The Crown Procedure Step by Step

Getting a dental crown is a straightforward process that's completed over two appointments, usually spaced 2–3 weeks apart. Here's exactly what happens at each stage.

First Appointment: Preparation

This is the longer of the two appointments, typically lasting 45–90 minutes. Here's what's involved.

Step 1: Consultation and X-Ray

If this is your first visit regarding the tooth, I'll start by taking an X-ray to assess the tooth's root and surrounding bone. This helps me confirm that a crown is the right approach and that the underlying tooth structure is sound enough to support one. We'll discuss the type of crown material that's best suited to your situation, taking into account the tooth's position, the forces it needs to withstand, and your aesthetic preferences.

Step 2: Local Anaesthesia

I'll numb the tooth and surrounding area with a local anaesthetic. This ensures you're completely comfortable throughout the preparation process. You'll feel pressure during the procedure, but no pain.

Step 3: Reshape and Prepare the Tooth

Using a dental drill, I carefully reshape the tooth by removing a thin layer of enamel from all surfaces. This creates room for the crown to fit over the top without making the tooth bulkier than its neighbours. The amount of tooth reduced depends on the crown material — porcelain crowns typically require slightly more reduction than metal crowns.

If the tooth is severely broken down or has had a large filling, I may need to build it up with a core material first to provide a solid foundation for the crown.

Step 4: Take Digital Impressions

Once the tooth is prepared, I take a precise impression of both the prepared tooth and the opposing arch. This is sent to the dental laboratory where your crown will be custom-made. The impression captures every detail of your tooth's shape, your bite relationship, and the position of neighbouring teeth, ensuring your crown fits perfectly.

I'll also take a shade match — selecting the precise colour that matches your surrounding teeth so the crown blends in naturally.

Step 5: Fit a Temporary Crown

While the laboratory fabricates your permanent crown (which takes approximately 2 weeks), I'll fit a temporary crown to protect the prepared tooth. The temporary is made from acrylic and is cemented with a weaker adhesive so it can be easily removed at your next appointment.

Important notes about your temporary crown:

It's not as strong as your permanent crown — avoid chewing hard or sticky foods on that side
Brush gently around it and floss carefully, pulling the floss out sideways rather than snapping it up, to avoid dislodging it
If it comes loose or falls off, contact my practice promptly — don't leave the prepared tooth exposed

Between Appointments

The dental laboratory will fabricate your crown based on my impressions and specifications. Skilled technicians build the crown layer by layer, matching the shape, colour, and translucency of your natural teeth. This process takes approximately two weeks.

During this time, you can go about your normal routine. Just be mindful of the temporary crown and follow the guidance above.

Step 6: Laboratory Fabrication

Your permanent crown is crafted in a dental laboratory by experienced technicians. They use the impressions, shade information, and any photographs I've provided to create a crown that's customised specifically for you. Modern crowns are remarkably natural-looking — in many cases, even a dentist would struggle to tell the difference between a high-quality crown and a natural tooth.

Second Appointment: Fitting

This appointment is shorter, typically 30–45 minutes.

Step 7: Remove Temporary, Fit Permanent Crown

I'll carefully remove the temporary crown and clean the prepared tooth underneath. Then I'll try the new permanent crown in place to check the fit, the colour match, and the way it sits against your neighbouring teeth. This is a critical step — I want to make sure everything looks and feels right before I cement it permanently.

If any minor adjustments are needed, I can make them chairside. In the rare event that the crown doesn't meet my standards, I'll send it back to the laboratory for modification and you'll continue wearing the temporary for a bit longer. I'd rather get it right than compromise on quality.

Step 8: Adjust the Bite and Cement

Once I'm satisfied with the fit and appearance, I'll check your bite carefully. I'll place articulating paper (a thin coloured paper) between your teeth and ask you to bite down and move your jaw from side to side. This highlights any spots where the crown is hitting too high or interfering with your natural chewing movement.

After any final adjustments, I'll cement the crown permanently in place using a strong dental adhesive. I'll clean away any excess cement and do a final check of the margins and your bite.

You'll leave the practice with your new crown fully functional. Most patients tell me they quickly forget which tooth has the crown — it feels that natural.

What to Expect Afterwards

Mild sensitivity to hot and cold is normal for the first few days as the tooth adjusts
Your bite may feel slightly different at first, but this typically settles within a day or two as you get used to the crown
The numbness from the anaesthetic will wear off within 2–4 hours

If your bite still feels off after a few days, contact me — a quick adjustment is easy to do and important for your comfort and the longevity of the crown.

For detailed guidance on looking after your new crown, see my dental crown aftercare guide.

What to Expect When Getting a Dental Crown