Dentures
Will Dental Insurance Cover Crown Replacement?
If you’re dealing with a cracked, chipped, or broken dental crown, you’re probably wondering about the cost of replacement and whether your insurance will cover it. You’re not alone—this is one of the most common questions we hear from patients at our Oakville dental practice.
The good news? Dental insurance typically covers crown replacement when it’s medically necessary. However, the specifics can vary significantly depending on your plan, the reason for replacement, and how long you’ve had your current crown. Let’s break down everything you need to know about dental crown replacement coverage.
Understanding Dental Crowns: What They Are and Why You Need Them
posted by Burloak Centre Dentistry
A dental crown is essentially a custom-made cap that fits over your entire tooth, restoring its shape, strength, and appearance. Think of it as a protective helmet for your tooth—it covers and protects the natural tooth structure underneath.
At Burloak Centre Dentistry, we recommend crowns for several situations:
- Severely decayed teeth where fillings won’t provide adequate support
- Cracked or fractured teeth that need structural reinforcement
- After root canal therapy to protect the weakened tooth
- To anchor a dental bridge for missing teeth
- Covering dental implants as the visible portion of the restoration
- Protecting worn-down teeth from grinding or erosion
- Improving severely discolored or misshapen teeth
Types of Dental Crown Materials
Modern dentistry offers several crown materials, each with unique benefits:
Porcelain or Ceramic Crowns: These are the most popular choice for visible teeth because they match your natural tooth color perfectly. They’re biocompatible, durable, and stain-resistant—ideal for anyone with metal sensitivities.
Porcelain-Fused-to-Metal (PFM): Combining strength and aesthetics, these crowns have a metal base covered with porcelain. They’re strong enough for back teeth but can show a metal line at the gum line over time.
Gold or Metal Alloy Crowns: While not aesthetically pleasing for front teeth, these are extremely durable and gentle on opposing teeth. They’re often used for molars where strength matters more than appearance.
Zirconia Crowns: The newest option combines the strength of metal with the appearance of porcelain. These are becoming increasingly popular due to their durability and natural look.
The Crown Replacement Procedure: What to Expect
Understanding the procedure can help ease any anxiety about crown replacement. Here’s what you can expect at our Oakville dental office:
Initial Consultation and Examination
During your first visit, we’ll thoroughly examine your damaged crown and the tooth underneath. We’ll take X-rays to assess the tooth’s root and surrounding bone structure. This helps us determine if simple crown replacement is sufficient or if additional treatment is needed.
Tooth Preparation
Once we’ve confirmed you need a crown replacement, we’ll numb the area with local anesthetic to keep you comfortable throughout the procedure. We’ll then carefully remove the old crown and examine the underlying tooth structure.
If the tooth is healthy, we’ll reshape it slightly to accommodate the new crown. If there’s decay or damage, we’ll address that first—this might involve filling material to build up the tooth or, in some cases, root canal therapy.
Taking Impressions
We’ll take detailed impressions of your prepared tooth and the surrounding teeth. These impressions are sent to a dental laboratory where skilled technicians will craft your custom crown to match your natural teeth perfectly.
Temporary Crown Placement
While your permanent crown is being made (typically 2-3 weeks), we’ll fit you with a temporary crown to protect your tooth and maintain your appearance. You’ll need to be gentle with this temporary restoration—avoid sticky or hard foods and be careful when flossing around it.
Final Crown Placement
When your permanent crown is ready, you’ll return to our office. We’ll remove the temporary crown, clean your tooth thoroughly, and check the fit and color of your new crown. Once we’re both satisfied with how it looks and feels, we’ll permanently cement it in place.
We’ll check your bite to make sure everything feels comfortable and natural. You might need a brief adjustment period, but most patients adapt to their new crown within a few days.
How Much Does Crown Replacement Cost?
The cost of dental crown replacement in the Oakville and Burlington area typically ranges from $1,000 to $1,800 per crown. This variation depends on several factors:
- Material choice: Porcelain and zirconia crowns tend to cost more than metal crowns
- Location of the tooth: Front teeth requiring more aesthetic work may cost more
- Complexity of the case: Additional procedures like build-ups or root canals increase costs
- Laboratory fees: High-quality dental labs charge more for superior craftsmanship
- Dentist’s experience and expertise: Specialists may charge different fees
It’s important to remember you’re not just paying for the crown itself. The fee covers the examination, preparation, impressions, temporary crown, lab fees, and the final placement—essentially two to three appointments and weeks of lab work.
Will Dental Insurance Cover Crown Replacement?
Here’s the question everyone wants answered: Yes, most dental insurance plans do cover crown replacement, but with some important conditions.
