What happens if you don’t get a crown when recommended?

Simply put (and we’ll get more in-depth below), a dental crown is a permanent tooth-shaped cap placed over a damaged or weak tooth to protect and restore it.

While a filling may be able to fix minor decay or damage, certain more serious or advanced oral health issues are best solved with a crown. If your dentist recommends one, it's something to take seriously.

See, your teeth can’t heal themselves. If you have a cavity, it won’t get better on its own. And the longer you go without treating it, the more painful it will become. (And the more expensive and complicated to fix.)

Fortunately, crowns can halt the damage caused by cavities and restore your mouth to a state of health. (Plus, they’re often covered by dental insurance!)

Dental Crowns: everything you need to know

What is a dental crown?

A dental crown is a custom-made, tooth-shaped “cap” that is placed over a damaged or decayed tooth. It restores the strength, function, and appearance of the tooth so you can chew and smile comfortably. Permanent crowns are custom-built to match the shape and color of your natural teeth and are designed to last for many years with proper care.

How long do crowns last? 

Most dental crowns will last at least 15 years, but proper care and maintenance will greatly extend their lifespan. A well-cared for crown can last up to 30 years.

Why would I need a dental crown?

“If your teeth are damaged, injured, or simply worn down over time, a crown could be an excellent treatment option to restore the look and function of your smile,” explains Dr. Chris Salierno, Tend's Chief Dental Officer.

“Cavities are an incredibly common dental problem. They’re nothing to feel bad about, but they do need to be taken care of quickly, before they do more damage. Sometimes, a dental filling may not be enough to correct the damage and improve structural tooth integrity—in that case, we’ll use a dental crown.”

In addition to covering damaged teeth, cracked teeth or broken teeth, crowns can be a good option for missing teeth when combined with a dental implant.

Why do I need a dental crown instead of a filling?

Even the most diligent brushers can end up with a cavity, and it’s nothing to be ashamed of. What matters is what you do about it. A cavity won’t go away on its own; it needs your dentist’s care to stop further decay.

Your dentist can determine if a composite filling is enough to repair your tooth. Fillings are ideal for small, shallow cavities or minor damage where most of the natural tooth structure is strong and intact.

However, if the damage is more advanced, a crown is often the better option. A dental crown is preferable when:

• The tooth is cracked or fractured and needs reinforcement to prevent further breakage.
• Decay is too extensive for a filling to stay stable long-term.
• A large filling has already been placed and the remaining tooth structure is weak.
• After root canal treatment, when the tooth requires extra protection.
• Molars or premolars are affected by damage or decay and require extra strength to withstand the intense pressure of chewing.

In these cases, a crown covers and protects the entire tooth, restoring both function and appearance in a way a filling simply can’t.

How much do dental crowns cost? 

Most in- and out-of-network insurances offer coverage for dental crowns.

If you’re scheduling your dental crown at Tend, the studio team will let you know any cost you may be responsible for, as well as how much will be covered by insurance. (Pro tip: you can also check the cost of your dental treatment plan by using the Tend App.)

What is the cost vs benefit of getting a crown now?

Having a dental crown placed is typically a sound long-term investment. Although crowns have a more significant upfront cost than fillings, the coverage they provide offers more extensive protection for your tooth and can help prevent more severe problems from developing.

What happens if I don’t get a dental crown?

Delaying a dental crown doesn’t just put off treatment, it increases the risks to both your tooth and your comfort.

“If your dentist has recommended a dental crown for a tooth damaged by a cavity, it’s important to get the crown placed as soon as possible,” says Dr. Chris Salierno. “It’s one of the most trusted procedures in dentistry to stop decay from spreading, relieve pain, and protect your healthy tooth. The longer you wait, the more painful, and expensive, the problem becomes.”

Cracks or fractures

One of the biggest concerns is the tooth fracture risk without a crown. A weakened tooth can easily crack, and if the fracture extends below the gumline, the tooth may not be salvageable. This often means extraction and replacement with a bridge or dental implant—treatments that are far more involved.

Bacterial infiltration

Another complication is bacterial infiltration of the tooth. Once bacteria penetrate deeper layers, they can reach the nerve, causing severe infection or abscesses. At that point, a root canal (or even tooth removal) may be the only option.

Pain and tooth loss

Delaying treatment also puts you at risk for chewing pain without crown support, making everyday eating uncomfortable. And without treatment long term, you may eventually lose the tooth. In turn, this can cause the surrounding bone to deteriorate, which affects your bite and may complicate future tooth replacement options.

In short, delaying dental crown treatment can increase the likelihood of more advanced decay, fracture, or even tooth loss. By getting a crown when it’s recommended, you protect your natural tooth, avoid unnecessary pain, and reduce the need for costly, complex treatments later.

