Dental crowns are one of the most effective and widely used solutions for restoring damaged, weakened, or heavily worn teeth. Whether placed after a root canal, to repair a fractured tooth, or to improve the appearance of a discolored tooth, crowns can restore both function and confidence while helping preserve your natural smile.
While dental crowns offer significant advantages, they are not always the ideal solution for every patient. For instance, a crown can help protect a fragile, root canal-treated tooth from further breakage. However, using a healthy tooth as part of a bridge or for cosmetic purposes should be carefully considered.
Understanding both the benefits and disadvantages of dental crowns is essential before making a decision.
In this guide, we’ll explore the potential drawbacks of dental crowns, compare the most common crown materials, and help you determine which type of crown is best suited to your oral health needs, cosmetic goals, and budget.
What Is a Dental Crown?
Dental crowns are custom-made caps that are placed over damaged, weakened, or heavily restored teeth to restore their strength, function, shape, and appearance. They completely cover the visible portion of a tooth above the gum line, acting like a protective shield.
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6 Scenarios where you need a dental crown
Dental crowns are commonly given to:
- Protect root canal-treated teeth
- Restore severely decayed teeth
- Cover cracked or fractured teeth
- Support dental bridges
- Restore dental implants
- To cover a malformed tooth or improve tooth imperfections
Because crowns are designed to mimic natural teeth, they are available in several materials, each with unique advantages and disadvantages.
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The Main Disadvantages of Dental Crowns
While crowns are often the best treatment option, you should understand the potential limitations before proceeding.
1. Tooth Cutting Is Permanent
One of the biggest disadvantages of dental crowns is that the procedure is irreversible.
Before a crown can be fitted, the dentist must remove a layer of tooth structure to create enough space for the restoration. Once enamel and dentin are removed, they cannot grow back.
For root canal-treated teeth, this is usually a worthwhile trade-off because the crown protects an already weakened tooth. However, for healthy teeth being crowned for cosmetic reasons permanent tooth reduction should be carefully considered.
2. Healthy Teeth May Need to Be Cut for a Bridge
When crowns are used as part of a dental bridge, healthy neighbouring teeth often need to be reduced to support the bridge.
This means removing healthy tooth structure from teeth that might otherwise never need treatment.
For this reason, many dentists now consider dental implants a better long-term solution when replacing a single missing tooth, as implants leave neighbouring teeth untouched.
3. Crown Preparation in vital (healthy) teeth may Cause Sensitivity
One common side effect of preparing vital teeth for full-coverage crowns is dentinal hypersensitivity, which can cause sudden, sharp discomfort.
The tooth becomes temporarily more sensitive to hot and cold temperatures because:
- The tooth nerve becomes irritated during preparation.
- Exposure of dentinal tubules during tooth reduction
Women are generally more likely than men to experience and report this sensitivity, both prior to and following tooth preparation. The risk can be greater in:
- Younger patients
- Healthy teeth with large nerve chambers
- Discoloured teeth being crowned for cosmetic purposes
- Teeth being reshaped due to alignment issues
This discomfort is usually temporary and fades within about two weeks as the tooth heals and adapts. The duration can vary from person to person depending on factors such as healing, crown fit, and the material used. However, if the sensitivity persists for more than three weeks or worsens over time, it is important to contact your dental office for further evaluation.
4. Mild tooth discomfort after crown placement
Following crown placement, the cement used to bond the crown may irritate the dental pulp, resulting in transient pain and sensitivity.
In addition, the removal of the protective smear layer from the dentin during crown preparation can increase dentinal permeability and further exacerbate pulpal sensitivity after treatment.
4. Bite Problems May Occur
A newly placed crown should fit perfectly within your bite.
If the crown sits slightly too high, it may result in:
- Pain when biting
- Jaw soreness
- Tooth sensitivity
- Pressure when chewing
Fortunately, this is usually a simple adjustment that can be corrected in a follow-up appointment.
5. Poorly Fitted Crowns Can Fail
The long-term success of a crown depends heavily on its fit.
If a crown does not seal properly against the tooth, bacteria can enter underneath and lead to:
- Tooth decay
- Sensitivity
- Crown loosening
- Discolouration beneath the crown
- Eventual crown failure
Choosing an experienced dentist and a high-quality laboratory is critical for achieving a precise fit.
6. Porcelain Crowns Can Chip or Crack
Although porcelain crowns offer excellent aesthetics, they are not as resistant to fracture as some other materials. Over time, porcelain crowns may:
- Chip
- Crack
- Fracture under heavy chewing forces
Small chips can sometimes be polished or repaired. Larger fractures often require complete crown replacement.
7. Dental Crowns May Wear Down Opposing Teeth
Dental ceramics are harder than tooth enamel. For instance,
- Porcelain is 1.5x harder than dental enamel
- Zirconia is 4.5 times harder than dental enamel.
