A dental crown is a tooth-shaped cap used to cover a damaged or weakened tooth, restoring its original size, strength, and appearance. This restoration is necessary when a tooth has extensive decay, a large fracture, or has undergone a root canal procedure, providing protection from further breakdown. Whether a crown constitutes a “major” procedure depends on the context, referring to either the clinical invasiveness of the treatment or its administrative classification by dental insurance companies.
The Clinical Steps of Getting a Crown
The physical process of receiving a dental crown is typically spread across two separate appointments. The first visit focuses on preparing the tooth and capturing its precise dimensions for the custom cap. This preparation requires the dentist to use local anesthesia to numb the area before reshaping the natural tooth by filing down the enamel.
Reshaping the tooth is necessary to make room for the crown material, ensuring the final restoration does not interfere with the patient’s bite. After preparation, an impression or digital scan of the prepared tooth is taken and sent to a dental laboratory for fabrication. The patient leaves the first appointment with a temporary crown cemented in place, which protects the vulnerable tooth while the permanent restoration is being created over the next two to three weeks.
The second appointment involves the placement of the final crown, beginning with the removal of the temporary cap. The dentist checks the permanent crown for proper fit, marginal seal, and comfortable occlusion with the opposing teeth. Once all adjustments are made, the crown is bonded to the natural tooth structure using a strong dental cement. This two-step process, involving local anesthetic, tooth reduction, and lab fabrication, is clinically restorative.
How Dental Insurance Classifies Crowns
Dental insurance plans almost universally categorize crowns as a “Major Restorative” service. This administrative classification dictates the percentage of the procedure’s cost the plan will cover. While preventive services like cleanings are often covered at 100%, and basic services like fillings are typically covered at 70% to 80%, major restorative work receives a substantially lower benefit.
Most dental plans reimburse only about 40% to 60% of the cost for a crown, leaving the patient responsible for a larger portion of the total fee through coinsurance. Major restorative services are often subject to the plan’s annual maximum, the total dollar amount the insurance company will pay out in a calendar year. Patients must also meet their plan’s deductible before any coverage for a major service begins.
Another financial consideration is the waiting period, which many insurance policies impose on major procedures to prevent immediate high-cost claims. This period often lasts between six and twelve months from the policy’s effective date before coverage for a crown is active. The insurance classification of “major” is therefore a financial one, reflecting the higher cost and complexity of the material and labor involved.
Post-Procedure Expectations and Longevity
Immediately following the placement of the permanent crown, patients may experience some temporary sensitivity to hot or cold temperatures. This discomfort is usually managed effectively with over-the-counter anti-inflammatory medication. For the first 24 to 48 hours, it is advisable to avoid chewing hard or sticky foods on the side of the mouth where the crown was placed to allow the dental cement to fully set.
A dental crown is a long-term restoration, with an expected lifespan that typically ranges from 5 to 15 years, depending on the material and the patient’s oral hygiene. Maintaining the crown requires the same dedication to daily care as natural teeth, including brushing twice a day and flossing at the gumline. Regular dental checkups allow the dentist to monitor the crown’s margins and surrounding gum tissue to ensure its longevity.