When Insurance Typically Covers Crowns
Insurance companies generally cover crown replacement when it’s deemed medically necessary. This includes situations like:
- Your crown is cracked, broken, or has fallen off
- The crown is failing and causing decay underneath
- You’ve had a root canal and need a crown to protect the tooth
- Your tooth is severely decayed and a crown is necessary to save it
- Your crown is causing pain or bite problems
Most dental plans classify crowns as a major restorative procedure, typically covering 50-80% of the cost after you meet your annual deductible. However, every plan is different, so it’s crucial to verify your specific coverage.
When Insurance Won’t Cover Crowns
Insurance typically won’t cover crown replacement in these scenarios:
- Cosmetic reasons: If you simply want to replace a crown because you don’t like its appearance and it’s functioning properly, insurance likely won’t cover it
- Too soon after the last crown: Many insurance plans have a replacement clause, often requiring 5-10 years before they’ll cover a new crown on the same tooth
- Pre-existing conditions: Some plans won’t cover issues that existed before your coverage started
- Annual maximum reached: Most plans have annual maximums ($1,000-$2,000), and if you’ve already used this, you’ll pay out of pocket
How to Maximize Your Insurance Benefits
Here are some strategies to get the most from your dental insurance:
Get a pre-authorization: Before proceeding with crown replacement, ask our office to submit a pre-authorization to your insurance company. This provides a written estimate of what they’ll cover, so there are no surprises.
Timing matters: If you’re close to your annual maximum, consider whether waiting until your benefits renew makes sense. However, don’t delay necessary treatment—damage can worsen.
Understand your plan year: Knowing when your benefits renew and your deductible resets can help you plan expensive procedures strategically.
Check if you have unused benefits: Many people don’t use their full annual maximum. If you’re nearing the end of your plan year with unused benefits, it’s a good time to address needed dental work.
What If You Don't Have Dental Insurance?
Don’t let a lack of insurance prevent you from getting the dental care you need. At Burloak Centre Dentistry, we understand that dental costs can be a concern, which is why we offer several options to make treatment affordable:
Flexible Payment Plans
We work with our patients to create payment plans that fit their budgets. Instead of paying the full amount upfront, you can spread the cost over several months, making it much more manageable.
Third-Party Financing
We partner with healthcare financing companies that offer low-interest or interest-free payment plans for dental procedures. These programs often approve patients who might not qualify for traditional credit cards.
Dental Savings Plans
Consider joining a dental savings plan—an alternative to traditional insurance. You pay an annual fee and receive discounted rates on dental procedures. For patients who need multiple procedures, this can result in significant savings.
Government Programs in Ontario
Depending on your situation, you might qualify for government-assisted dental programs:
- Ontario Seniors Dental Care Program: For low-income seniors 65 and older
- Healthy Smiles Ontario: For children and youth from low-income families (17 and under)
- Ontario Works and ODSP: May cover emergency dental services
While these programs have specific eligibility requirements, they can provide substantial help for those who qualify.
How Long Do Dental Crowns Last?
With proper care, dental crowns can last 15-25 years or even longer. The longevity of your crown depends on several factors:
- Oral hygiene: Regular brushing, flossing, and dental visits are essential
- Material quality: High-quality materials last longer
- Habits: Grinding your teeth, chewing ice, or using teeth as tools can damage crowns
- Diet: Excessive consumption of hard or sticky foods can affect crown longevity
- Location: Back teeth endure more chewing force than front teeth
Signs Your Crown Needs Replacement
How do you know when it’s time to replace your crown? Watch for these warning signs:
Visible Damage
If you notice cracks, chips, or pieces breaking off your crown, it’s time for a replacement. Even small cracks can let bacteria reach the tooth underneath, leading to decay.
Crown Feels Loose
A crown that feels loose or wiggles when you touch it with your tongue needs immediate attention. The cement may have worn away, leaving your tooth vulnerable.
Pain or Sensitivity
New sensitivity to hot, cold, or pressure around a crowned tooth could indicate that the crown is failing or that decay has developed underneath. Don’t ignore this symptom—schedule an appointment right away.
Gum Changes
Dark lines at your gum line or receding gums around the crown could signal problems. These might indicate that the crown’s metal is showing through or that gum disease has developed.
Bite Problems
If your bite feels off or the crown feels higher than your other teeth, the crown may have shifted or the cement may have deteriorated.
Decay or Bad Breath
Persistent bad breath or a bad taste around the crowned tooth, especially after thorough brushing, might indicate decay underneath the crown.
Caring for Your Dental Crown
Extending the life of your crown is straightforward with these care tips:
Brush twice daily with fluoride toothpaste, paying special attention to the gum line where the crown meets your natural tooth.
