Why does a tooth have to be prepared for a crown?
What patients call “grinding down” or “shaving” a tooth is known in dentistry as preparation: the outer surfaces are reduced with fine rotating instruments by as much as the planned crown needs in thickness.
A zirconia crown covers the tooth like a cap, and that cap has a thickness of its own. On an unprepared tooth it would be too bulky and would meet the opposing teeth too early when you bite. According to Cleveland Clinic, removing enamel makes room for the crown and helps it stay firmly in place after cementing; the patient leaflet from Cork University Dental School & Hospital describes the same thing.
A crown is not the first choice for every tooth. According to Bristol Dental School, crowns are mainly considered for teeth that have lost a lot of tissue to decay or fracture, and after root canal treatment. The starting condition of the tooth also determines how much is removed.
How much tooth tissue is removed?
There is no single figure that applies to everyone. The amount depends on the position of the tooth, existing fillings and fractures, your bite, the discolouration to be covered and the material. The differences between zirconia and other ceramics are explained in our guide Zirconia or porcelain crowns.
For a sense of scale: the review by Vanlıoğlu and Kulak-Özkan (2014) cites a study on front teeth in which preparing for a veneer, which covers only the front surface, removed 3 to 30 per cent of the tooth by weight, a quarter to a half of what a crown that covers the whole tooth requires.
The same review points out that the enamel of incisors is only 0.3 to 0.4 millimetres thick at the gum line, so even half a millimetre of reduction there can expose the dentine underneath. Dentine is more sensitive than enamel.
Can the preparation be reversed?
No. Enamel and dentine do not grow back. Bristol Dental School therefore describes the preparation of supporting teeth for a bridge as an irreversible procedure, and the same applies to single crowns. Cleveland Clinic likewise stresses that most veneers cannot be reversed.
In practice this means that a tooth prepared for a crown will always need a crown. If the crown fails, it is replaced, but the tooth does not return to its original state. For healthy teeth where appearance is the only concern, options that remove less tooth should therefore be discussed first.
What is the “Turkey teeth” debate about?
“Turkey teeth” is a colloquial term for conspicuously white, uniform crowns, often placed on largely healthy teeth that were heavily prepared, usually during a trip abroad. The Royal College of Surgeons of Edinburgh (RCSEd) sums up the core problem: quick cosmetic fixes with veneers, crowns or bridges may be unnecessarily invasive in relation to the underlying teeth, often requiring the removal of excessive sound tooth tissue. It adds that poor post-treatment care for complex work causes difficulties, since aftercare from a distant clinic is sometimes advice only.
A British Dental Association (BDA) survey of 1,000 UK dentists found that 86 per cent had treated patients who developed problems after treatment abroad, that crowns (87 per cent) and implants (85 per cent) were the treatments most likely to need follow-up work, and that dentists reported over-prepared teeth and ill-fitting crowns among the problems. The General Dental Council advises talking to your own dentist before going abroad, asking plenty of questions and not committing on the day if the answers do not satisfy you.
The problem is not the country but the indication. A crown on a badly broken-down or root-treated tooth is medically justified; it becomes a problem when healthy teeth are crowned purely for colour or shape although options with little or no tooth removal exist. Ask any clinic, including us, why a crown is planned for each individual tooth and what the alternative would be. More on this in our guide How to choose a dental clinic in Türkiye.
Which options remove less tooth?
Depending on the condition of the tooth, there are options that cost less or no tooth tissue:
- Whitening: If colour is the only concern with healthy teeth, professional whitening at the clinic is often the first step (see teeth whitening); it does not change the shape of the tooth.
- Composite bonding: Tooth-coloured filling material built up directly on the tooth can reshape it or close a small gap. According to the American Dental Association, composite veneers usually need less enamel removed than porcelain and are easier to repair, but stain and wear more readily.
- Veneers: A thin ceramic shell for the front surface of the front teeth. According to Vanlıoğlu and Kulak-Özkan, minimal-preparation veneers remove about 0.1 millimetres at the gum line, 0.2 to 0.5 in the middle of the tooth and 0.7 to 1.0 millimetres at the biting edge; Cleveland Clinic notes that no-prep veneers exist but may still involve some enamel removal. More in our guide Veneers or zirconia crowns.
- Onlay: According to Bristol Dental School, it is similar to a crown but covers only the biting surface; Cleveland Clinic sees it as an option for teeth too damaged for a filling but too healthy for a crown.
- Filling: If the loss of tissue is limited, a filling is enough.
- Orthodontics: For healthy teeth that are crowded or rotated, moving them can spare tooth tissue.
What do you feel during and after the preparation?
The preparation is usually carried out under local anaesthetic; according to the Cork leaflet, more anaesthetic can be given if you feel sensitivity during the procedure. After the crown is fitted, Cleveland Clinic says some sensitivity to heat and cold for a few weeks is normal, and the gum may be slightly sore for a few days.
In some teeth the preparation can affect the nerve. Bristol Dental School puts the risk that the nerve of a living tooth becomes inflamed and dies at about 20 per cent; Cork gives 10 to 20 per cent. Root canal treatment is then needed, rarely an extraction. For treatment abroad this means: ask beforehand how such a case is handled after you return home. If sensitivity increases rather than fades, or if throbbing pain or swelling develops, see a dentist near you promptly and let us know.
What is the temporary crown for?
While the final crown is made in the laboratory, an acrylic temporary crown protects the prepared tooth, according to the Cork leaflet. Cleveland Clinic gives two to three weeks for the laboratory stage; how this is organised when you travel is explained in our guide How many visits do zirconia crowns take?.
A temporary crown is less robust than the final one. Bristol Dental School stresses that temporaries break easily and are not meant for long-term use; Cleveland Clinic advises avoiding very hard and very sticky foods during this time.
How do we plan crowns at Rönesans?
At the examination at our clinic in Serdivan we assess your teeth and gums, discuss your expectations and the alternatives, and choose the shade together with you. For healthy teeth where colour or shape is the concern, we first look at options with little or no tooth removal, such as whitening or composite; whether they are enough in your case is decided at the examination. We work with digital smile design, and if you wish, the planned tooth shape is shown on your teeth as a mock-up beforehand (see smile makeover). Impressions can be taken with an intraoral scanner, and crowns are made with CAD/CAM by the dental laboratory we work with. Root canal treatment, if needed, is one of the clinic’s fields.
For a preliminary assessment, send photos on WhatsApp to +90 532 363 49 54; during working hours we reply in English within 15 minutes. Before treatment starts, you receive a written treatment and cost plan that names the planned restoration for each tooth. When you leave, you receive a copy of your treatment summary and your X-rays for your dentist at home. The steps of treatment are on our zirconia crowns page and follow-up after your return under aftercare and follow-up.