Key takeaways
- The price of a dental crown and your out-of-pocket costs are not the same thing. Treatment needs shape the total cost, while plan benefits determine how that cost is shared..
- Network status, annual maximums, waiting periods and replacement rules can all change what you owe, even when dental crowns are listed as a covered benefit.
- A dental crown is more likely to qualify for coverage when it restores a tooth’s health or function rather than changing how it looks. This is because many benefit plans exclude cosmetic coverage.
You went in for a routine dental exam expecting everything to look good. Instead, your dentist tells you that one of your teeth needs a crown. Maybe you cracked a tooth without realizing it, or an old filling has failed and left the tooth too weak to support another filling. While your dentist is focused on saving your tooth, you’re probably thinking, “How much is this going to cost me?” Dental crowns can be expensive, and it’s not always easy to know what your dental insurance will cover.
Understanding when dental insurance might cover a crown, what affects your costs and what to expect before treatment can help you plan ahead.
What is a Dental Crown?
A dental crown is a custom-made “cap” that covers a tooth that’s been damaged by decay or fracture. It helps restore the tooth’s shape and strength while protecting it from future damage.
Think of a crown as a protective outer shell for a damaged tooth that helps you chew safely. Unlike a filling, which repairs just one damaged spot, a crown covers the entire tooth above the gumline. That extra protection is why your dentist might recommend a crown when a silver-colored amalgam filling or tooth-colored composite filling isn’t enough to save your natural tooth.
Common Reasons You Might Need a Dental Crown
You might need a dental crown if your tooth is too damaged or too weak for a filling to provide enough support while chewing. In many cases, the goal is to protect your tooth to prevent further damage or non-restorability.
Your dentist might recommend a dental crown if you have:
- A large cavity that leaves too little healthy tooth for a filling.
- A cracked or broken tooth that needs extra support.
- A tooth that’s worn down from grinding or everyday wear.
- A tooth that has had a root canal, which can make it more likely to crack.
- A dental implant that needs a crown.
- A dental bridge, which is a fixed appliance that replaces one or more missing teeth with a fake tooth or teeth anchored between crowns placed on adjacent teeth.
Not every damaged tooth needs a crown. If the damage is small, a filling or another treatment might be enough. Your dentist will look at how much of the healthy tooth is still there before recommending the treatment that’s right for you.
Older Adults Are More Likely to Have Dental Crowns
Dental crowns can be needed at any age, but the chances of needing restorative dental care can increase as you get older.
Your teeth have had more time to experience everyday wear, cavities and previous dental work.
Did you know?
More adults are keeping their natural teeth longer. That’s a good thing, but it can also mean caring for teeth that have already been filled, repaired or treated over the years. If one of those teeth becomes too weak for another filling, a crown can help protect it and keep it working.
Older adults are also more likely to experience oral health problems such as gum disease and tooth loss, while tooth decay can continue throughout adulthood.
Understanding the Different Types of Dental Crowns
Not all dental crowns are the same. The best type of crown for you depends on a few things, like which tooth needs treatment, how much chewing it will do and the look you want. For example, a back tooth that does most of the chewing might benefit from a different type of crown than a front tooth that’s more visible when you smile. The good news is that dental crowns can help protect damaged teeth and keep them working for years to come.
Some of the most common types of dental crowns include:
- Porcelain or ceramic: Made to closely match the color of your natural teeth, making them a popular choice for front teeth.
- Zirconia: A durable, tooth-colored material that offers both strength and a natural appearance.
- Metal: Made from metal alloys that can withstand heavy chewing (or gold!) These crowns are often used on the back teeth because their color is more noticeable.
- Porcelain-fused-to-metal (PFM): Combines a strong metal base with a porcelain outer layer, so it’s both strong and looks natural.
- Resin: A tooth-colored option that may cost less than other materials but can wear down more quickly.
Each type of crown has its own advantages, and your dentist will recommend the type of crown that best fits your needs.
How Much Does a Dental Crown Cost?
Without insurance, a dental crown for an adult tooth may cost $1,500 to $2,300 per tooth. However, the crown itself is only part of the cost. Before placing a dental crown, a dentist might need to perform other procedures to prepare or treat the tooth.
For example, imagine you crack a molar while eating. During the exam, your dentist discovers the tooth has a deep cavity that has reached the blood and nerve supply of the tooth. Before placing the crown, you’ll first need a root canal to remove the damaged tissue. You may also need a buildup to strengthen the tooth if enough of the tooth is damaged from fracture or decay. Only then can the permanent crown be placed. In this situation, you’re paying for multiple procedures and not just for the crown itself.
The type of crown your dentist recommends also plays a role in the cost. Other factors can affect the total cost too. The location of the tooth, how much damage needs to be repaired and the complexity of the procedure can all make a difference. Because every tooth is different, the total cost of a dental crown can vary from person to person.