The high hardness of porcelain and zirconia can gradually wear down opposing teeth, particularly in patients with bruxism (teeth grinding habit). In addition, aged zirconia may contribute to increased wear of the opposing dentition.
The risk increases when:
- Poorly polished crowns
- Patients have bruxism (teeth grinding)
- The opposing teeth already have worn enamel
A custom night guard can help protect both the crown and natural teeth.
8. Dental Crowns Can Be Costly
Cost remains one of the most significant disadvantages of dental crowns.
Depending on the material and complexity of treatment, a crown can cost anywhere from $1,000 to $3,000 or more per tooth.
Additional costs may include:
- Root canal treatment
- X-rays
- Consultations
- Temporary crowns
- Core build-ups
While crowns are often a worthwhile investment, the upfront expense can be challenging for some patients.
9. Crown Replacement Can Be Expensive
Unlike fillings, crowns cannot always be repaired when significantly damaged.
If a crown fractures or fails, replacement is often necessary.
This means patients may face additional costs years after their initial treatment, particularly if multiple crowns need replacement at the saReme time.
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Comparing Different Types of Dental Crowns
Not all crowns are created equal. Understanding the strengths and weaknesses of each material can help you make the best choice.
Emax Crowns (Lithium Disilicate)
Emax crowns are a popular type of dental crown made from lithium disilicate ceramic. They are known for their exceptional strength, durability, and natural-looking appearance, allowing them to closely mimic the appearance of real teeth. This makes Emax crowns an excellent option for patients who want both long-lasting results and a beautiful smile.
What makes Emax crowns special
What sets Emax crowns apart is the advanced technology used to create them. Dentists use digital impressions and CAD/CAM technology to design crowns that are customized to each patient’s tooth structure.
The crown is then precisely milled to ensure an accurate fit and a natural-looking finish. This technology not only improves comfort and aesthetics but also reduces treatment time and minimizes the risk of errors, resulting in a more efficient and predictable dental experience.
Advantages
- Require less tooth reduction
- Exceptional aesthetics
- Highly translucent and natural-looking
- Strong and durable
- Metal-free
Disadvantages
- More expensive
- May not fully mask deep brown or black discoloration
- Not suitable for long-span bridges
- Can fracture if made too thin
Best for: Front teeth and cosmetic smile makeovers.
Porcelain-Fused-to-Metal (PFM) Crowns
PFM crowns combine a metal substructure with a porcelain outer layer.
Advantages
- Strong and reliable due to metal coping
- More affordable than many all-ceramic crowns
- Proven long-term success
Disadvantages
- Require significant tooth reduction (for porcelain and metal)
- Porcelain can chip
- Metal margins placed under the gums may uncover over time due to gum recession appearing as a grey line along the gums
- Less natural appearance than modern ceramic crowns because of the light reflecting from the metal coping
Best for: If you’re seeking durability at a lower cost. Best for back teeth due to metal coping which gives strength to the fragile porcelain.
Porcelain Jacket Crowns
These crowns are made entirely from porcelain and are commonly used for aesthetic restorations.
Advantages
- Excellent aesthetics
- Natural translucency
- Good gum compatibility
Disadvantages
- More fragile than other options
- Unsuitable for bridges
- Not recommended for heavy grinders
- Require greater tooth reduction
Best for: Single front tooth restorations.
Zirconia Crowns
Zirconia crowns have become one of the most popular modern crown options due to their combination of strength and aesthetics.
Advantages
- Extremely durable
- Resistant to fracture and chipping
- Long lifespan
- Resistant to staining
- Suitable for patients who grind their teeth
Disadvantages
- Higher cost
- Can be difficult to achieve the same translucency as Emax
- Harder than natural tooth enamel
Best for: Suitable for all teeth when durability and aesthetics are the main concerns.
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How to Choose the Right Dental Crown for You?
The best crown depends on several factors, including your oral health, cosmetic expectations, habits, and budget.
Choose Emax if:
- Appearance is your highest priority.
- The tooth is visible when smiling.
- You want the most natural-looking restoration.
Choose Zirconia if:
- You grind your teeth.
- Strength and longevity are important.
- The crown will be placed on a molar.
Choose PFM if:
- Budget is a major consideration.
- You need a durable restoration.
- The tooth is not highly visible.
Consider Alternatives If:
- A healthy tooth must be cut for a bridge.
- Veneers could improve cosmetic concerns with less tooth reduction.
- Orthodontics could correct crooked teeth without altering healthy enamel.
- A dental implant can replace a missing tooth while preserving adjacent teeth.
Conclusion
Dental crowns remain one of the most effective ways to restore damaged teeth and protect root canal-treated teeth. However, they are not a perfect solution. Permanent tooth reduction, sensitivity, maintenance costs, potential crown failure, and material-specific limitations are all factors worth considering.
The good news is that modern dentistry offers a wide range of crown materials and alternatives. By understanding the advantages and disadvantages of each option and discussing your goals with your dentist, you can choose a solution that provides the ideal balance of aesthetics, strength, longevity, and value.