What Happens During a Dental Crown Procedure — And Is It Really That Scary?
By Dr. Elizabeth Wakim, DDS·2026·9 min read·Enhanced Wellness — Washington, PA
Nervous about a dental crown? Dr. Liza Wakim walks through every step — what you'll feel, what takes longest, and what's easier than you expect.
Of all the procedures patients tell me they're nervous about, dental crowns come up more than almost anything else. And when I ask what specifically they're worried about, the answers are usually some version of the same thing: they don't know what's going to happen, and the not-knowing is the worst part.
That's the most common source of dental anxiety I see in my practice — not pain, not needles, not the sound of the drill. It's the uncertainty. Not knowing what to expect, how long it will take, what you'll feel, and what you'll look and feel like when it's over.
So let me just tell you. All of it, step by step, the same way I'd explain it to a patient sitting in my chair before we start.
2
Appointments — that's all it takes
1–2 hrs
Appointment one — the longer of the two
30–45
Minutes — appointment two, much easier
First — Why Crowns Exist
A dental crown is a cap that fits over the entire visible portion of a tooth, from the gumline up. It's used when a tooth needs more protection or structural support than a filling can provide — after a root canal, when a tooth is cracked or significantly decayed, when an existing filling has failed and there isn't enough healthy tooth structure left to place a new one, or when a tooth has become so weakened that it needs to be fully covered to function safely.
A crown restores the tooth's shape, size, strength, and appearance. Once it's placed, it looks and functions like a natural tooth — you bite with it, chew with it, brush and floss around it the same way you would any other tooth.
A preservation outcome — not a bad one
Patients sometimes come in feeling like a crown is a bad outcome. It isn't. The goal of a crown is always to save a tooth that would otherwise be lost or continue to deteriorate. It's keeping a tooth that's worth keeping.
Appointment 1
Preparation
~1–2 hours
1
Anesthesia
The area is numbed thoroughly before anything else begins. You should feel pressure, not pain.
A thin, uniform layer is removed from the outer surface to create space for the crown.
3
Impressions or scan
A digital scan or mold captures the exact shape needed to fabricate your permanent crown.
4
Temporary crown
A temporary crown is placed to protect the tooth while the permanent one is made — typically 1–2 weeks.
Appointment 2
Permanent placement
~30–45 minutes
1
Temporary removed
The temporary is taken off and the tooth is cleaned in preparation for the permanent crown.
2
Fit and bite check
The permanent crown is tested for fit, contact, and bite before anything is cemented.
3
Permanent cementation
Once everything checks out, the crown is bonded permanently. Edges are cleaned, bite confirmed.
4
You're done
Mild sensitivity for a few days is normal. Most patients are back to normal within a week.
What Actually Happens, Appointment by Appointment
Appointment One: Preparation
The first appointment is the longer of the two, typically lasting one to two hours depending on the complexity of the tooth. This is where most of the dental crown procedure happens.
1
Anesthesia first
Before anything else, I numb the area thoroughly. The anesthetic injection itself is brief, and once it takes effect, you shouldn't feel pain during any of what follows. Pressure, yes. Vibration, sometimes. Pain, no. If at any point you feel something sharp, I want to know immediately.
2
Reshaping the tooth
I reshape the tooth to create space for the crown — removing a thin, uniform layer from the outer surface on all sides. A drill is used for this, which produces sound and vibration. The sound, I'll be honest, is not the most pleasant. The sensation, with proper anesthesia, should be pressure without pain.
3
Impressions or digital scan
Once the tooth is prepared, I take either a traditional impression or a digital scan to capture the exact shape of the prepared tooth and surrounding teeth. This is what the lab uses to fabricate your crown to precise specifications.
4
Temporary crown placement
Before you leave, I place a temporary crown over the prepared tooth. It protects it while your permanent crown is being made — typically one to two weeks. Avoid sticky foods and chewing heavily on that side during this window.
