

Reasons why teeth are capped. | Examples of applications and uses for crowns. | Age limitations.

1) What are dental crowns?

  1. A crown ("cap") is a type of dental restoration that fully cups over that portion of a tooth or dental implant that lies at and above the gum line.
  2. Once placed, it in effect becomes the tooth's new outer surface. (In comparison, a dental filling just fills in or repairs a portion of a tooth.)
  3. Crowns are permanently cemented into place. The tooth-crown unit that results functions and is cared for just like a natural tooth.

Slideshow: What Are Dental Crowns?

Slideshow explaining what dental crowns are.

2) Why are they placed?

There are several reasons why a dental crown might be made for a tooth. Dentists routinely use them to:

  1. Repair and strengthen damaged teeth.
  2. Improve tooth appearance (including color, shape and even apparent alignment).

While some other treatment alternatives do exist, no other kind of dental restoration provides the exact same set of benefits and advantages as a crown.

For more details about why they're placed, see below.

3) Other terms for crowns.

Is a cap and a crown the same thing?

Yes, the terms "caps," "dental caps" and "tooth caps" are all interchangeable and can be used to refer to any type of dental crown. To its credit, this name aptly describes what this type of restoration does. It caps (covers over) a tooth.

What is a tooth jacket?

As another alternative, the term "porcelain jacket" can be used to refer to some types of all-ceramic dental crowns (these are typically just placed on front teeth).

What terminology does your dentist use?

All of the terms above are relatively archaic and most frequently just used by patients or the popular press.

In dental literature (textbooks, journals, studies, etc...), you'll essentially never see the word "cap" used. Nor do most dentists use it when conversing with professional colleagues. The word "jacket" does still linger professionally but its use is far overshadowed by the term "crown."


Slideshow: The different types of dental crown construction.

Slideshow outlining different types of dental crown construction.

4) What kinds of materials are crowns made out of?

Crowns can be constructed using:

  1. Porcelain (or other type of dental ceramic.)
  2. Metal (precious, semi-precious or non-precious dental alloy).
  3. A combination of dental ceramic and metal alloy (porcelain-fused-to-metal crowns).

Each of the above types of restorations has its own characteristic advantages and disadvantages, and therefore its own set of most-suited applications.

We've dedicated an entire page to this topic. - What type of dental crown makes the best choice for you?


5) Dental crown age limitations.

While there are no strict age-related limitations regarding when a dental crown can be placed, there are some important issues that should be considered.

How old do you need to be to get a crown?

Generally speaking and primarily based on growth and development issues, a dentist will usually want to wait until a patient has reached the age of 17 or 18 years before they consider placing a permanent dental crown for them. Here's why:

  • Concerns with front teeth. - During the course of jawbone growth and tooth eruption, the position of a tooth's gum line will change. If placed before this process has been substantially completed, the gum-line edge of a crown may rise above it, thus spoiling the restoration's appearance.
  • Concerns with back teeth. - A crown's retention can be enhanced by designing it so it cups over a greater portion of its tooth. If this issue is a concern, delaying crown placement until the tooth has substantially erupted makes accomplishing this design easier.
  • Issues with dental insurance. - Some insurance policies include permanent crown age-limit restrictions.

    (In cases where a dentist feels their patient is too young to have a permanent dental crown placed, interim alternatives do exist.)

6) Reasons why dental crowns are placed.

A dentist might recommend capping a tooth for a variety of reasons but most tend to fall within one or more of the following categories:

Make sure you understand why a crown is needed.

In some instances, a dentist's recommendation to place a "cap" is based solely on their judgment, as opposed to clear-cut clinical signs. Adding in the fact that they can be quite costly (and therefore a substantial profit center for a dental practice), creates the situation where finances may influence the diagnosis given.

Just as not placing a crown when one is needed has associated risks, performing the process of crown placement opens the door for potential complications too.

For this reason, this procedure should not be performed without reasonable justification. Let your dentist explain to you why they feel it's required. You may not fully understand all of their arguments (read our text below for further insight) but they should at least make some logical sense.

A dental crown case.

Before picture of a dental crown case..

Example smile makeover cases where crowns are used to rebuild damaged teeth.

7) Applications for placing crowns.

A) Rebuilding / Changing the shape of teeth.

