A dental crown is a custom-made, tooth-shaped cap used to restore a tooth that is damaged, fractured, or severely decayed. This restoration works by completely encasing the entire visible portion of the tooth, strengthening it and improving its appearance. The number of appointments required depends on the technology available at the practice and the underlying health of the tooth. Understanding the different methods and preparatory procedures clarifies why the process may take one, two, or even more visits.
The Standard Two-Appointment Process
The traditional approach typically involves two separate appointments spaced two to three weeks apart. This method is necessary when the permanent crown is fabricated by an external dental laboratory. The first visit prepares the compromised tooth and gathers the necessary information for the lab technicians.
During this initial appointment, the dentist reshapes the tooth by removing enamel and dentin to create space for the crown material. This preparation ensures the final cap fits securely without interfering with the patient’s bite. The dental team then takes a precise impression, often using putty or a digital scanner, to create a mold of the prepared area. This impression is sent to the laboratory, along with instructions on the shade and material selection.
A temporary crown, usually made of acrylic or resin, is cemented onto the prepared tooth to protect it from sensitivity and maintain spacing. This interim period allows the dental laboratory ten to fourteen days to craft the final crown. The second appointment involves removing the temporary restoration and cleaning the tooth. The dentist checks the permanent crown for proper fit, color match, and bite alignment before permanently bonding it with dental cement.
The Single-Visit Crown Option
The possibility of receiving a dental crown in just one appointment is made possible by computer-aided design and manufacturing (CAD/CAM) technology. Systems like CEREC allow the entire fabrication process to be conducted in the dental office, eliminating the need for a temporary crown and the two-week waiting period. The single, extended appointment usually lasts between two and three hours, consolidating all steps into one visit.
The process begins with the same tooth preparation, where the tooth is reshaped to accommodate the material. Instead of a physical mold, a specialized intraoral camera takes a detailed digital scan, creating a precise three-dimensional model of the prepared tooth. The dentist then uses specialized software to design the crown on a computer screen, ensuring the contours and bite are correct.
Once the design is finalized, the information is sent to an in-office milling unit, which carves the crown out of a solid block of high-quality ceramic or porcelain. This milling process typically takes about 10 to 20 minutes. The dentist may then stain and glaze the crown to achieve a natural appearance before bonding it directly to the prepared tooth. This method offers the advantage of fewer visits and avoids complications associated with wearing a temporary crown.
Pre-Treatments That Add Appointments
While crown placement may be a one- or two-visit procedure, underlying dental health issues often require separate preparatory appointments, increasing the total number of visits. If the tooth has extensive decay reaching the pulp or an existing infection, a root canal treatment must be completed first. This endodontic therapy is a distinct procedure requiring its own appointment to remove infected tissue and seal the canals.
A severely damaged tooth or one that has lost too much structure may require a core buildup before the crown process begins. This involves using a filling material to restore enough bulk to provide a stable foundation for the final restoration. Additionally, if the gums are inflamed or the gum line is positioned incorrectly, treatment for periodontal disease or crown lengthening may be necessary. These preparatory steps ensure the foundation is healthy and strong, allowing the dental crown to be placed securely.