Floss daily around your crown just as you would natural teeth. This prevents gum disease and decay at the crown margins.
Avoid hard foods like ice, hard candy, and popcorn kernels that could crack the crown.
Don’t use your teeth as tools to open packages or bite your nails—this puts unnecessary stress on crowns.
Wear a night guard if you grind your teeth. Grinding can crack crowns and wear them down prematurely.
Visit us regularly for checkups and cleanings. We’ll monitor your crown’s condition and catch potential problems early.
Address problems immediately. If you notice any issues with your crown, don’t wait for your next scheduled appointment—call us right away.
Alternatives to Crown Replacement
Depending on your situation, there might be alternatives to complete crown replacement:
Crown Repair
Small chips or minor damage sometimes can be repaired with composite resin rather than replacing the entire crown. This is less expensive and can be done in a single visit.
Onlays or 3/4 Crowns
If your tooth doesn’t require full coverage, an onlay or partial crown might work. These are more conservative options that preserve more of your natural tooth structure.
Veneers
For front teeth where the issue is primarily cosmetic and the tooth is structurally sound, a veneer might be an option instead of a full crown.
During your consultation at Burloak Centre Dentistry, we’ll discuss all your options and recommend the best solution for your specific situation.
Why Choose Burloak Centre Dentistry for Crown Replacement?
When it comes to something as important as crown replacement, you want to feel confident in your dental team. Here’s what sets our Oakville practice apart:
Experienced and caring team: Our dental professionals have years of experience with crown procedures and stay updated on the latest techniques and materials.
Quality materials: We use only high-quality dental materials and work with reputable dental laboratories to ensure your crown looks natural and lasts for years.
Patient-centered approach: We take time to explain your options, answer your questions, and make sure you’re comfortable with your treatment plan.
Flexible financing: We offer various payment options to make dental care accessible, regardless of your insurance situation.
Convenient location: Serving Oakville and Burlington, we’re easily accessible with convenient appointment times to fit your schedule.
Comprehensive care: From preventive care to advanced restorative treatments, we provide all the dental services your family needs under one roof.
Frequently Asked Questions About Crown Replacement
How long does the crown replacement process take?
Typically, crown replacement requires two appointments spread over 2-3 weeks. The first appointment involves examination, tooth preparation, impressions, and temporary crown placement (about 90 minutes). The second appointment is for permanent crown placement (about 60 minutes).
Is crown replacement painful?
No, crown replacement shouldn’t be painful. We use local anesthetic to numb the area completely before working on your tooth. You might feel some pressure during the procedure, but you shouldn’t experience pain. After the anesthetic wears off, you might have mild sensitivity for a few days, which is normal.
Can I eat normally with a temporary crown?
You’ll need to be careful with your temporary crown. Avoid sticky foods (gum, caramels), hard foods (nuts, ice), and try to chew on the opposite side of your mouth. The temporary crown is held with weaker cement so it can be easily removed when your permanent crown is ready.
Will my new crown look natural?
Absolutely. Modern dental materials, especially porcelain and zirconia, are designed to match the color, translucency, and shape of your natural teeth. We’ll work with you to ensure your crown blends seamlessly with your smile.
What happens if I delay crown replacement?
Delaying necessary crown replacement can lead to serious problems. A damaged crown exposes the tooth underneath to bacteria, increasing the risk of decay and infection. The tooth could fracture further, potentially requiring extraction. What might start as a simple crown replacement could become a much more complex and expensive problem.
How much of crown replacement will my insurance cover?
Most dental insurance plans cover 50-80% of crown costs for medically necessary replacements after your deductible is met. However, coverage varies significantly by plan. We recommend requesting a pre-authorization so you’ll know exactly what to expect before treatment begins.
Can I replace my crown with a whiter shade?
Yes, when replacing a crown, you can choose a whiter shade. However, keep in mind that if you’re replacing just one crown among natural teeth, you might want to consider teeth whitening first to brighten your natural teeth, then match your crown to your new, brighter smile.
Take the Next Step
If you’re dealing with a damaged crown or have questions about crown replacement and insurance coverage, don’t put off getting the care you need. The team at Burloak Centre Dentistry is here to help you navigate your options and find a solution that fits both your dental health needs and your budget.
We’ll work directly with your insurance company to maximize your benefits and provide transparent cost estimates before beginning any treatment. Our goal is to make quality dental care accessible to all our patients in Oakville and Burlington.
Have Questions?
If you’re unsure what counts as a dental emergency, how to prevent urgent issues, or what to do if one occurs, our team at Burloak Centre Dentistry is here to help. Contact us anytime — we’re happy to answer your questions and guide you through protecting your smile
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