Dental Crowns Explained: When Do You Actually Need One?

A dental crown is a custom-made cap that fits over a damaged tooth, restoring its shape and strength and protecting what's left of it underneath.

The practical difference from a filling is scale. A filling replaces part of a tooth; a crown replaces the outside of the whole thing. That's why a crown is what's used once there isn't enough sound tooth left for a filling to hold onto safely — and why "crown" and "cap" are the same thing, just the dental word and the everyday one.

Read more about dental crowns

• After root canal treatment, usually on a back tooth — removing the pulp leaves it more brittle.
• A large filling has failed or there isn't enough tooth left for another filling to hold onto.
• A cracked or fractured tooth that would otherwise split further under normal chewing.
• Heavily worn teeth, often from years of grinding, where the biting surface itself needs rebuilding.

A crown is rarely the first choice for a purely cosmetic change — composite bonding or a veneer usually achieves that with far less removed from the healthy tooth.

First: preparation

The tooth is numbed and shaped to make room for the crown, and an impression is taken and sent to the laboratory. A temporary crown protects the tooth while the permanent one is made.

Second: fitting

The finished crown is checked for fit and bite, then cemented permanently. Any sensitivity from the temporary settles once the final crown is in place.

A porcelain or metal-free crown here is £950; a full gold crown is also £950, and a porcelain inlay or onlay — a more conservative option where enough tooth remains — is £850.

• What happens during root canal treatment — what usually comes before a crown.
• Night guards and teeth grinding — what protects a crown once it's fitted.