Understanding the Procedure, Risks, and What to Expect

That uncomfortable feeling when you’re told you need more dental work on a tooth that already has a crown is pretty common. You might worry about pain, money, or if your crown will be ruined. Maybe your dentist said they might drill through your crown, and you’re thinking, “Can you even do that? Will it mess up the crown? Will I need to pay for a new one?” If you’re wondering about these things, you’re not alone. Here’s the good news: modern dentistry has ways to fix things, and you’re in the right place to learn about them.

Can a Dentist Drill Through a Crown? (The Direct Answer)

Let’s answer the main question right away:

Yes, a dentist can drill through a dental crown—and sometimes, it’s actually the best idea. This might sound strange at first, but let’s keep going.

Crowns are meant to protect and fix teeth. But sometimes, big problems like infection, deep decay, or a failed root canal happen under the crown. Instead of taking off the whole crown (which is hard, takes a lot of time, and can cost a lot), your dentist can make a small hole in the crown itself to fix the tooth inside. This saves your crown—and saves you money and trouble.

But like lots of things in dentistry, it’s not always this simple. Whether your crown can—and should—be drilled depends on things like: why you need the treatment, what your crown is made of and how old it is, how skilled your dentist is, and what matters most to you, like cost or how it looks.

Sound complicated? Don’t worry. We’ll go through the reasons, steps, and what you need to think about.

Why Would a Dentist Need to Drill Through a Crown?

Let’s look at some of the most common reasons a dentist would choose to drill through a crown. Knowing why your dentist wants to do this can help you feel better about the choice.

1. Root Canal Treatment or Retreatment

Think of your crowned tooth like a little castle. Sometimes, problems happen inside—like the nerve or tissue gets infected. The only way to fix it is to clean out the infection with a root canal.

If your crown is still in good shape, your dentist can make a small “door” (a hole) through the top so they can treat the infection and keep the crown in place. This is normal when:

The infection starts after you’ve had the crown for a while.
A past root canal didn’t work and needs to be redone.

2. Fixing Decay Under the Crown

Crowns are strong, but not perfect. Decay can sneak in at the edges, where the crown meets your real tooth. If the cavity is pretty small, your dentist can drill through the crown, clean out the bad part, and fill the spot—without putting on a new crown.

3. Putting In a Post (To Help Support the Tooth)

Sometimes, especially after a root canal, your dentist needs to put in a tiny rod inside the tooth for extra support (kind of like adding a support beam in a house). The best way might be to do this through a little hole in your crown.

Quick Check:

Dentists don’t drill through the crown for every problem. They’ll look at things like:

How bad is the infection or decay?
How old, strong, and what type is your crown?
How important is it to keep the look just right?

If your crown is still good, a drilled and fixed crown can last many more years!

How Drilling Through Crowns Is Done (The Step-by-Step Process)

Ever wonder what really happens when your dentist does this? Here’s the process, from start to finish.

Step 1: Figuring Out What’s Wrong

Dentists ask about any pain, swelling, or if your tooth is sensitive. They also look at X-rays to find out if you have:

An infection inside the tooth,
Decay hiding under the crown,
Or some other trouble.

They’ll also figure out what your crown is made of, since different types are drilled differently. Is it:

Porcelain Fused to Metal (PFM)?
All-Ceramic (like e.max, zirconia, or feldspathic)?
Gold or another metal?

Step 2: Making You Comfortable

You’ll get a shot to numb the area. Most people say this is “easier than they thought.” They might put a rubber sheet (called a dental dam) to keep the spot clean and dry.

Step 3: Making the “Access Hole”

The dentist uses tiny drills to make an opening right through the top (chewing side) of the crown.

Water is sprayed to keep things cool, so the crown or tooth doesn’t get too hot.
The dentist tries to make the hole as small as possible to keep the crown strong.

It’s more like doing delicate work on a tiny space than just drilling a big hole.

Step 4: Treating the Tooth Inside

If it’s a root canal:

The dentist takes out any bad tissue, cleans out the inside, shapes it, then fills it to seal it up.

If it’s a cavity:

The decay is cleaned out, and the hole is filled with a tooth-colored material (composite resin, just like normal fillings).

Step 5: Fixing and Sealing the Crown

When the treatment is done, the dentist patches up the opening using modern materials and skill:

The hole is filled with strong, tooth-colored resin.
For front teeth, they’ll work to match the color so it’s hard to see the repair.
It’s polished and smoothed so it works and looks as good as before.

A well-fixed crown usually feels no different from before—at least, after the numbing goes away!

What Are the Risks of Drilling Through a Dental Crown?

It’s normal to wonder about any risks. Here’s what’s most common:

1. Crown Damage:

Chipping or Breaking:

Crowns made of porcelain or ceramic are nice but a bit brittle, so there’s a small chance the crown could chip or break when being drilled—especially if it’s older or has tiny cracks already.

Weakened Crown:

Any hole makes the crown a little less strong. If you bite really hard on it, that spot might be weaker than before.

2. How Long Will It Last?

Might Not Last As Long:

Most crowns fixed this way last for many years, but sometimes not quite as long as a crown that’s never been drilled.

One study found 60–70% of these crowns are still working fine five years later[^1].

3. Looks

Color Match:

The filling usually looks a lot like the crown, but getting a perfect match on the front teeth can sometimes be tricky.

Staining:

The new filling might not stay as white as the crown, so after a while you might see a faint line or spot.

4. How Good Is the Repair?

Not all repairs are the same. It depends on:

How skilled your dentist is,
What materials they use,
How big and where the hole is.