Since a cemented crown becomes its tooth's new outer surface, it's not hard to imagine how placing one can be used to rebuild or improve a tooth's shape.

"Caps" are routinely used as a solution for worn, chipped or broken teeth. Or those that are misshapen due to a developmental anomaly.

Advantages of a crown.

In some instances, it's conceivable that a dental filling might be placed as an alternative to a crown. But the latter may offer big advantages due to the way that it's fabricated.

  • Crowns are made in a dental laboratory, by a dental technician using copies (impressions) of your teeth.
  • In comparison, dental fillings are built during your dental appointment, within the confines and limitations presented by your mouth.

Due to this difference, a dental laboratory technician, at their own pace, will get an opportunity to evaluate aspects of your bite and jaw movements from a variety of angles, and then sculpt your dental crown so it has the ideal shape.

With a dental filling, the dentist may have far less control over the restoration's final contours because it may be difficult for them to visualize, evaluate, or have access to the tooth they're working on. There may also be time constraints involved, either associated with the materials being used or the patient's tolerance for the procedure.

When a crown is made, the lab technician and dentist have an opportunity to create the most ideal shaped restoration possible essentially 100% of the time. With fillings, while a perfectly serviceable result can usually be expected, achieving absolute perfection is quite difficult.

B) Strengthening teeth.

Dental crowns are routinely placed on teeth that have broken, have had large portions destroyed by tooth decay or have had root canal treatment.

That's because beyond just restoring a tooth's shape, a crown can provide a reinforcing and strengthening effect too.

(This is always true for all-metal and porcelain-fused-to-metal crowns. The strength and durability characteristics of all-ceramic crowns vary, so quiz your dentist about the track record of the type they plan to place for you if a strengthening effect is needed.)

In comparison, fillings (amalgam or dental bonding) typically can't provide a substantial reinforcing effect for a tooth to the same degree. We discuss the issue of how to choose between having a filling or crown placed here.

C) Improving the appearance of teeth.

Because a dental crown encases the entire visible portion of a tooth, porcelain crowns (porcelain-fused-to-metal and especially all-ceramic ones) can be used to enhance or idealize the cosmetic appearance of teeth.

A dental crown case.

Before picture of a dental crown case.

Example makeover cases where crowns are used to enhance the appearance of a smile.

If taken to an extreme, this technique can be used to radically improve the appearance of a person's smile. In fact, in decades past it was common to hear of movie stars who had had their teeth "capped." This simply meant that they got their perfect "Hollywood" smile by way of having dental crowns placed.

Capping isn't necessarily a good idea.

Actually, having your teeth capped just to improve their appearance can, in most cases, be a very poor choice. For example, you can't expect that any crown's perfect look will last a lifetime (here's why). And as a result, the crowning process will likely need to be repeated multiple times over the person's lifetime.

Dental crowns only make the best choice for making cosmetic changes in situations where they simultaneously serve other purposes, such as restoring teeth to their original shape or strengthening them. If those applications aren't needed, then it's best to at least consider alternative approaches first.

You should always consider the alternatives.

As a general rule, a crown shouldn't be placed solely to improve the appearance of a tooth if there is some alternative procedure that could just as well achieve the same end result. That's because during the crowning procedure large portions of the tooth are trimmed away.

If a more conservative dental procedure (one that tends to preserve tooth structure, as opposed to sacrificing it) can equally improve a tooth's appearance, such as a porcelain veneer, dental bonding, or even just teeth whitening (professional or at-home), then it's usually best to consider that treatment option first.

(Even though one of the above alternatives may only offer an improved, but not perfect, result, choosing it may offer substantial advantages over the long run. Here's a link to our page that discusses this issue from a standpoint of having veneers placed. In general, these same arguments apply to a set of crowns too.)

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Other aspects of capping teeth we cover on our pages.

Besides the links we've referenced in our text above, there are several other pages on that visitors frequently seek.

One involves an explanation of some of the common problems people experience with crowns (both permanent and temporary). This includes not only various types of pain and sensitivity but also what to do if you've lost or even swallowed one.

Due to the high price of gold, people are often interested in our page that discusses how to sell scrap dental restorations. And then, as a brief overview, we've also composed a page titled: 6 things to consider when choosing what kind of dental crown to have made.



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