How Dental Insurance Typically Covers Dental Crowns
Dental insurance can help cover a crown when it is part of necessary dental treatment. That means the crown is being used to restore or protect a tooth affected by a cavity, a crack, a large filling or another issue that has weakened the tooth to the point that it can’t be restored with a basic restorative procedure (like a filling). A crown placed only to change how the tooth looks is less likely to be covered by dental insurance.
Most dental plans classify crowns as major restorative care, along with treatments used to repair or replace damaged teeth. Coverage usually works by splitting the approved cost between you and your plan rather than paying for the crown in full.
Still, seeing your crown coverage listed in your benefits doesn’t tell you exactly what you will pay. Your plan has its own terms for when a crown is covered and how much of the cost it will share.
What Can Affect Your Out-of-Pocket Costs?
Even when your dental insurance covers crowns, several factors can change how much you’d owe. Your plan can help with part of the cost, but details like your deductible, annual maximum and dentist’s network status can affect your out-of-pocket costs.
First, check how your plan covers major restorative care. This tells you how the cost is typically shared between you and your dental plan. If you have a deductible, you might need to pay that amount before your plan starts contributing.
Your annual maximum matters, too. That is the most your plan will pay toward covered dental care during the year. If you have already used part of it on other treatment, less might be available for your dental crown.
Did you know?
Visiting an in-network dentist can help with your total cost. In-network dentists agree to set fees with your dental plan, which can make your bill easier to predict. If you go out of network, you risk being responsible for a larger share of the bill.
Find an In-Network Dentist
Timing can make a difference as well. Some plans have waiting periods before they cover major services (which is just a category name in dental insurance) and others limit how often they will help pay to replace an existing dental crown.
To avoid too many surprises, ask your dentist for a pre-treatment estimate. It can give you a clearer idea of what the plan can pay and what you’d likely owe. It’s not a guarantee of payment, but it can make it easier to plan for.
Finding the Right Delta Dental of Arizona Plan
A dental crown might not be top of mind when you choose a dental plan. But when a routine exam uncovers a cracked tooth or large cavity, coverage for major services can suddenly matter.
If you have dental insurance through your employer, your dental crown benefits depend on the plan your employer selected. If you’re shopping for yourself or your family, Delta Dental of Arizona offers Individual and Family plans designed for different needs and budgets.
Comparing your options can help you find the right plan that supports the care you use today and the treatment you might need later.
Frequently Asked Questions
Yes, but coverage varies by plan. Dental insurance plans often help cover crowns when they are needed to restore or protect a damaged tooth. Crowns are often classified as major restorative care, so your plan can pay part of the covered cost rather than the full amount.
Yes! Some Delta Dental of Arizona plans include coverage for crowns and other major dental work. With several plan options to choose from, you can shop for the right individual dental plan that fits your needs and budget at deltadentalaz.com/shop-for-plans.
The amount dental insurance pays for a crown depends on your specific plan. Your coverage level, deductible, annual maximum and any plan limits can all affect how much the plan pays and what is left for you.
A dental crown might not be covered if your plan excludes major restorative care, a waiting period hasn’t ended, or the treatment doesn’t meet the plan’s coverage requirements. Limits on replacing an existing crown or reaching your annual maximum can also affect coverage. Keep in mind that most dental plans consider crowns placed for cosmetic reasons “optional” and generally will not share the cost in that case.
Dental insurance can cover a replacement if the existing crown is damaged, failing or old enough to meet the plan’s replacement rules. Some plans limit how often they will help pay for a new crown, so check the frequency requirements in your benefits.
Dental insurance can cover a crown after a root canal if both treatments are included in your plan and considered necessary for the tooth. The root canal and crown are separate procedures, so they might have different coverage levels, waiting periods or out-of-pocket costs. Keep in mind that not all root-canaled teeth require a full-coverage crown afterward. Generally, even after a root canal, a tooth must still be damaged by decay or a fracture to the point that it can’t be restored with an amalgam or resin restoration for the crown to be covered by your dental plan.
Some dental insurance plans cover implant-supported crowns, but implant coverage varies widely. Check whether your plan covers both the implant and the crown because they are separate parts of the treatment and can be subject to different limits.
Dental insurance usually doesn’t cover a crown placed only for cosmetic reasons, which is to improve the appearance of a healthy tooth. Coverage is more likely when the crown is needed to restore the tooth’s health, strength or function when decay or a fracture makes the tooth unable to be restored with a basic filling restoration.
Yes. The type of dental crown can affect the total treatment cost, but coverage depends on the terms of your plan. Your plan might base its payment on the covered crown or material it considers appropriate, which could leave you responsible for an additional cost if you choose a more expensive option.
Ask your dentist to send a pre-treatment estimate to your dental carrier before the crown is placed. The estimate can show what your plan can pay and what you’d likely owe, although it is not a guarantee of final payment.