5. When Should You Just Get a New Crown Instead?

Sometimes getting a new crown really is better:

If the decay is really big or the tooth underneath is weak,
If the crown is already worn out, loose, or cracked,
Or if how your front teeth look is super important for you.

The Good News

The chance of a really bad break while drilling is low—less than 5% based on recent studies[^2]—especially if your dentist has experience. And if something does go wrong, you can always get a new crown.

[^1]: Clinical Oral Investigations, 2020 Study.

[^2]: Dental Materials Journal, 2019.

What Happens After? Outcomes and Aftercare for a Drilled Crown

So, your crown was drilled and fixed—now what?

Right After the Treatment:

You’ll probably have a bit of sensitivity, especially when eating or drinking hot or cold things.
Your mouth might feel a little sore from the tools or the numb shot.

How to Care for Your New Repair:

Eat soft foods and try not to chew on that side for a day or so.
Brush and floss gently, but keep it clean to prevent problems.
Your dentist may suggest using a fluoride mouthwash.

Looking Forward

Most people don’t notice any difference in their daily life. Eating, smiling, and talking should be just like before!
Be sure to have regular dentist visits so they can check the repair and catch any problems early.
Most crowns fixed this way work well for years—a recent survey says about 90% of people are still happy after a few years[^3].

What to Watch Out For

Call your dentist if you notice:

Pain or swelling that won’t go away,
The filling in the crown comes loose or falls out,
Cracks, chips, or weird colors around the fixed spot.

These could be signs of a problem like infection or a crown that’s breaking.

[^3]: Patient Experience Survey, 2022.

Common Questions About Drilling Through Crowns (FAQ)

Q: Will it hurt?

A: Don’t worry—dentists use strong numbing, so you won’t feel pain while the tooth is being worked on. Some soreness after is normal, but it goes away, and you can take basic pain meds if needed.

Q: How long does a fixed crown last?

A: A good repair usually lasts for years, and sometimes almost as long as a crown that’s never been drilled—especially if you take care of your teeth. If the repair is big, or if you bite down really hard, it might not last quite as long.

Q: Will my crown look the same?

A: Most of the time, yes! Dentists work hard to get the filling to match your crown’s color and feel. For back teeth, it really doesn’t matter much. If it’s a front tooth, make sure to tell your dentist looks are important to you.

Q: Is it always better to repair a crown instead of getting a new one?

A: Not always. If the crown is really old, damaged, or is super important for your smile, getting a new one might be better. Your dentist will help you decide what’s best for you.

Key Takeaways and Your Next Steps

To sum up, here’s what you should remember about drilling through a dental crown:

Dentists often drill through crowns—it’s safe and saves money—especially when there’s infection or decay under the crown.
It lets you keep your crown, so it takes less time, hurts less, and costs less than getting a new one.
Most people don’t notice any difference after, once it’s fixed.
Bad stuff like cracks or ugly repairs can happen, but it’s not common.
Taking care of your teeth and seeing your dentist often is the best way to keep your repaired crown (and the rest of your mouth) healthy.

If you still have questions about your own tooth, the next step is easy—make an appointment with your dentist or an endodontist (root canal specialist). Bring this article if you want—it can help spark good questions and get you the best care.

Bonus: Who’s a Good Candidate for Drilling Through a Crown?

This method works great for:

People with crowns that are still strong and not too old who need a root canal or little repair.
Folks whose crowns aren’t cracked or falling apart at the edge.
Anyone who wants to keep their old crown and not spend too much.
People who don’t mind a small, well-matched patch on their crown (most of the time, you can’t even see it!).

It’s not so good if:

There’s a big area of decay under the crown,
Your crown is really old or loose, and might not survive drilling,
You care a lot about having a perfect-looking smile in the front—sometimes a new crown is better there.

Real World Dentistry: Simple Examples and Modern Materials

Think of your crown like a helmet for your tooth. If something goes wrong inside, you don’t have to throw the helmet away—just make a small opening to fix it.

Dentists use up-to-date materials (like tooth-colored resin) to fix that tiny opening so it’s strong and looks good. It’s just like fixing a small hole in the wall—if you use the right stuff, nobody will know it was there.

Dental technology keeps getting better! Digital labs and things like strong zirconia crowns mean longer-lasting, natural looking crowns and repairs. If you want to see how these crowns are made, check out this digital dental lab or learn more about crown materials at china dental lab.

Still Have Questions?

Remember, you are the one who knows your health best. Don’t be shy about asking:

For your dentist to explain all your options and what’s good or bad about each.
To see some photos of similar cases.
How much it’s going to cost, how strong it will be, and how to look after it.

In dentistry, just like in life, knowing what’s going on is half the battle.

The Healthier Smile Mindset

Act quickly: Small tooth problems never fix themselves. If a crowned tooth hurts or swells, get it checked out right away.
Trust your dentist: Drilling through a crown can sound scary, but it’s safe and normal in the right hands.
Talk openly: Tell your dentist your worries and what matters most to you. They’re here to help.

Summary – Fast Facts

Dentists can drill through crowns to fix infection or decay underneath, saving you time and money compared to getting a new crown.
The process works well and most people are happy with the results—when done by a good dentist.
Risks (like chipping or a repair that doesn’t match) can happen, but they’re not common.
Regular checkups and treating new issues early will keep your fixed tooth healthy for years.

Sources include research from top dental journals and surveys. If you want to see more about how crowns are made or fixed, see dental ceramics lab for a look at the work behind your dental care.

Take charge of your oral health. The best smile is a happy, pain-free one—and you’re the one in control!

Can a Dentist Drill Through a Crown?

In This Article

Can a Dentist Drill Through a Crown? (The Direct Answer)