A dental crown is a custom-made, tooth-shaped cap used to restore a damaged tooth’s shape, size, strength, and appearance. This restoration completely covers the entire visible portion of the tooth above the gum line. Crowns are often necessary when a tooth is severely decayed, fractured, or has a large filling that compromises its structural integrity. The placement process involves reducing the existing tooth structure to create a stable foundation for the permanent covering.
The Traditional Two-Visit Timeline
The most common approach for receiving a dental crown involves at least two separate appointments. This traditional timeline relies on an external dental laboratory to fabricate the final restoration, which requires a waiting period. The first visit is dedicated to preparing the tooth and gathering the precise measurements needed for the laboratory.
The initial appointment typically lasts between 60 to 90 minutes. The dentist first numbs the area and then carefully reshapes the tooth by removing the outer layer of enamel and dentin. This preparation creates a uniform surface onto which the final crown will fit without interfering with the patient’s bite.
After the tooth is shaped, a detailed impression of the prepared tooth and the surrounding teeth is taken, often using a putty-like material or an intraoral digital scanner. This impression serves as a blueprint that the dental laboratory uses to craft the custom crown. Before the patient leaves, a temporary crown is cemented over the prepared tooth to protect it from sensitivity and damage.
The time between the first and second appointment usually spans one to three weeks. This waiting period is determined by the dental laboratory’s workload and the complexity of the crown material. The laboratory uses the impression to fabricate the final crown, ensuring it matches the color, shape, and size of the surrounding teeth.
The second and final appointment is generally shorter, lasting approximately 30 to 60 minutes. The dentist removes the temporary crown and cleans the prepared tooth surface. The permanent crown is then placed onto the tooth to check its fit, color match, and how it interacts with the opposing teeth when the patient bites down.
Minor adjustments to the crown’s surface or edges may be necessary to ensure a comfortable and proper fit. Once the fit and color are satisfactory, the dentist permanently bonds the final crown to the prepared tooth using a strong dental cement. The entire process usually takes two to three weeks to complete.
The Same-Day Crown Procedure
A modern alternative is the same-day crown procedure, which dramatically reduces the overall time commitment. This expedited process uses in-office computer-aided design and manufacturing (CAD/CAM) technology, such as CEREC. By eliminating the need to send impressions to an outside lab, the entire treatment can be completed in a single, extended visit.
This single appointment typically requires two to three hours. The initial steps of tooth preparation remain similar, where the dentist reduces and shapes the tooth surface. Instead of conventional putty impressions, a specialized intraoral camera scans the prepared tooth to create a precise three-dimensional digital model. The advanced software uses this digital data to design the crown, allowing the dentist to customize the restoration’s shape and contours. Once finalized, the data is sent to an in-office milling machine which carves the new crown out of a solid block of ceramic material pre-selected to match the patient’s natural tooth color.
The milling process is quick, often taking only 15 to 30 minutes. After the crown is milled, the dentist checks the fit, polishes the restoration, and immediately cements the permanent crown onto the tooth. This technology bypasses the need for a temporary crown and the multi-week waiting period.
Variables That Can Extend the Duration of Treatment
While the timelines are generally predictable, several factors can necessitate preliminary procedures or cause unforeseen delays.
The most common cause for an extended timeline is the need for a root canal before the crown preparation can begin. If the tooth’s nerve is infected, the root canal procedure must be completed first, which can add one to three weeks and at least one extra appointment.
Another variable is the requirement for crown lengthening or gum contouring. This surgical step is sometimes necessary if decay extends too far below the gum line, meaning there is not enough healthy tooth structure remaining to securely hold the crown. The gum tissue must be allowed to heal and stabilize, which can delay the final crown placement by six to twelve weeks.
Complications during the fabrication or seating process can also add time. If the final crown fabricated by the external laboratory does not fit precisely or the color match is incorrect, it must be sent back for a remake. This quality control issue can easily add another week to the traditional waiting period.
Sometimes, a severely damaged tooth may not have sufficient structure left to support the crown. In these cases, the dentist must perform a “core build-up,” which involves placing a filling material to create a larger, more stable base for the crown. This adds time to the initial preparation appointment.