A dental crown is typically recommended when a tooth is too damaged, weakened, or heavily restored for a filling to provide long-term protection. Principal Dentist Andrew Stevenson explains when crowns are needed, the treatment process, available materials, and common patient concerns.
Experience & Credentials
About the expert
Andrew Stevenson
Principal Dentist, Kew Road Dental
- Qualified: Qualified in 1998, University of Newcastle Upon Tyne.
- Experience: Over 28 years of experience in restorative dentistry.
- GDC Number: 74427
- Special interest: Endodontics (Root Canal Treatment)
- Places approximately 100 crowns annually
- LinkedIn profile: www.linkedin.com/in/andrew-stevenson-891a4635
- Professional member of: GDC and British Endodontic Society.
Approximately how many crowns do you place each year?
I usually provide upwards of 100 crowns per year.
How many years have you been providing crown treatment?
I have been qualified and working since 1998, providing treatment for 28 years.
When is a crown needed?
What signs tell you a tooth is no longer suitable for a filling?
A tooth can need a crown for a variety of reasons. The main reason is the loss of too much tooth tissue to place a filling. A crown is a very good restoration when there is a large amount of tooth loss, but also after root canal treatment, a crown is placed to prevent reinfection and further tooth fracture. Finally, a crown can be placed for cosmetic reasons to change the shape of a tooth and give a more pleasing appearance.
What is the biggest misconception patients have about dental crowns?
Patients remember the older crowns, which have a metallic substructure, giving a dark line around the edge of the crown near the gum. Modern crowns don’t have the metal substructure and therefore don’t have the dark line near the gum.
Treatment options
What types of crowns do you most commonly provide?
Zirconium oxide and Emax crown.
What crown materials do you use, and what are the advantages and disadvantages?
Zirconium oxide crowns are very strong and nowadays look very aesthetic, but can’t be bonded to the tooth; they rely on a strong glue to cement the crown in place. Emax crowns are actually bonded to the tooth, so they can be more retentive, and for this reason, they are suitable for veneers, which zirconium oxide is not. Emax crowns, although the most aesthetic of all the crowns, are not as strong as zirconium oxide and are possibly better suited to the front of the mouth, where the bite forces aren’t as strong or as frequent.
The patient experience
Is it painful to have a crown?
No, it is not painful. It can’t be considered similar to having a filling placed.
What are common patient concerns?
How long will my crown last, and will it look natural? These are reasonable concerns, but modern-day crowns closely match natural teeth, and zirconium oxide crowns in particular are very strong and can last indefinitely.
Clinical Experience
Can you describe a challenging crown case where treatment significantly improved the patient's oral health or confidence?
This situation most often occurs when a patient breaks a tooth and fears it can’t be saved. They are often relieved to hear that, although a large part of the tooth is now missing, it can still be saved with a crown. In more serious cases, possibly involving an accident, such as falling from a bicycle, broken teeth can be restored with crowns in combination with root canal treatment first.
Professional Expertise
How has crown treatment evolved since you qualified?
This allows discussion of:
The provision of crowns has changed considerably since I qualified. Initially, crowns were made only of porcelain, but they were brittle, so they were made quite thick to prevent fracture. Since then, things have shifted to pressed porcelain, allowing for a thinner crown that is still strong; the best example of this is the Emax crown.
Aside from porcelain, zirconium oxide crowns have been developed; they are made of fake diamonds and are very strong. Initially, their appearance was not comparable to porcelain; however, in recent years, it has dramatically improved, and they can be used for all types of crowns. The way crowns are cemented has also changed with the advent of self-adhesive resin cements for zirconia crowns, and a more complex bonding process for porcelain crowns, such as Emax.
Digital scanners have significantly changed the workflow for producing crowns, without the need for impressions or moulds of the teeth, which is much more comfortable for the patient and produces a more accurately fitting crown. The laboratories receive digital images of the teeth, and the crowns are fabricated digitally, resulting in a dry laboratory and eliminating the need to pour plaster models. Overall, the provision of crowns has much improved since the 1990’s, and the resulting restoration is more satisfactory for the patient
How do you stay up to date with developments in restorative dentistry?
Like all dentists, I complete regular CPD hours both online and hands-on courses to stay up to date and relevant
Medically Reviewed By
Andrew Stevenson
Principal Dentist
GDC No. 74427
Date Reviewed: 06 2026
Next Review Date: 06 2027