After appointment one
Once anesthesia wears off — usually two to four hours later — it's common to have some soreness around the tooth and gum tissue. This is normal and settles within a day or two. Over-the-counter ibuprofen handles it comfortably for most patients.
The Two-Week Window
While the lab fabricates your permanent crown, you go about your normal life. Most patients forget they're even in a temporary after the first day or two. If the temporary comes off, call us and we'll re-cement it. Don't leave the prepared tooth uncovered for long.
Appointment Two: Permanent Crown Placement
The second appointment is considerably shorter — typically 30 to 45 minutes — and for most patients, much more comfortable than the first.
1
Removing the temporary
I take off the temporary crown, clean the prepared tooth, and check the fit of the permanent crown before cementing anything.
2
Checking the fit and bite
You'll bite down on articulating paper so I can see exactly how the crown meets your opposing teeth. Minor adjustments are common at this stage — getting the bite right before cementing is much easier than adjusting it after.
3
Permanent cementation
Once everything checks out, the crown is bonded with permanent dental cement. I clean up the edges, check the bite one more time, and that's it. The tooth is restored.
The Parts That Are Genuinely Uncomfortable — And the Parts That Just Seem That Way
Being direct about discomfort
I'd rather prepare you accurately than reassure you vaguely. Here's what's actually uncomfortable vs. what just sounds worse than it is.
The injection is the part most patients find most unpleasant — but it's brief. We can apply a topical anesthetic first to numb the surface before the injection. If needle anxiety is significant for you, tell me before we start.
The sound of the drill is unpleasant. It sounds like more than it is. With proper anesthesia, preparation should feel like pressure and vibration, not pain. Headphones and music help more than most patients expect.
The impression (if traditional rather than digital) can feel uncomfortable for patients with a strong gag reflex. Tell me if that's you — there are techniques to help, and a digital scan is often a more comfortable alternative.
The temporary occasionally causes mild sensitivity, especially to cold. This is manageable and temporary — the prepared tooth underneath is slightly more exposed than usual.
What is not particularly uncomfortable for most patients: the actual reshaping once numb, the waiting time with the temporary, and the second appointment.
The Question I Hear Most
"Will it feel like my real tooth?" — Yes. Once any post-placement sensitivity settles, a well-made, well-fitted crown should feel entirely normal. Patients who've had crowns for years often can't remember which tooth it's on without checking their records.
Frequently Asked Questions
The procedure itself should not be painful — the area is thoroughly numbed before anything begins. You may feel pressure and vibration during tooth reshaping, but not pain. If you do feel something sharp at any point, it's important to signal immediately so the anesthesia can be adjusted. Some soreness after the appointment is normal and typically manageable with over-the-counter ibuprofen.
With proper care, a well-placed crown can last 10 to 15 years or longer. Longevity depends on the material used, how well it was placed, and how well you maintain it — brushing, flossing, and avoiding habits like grinding or chewing on very hard things. Porcelain-fused-to-zirconia and full zirconia crowns tend to be particularly durable.
Call us as soon as you can and we'll re-cement it. Try not to leave the prepared tooth uncovered for long — it can cause sensitivity and, over a longer period, allow surrounding teeth to shift slightly. If it comes off in the evening, avoid chewing on that side and call first thing in the morning.
Minor bite adjustment is common and easy to address — it usually just requires a quick visit for a small polish on a high spot. Don't wait it out if your bite feels off after a week; call us and we'll take a look. It's a simple fix when addressed promptly and can become uncomfortable if left too long.
Yes — modern crown materials, particularly porcelain and zirconia, are designed to closely match the appearance of natural tooth structure, including color, translucency, and surface texture. Dr. Wakim will match the shade to your surrounding teeth so the crown blends naturally. Most patients find that after a short adjustment period, they're completely unaware of it.
The Procedure Is Manageable. The Outcome Is Worth It.
If you've been putting off a crown because you weren't sure what to expect, I hope this helps. If you're in the Washington, PA or Pittsburgh area and want to talk through what a crown would look like for your situation, I'm happy to have that conversation.