Getting a dental crown at Tend: what to expect

Because crowns are designed to perfectly fit your mouth and mimic your damaged tooth, the procedure will, in most cases, require two appointments.‍‍

“We designed the experience of getting a crown at Tend to be as easy and straightforward as can be,” says Dr. Salierno. Here's what will happen.

At your first appointment:

• Your dentist will numb your tooth and the surrounding area with a local anesthetic.
• Digital impressions will be taken (and sometimes X-rays) to get precise measurements for your new crown.
• Any remaining decay will be removed, and the tooth will be shaped so the crown fits properly.
• A temporary crown will be placed to maintain the appearance and function of your mouth until the permanent crown is ready.
• Your tooth measurements will be sent to a dental lab, where your custom crown will be made.
• Approximately one week later, you’ll return for a second visit to have the permanent crown placed.

At your second appointment:

• Your dentist will numb your tooth and the surrounding area.
• The temporary crown will be removed.
• The permanent crown will be checked to ensure it fits perfectly.
• Your dentist will secure the crown with dental cement and allow it to set.
• Finally, they’ll check your bite to make sure everything feels comfortable and natural.

What happens after you get a crown? 

You may feel some soreness in the first few days after getting your dental crown. That’s normal and will fade. Mild discomfort associated with your new dental crown can be treated with over-the-counter pain medications.

If the pain relievers don’t feel like enough or the pain doesn’t fade, especially if you feel pain when biting, contact your dentist. They can adjust the crown to make things more comfortable.

Crowns don’t require any special care, but it’s important to keep up your good at-home oral hygiene routine to protect the tooth underneath the crown from decay and gum disease. That means brushing, flossing, and getting regular dental checkups and cleanings.

Your new crown is strong enough to withstand biting and chewing, but it’s not indestructible. Try to avoid using the crown to chew very hard foods like nuts or ice, or very sticky foods like candy. And don’t use your teeth to open packages or chew your fingernails (please!). If your crown chips or breaks, call your dentist right away.

Types of dental crowns: permanent and temporary

In discussing your dental crown procedure, your dentist may have mentioned “temporary” and “permanent” crowns. Here’s the difference.

What is a temporary crown? 

Temporary crowns are designed to be worn for 2-3 weeks while a permanent crown is custom-made for your mouth.

It’s important that your tooth is protected and doesn’t sustain further damage after it’s prepared. That’s where a temporary crown comes in. Although you’ll only wear it for a short amount of time, it’ll protect your newly-prepared tooth (and keep your mouth looking and feeling good) until your permanent crown is ready.

If your temporary crown falls off or is damaged, contact your dentist right away. They will get you in for a dental appointment right away to reattach or replace it.

What is a permanent crown? 

A permanent crown is designed to be worn for decades. These types of crowns are carefully produced in a dental laboratory based on precise measurements of your tooth. Permanent crowns perfectly mimic the shape and color of your natural teeth.

Because permanent crowns take a week or so to make, you’ll wear a temporary crown in the meantime. When the permanent crown is ready, you’ll return to the dental office for a quick procedure to securely attach it.

Dental Crown FAQs

What are the advantages of getting a crown? 

Dental crowns are a relatively straightforward way of restoring the appearance, structure and function of teeth that have been damaged due to injury or decay. They play a crucial role in alleviating pain and discomfort associated with damaged teeth. Because they are custom-made to your mouth, porcelain crowns generally look, feel, and fit like your natural teeth.

What are the disadvantages of getting a crown? 

If your tooth has an issue that’s serious enough for a crown, there isn’t a downside. Dental crowns are a necessary restorative treatment vital to restoring and maintaining the health of your mouth. Though they’re more costly than a filling, they’re also meant to treat more advanced decay and damage.

Is it painful getting a crown?

“We’ll numb your mouth completely before we begin the process,” explains Dr. Chris Salierno, “so crowns don’t hurt at all. Your tooth may feel a bit sensitive for a day or two after, but that will fade.”

Is a dental crown necessary after a root canal treatment? 

If you’ve had a root canal, a dental procedure where diseased or damaged pulp in the center of your tooth is removed, your dentist may recommend a dental crown.

While dental crowns are not always required after root canals, in most cases, they’re the best course of action.

Root canal therapy stops the infection and prevents further damage, but the treated tooth still requires additional support. Back teeth, such as molars and premolars, take the brunt of chewing and grinding, so they almost always require a crown for long-term protection. Front teeth don’t face the same pressure, so a crown may not be strictly necessary for strength, but many people still choose one to improve appearance and restore a natural look.

Ultimately, a crown will protect your tooth and restore its original strength. It can also minimize any sensitivity and give your tooth a normal, natural appearance.