Strong, Natural-Looking Crowns, From £115 Per Tooth

What Is a Metal-Supported Porcelain Crown?

A metal-supported porcelain crown (also called a porcelain-fused-to-metal or PFM crown) is a dental restoration that fits over a damaged or weakened tooth to restore its shape, strength, and appearance. It consists of a strong metal base (typically a biocompatible alloy) covered with layers of tooth-coloured porcelain.

The metal substructure provides exceptional strength and durability, making PFM crowns particularly well-suited for back teeth (molars and premolars) where biting forces are greatest. The porcelain outer layer is shade-matched to blend with your natural teeth, giving the crown a natural appearance.

PFM crowns have been the workhorse of restorative dentistry for decades. They are reliable, long-lasting, and well-proven. While newer all-ceramic options (such as zirconium crowns) offer slightly better aesthetics for front teeth, PFM crowns remain an excellent choice for back teeth and situations where maximum strength is the priority.

The process typically requires two appointments over 3 to 5 days. At the first appointment, your tooth is prepared and an impression is taken. A temporary crown is fitted while the dental laboratory handcrafts your permanent crown. At the second appointment, your permanent crown is tried in, adjusted, and cemented into place.

Am I a Good Candidate?

A metal-supported porcelain crown may be recommended if you have:

• A tooth that is cracked, broken, or severely worn and needs structural reinforcement
• A tooth with a large filling that does not have enough natural tooth remaining to support a new filling
• A tooth that has had root canal treatment and needs protection from fracture
• A dental implant that needs a crown placed over it
• A bridge that requires strong supporting crowns (abutments)
• A tooth that needs improved shape or alignment for functional or cosmetic reasons

PFM crowns are particularly well suited for back teeth where strength is more important than perfect translucency. For front teeth where cosmetic appearance is the top priority, your dentist may recommend an all-ceramic or zirconium crown instead. Your dentist assesses each tooth and recommends the most appropriate type of crown for its position and function.

What Happens During Your Treatment?

Appointment 1, Preparation (45-60 Minutes)

Your dentist numbs the tooth with local anaesthesia. The tooth is carefully shaped (prepared) by removing a thin layer of enamel from all surfaces to create space for the crown. A detailed impression of the prepared tooth is taken, either with a traditional mould or a digital scanner, and sent to the dental laboratory. Your dentist selects a porcelain shade that matches your natural teeth. A temporary crown is fitted to protect the tooth while your permanent crown is being made.

Between Appointments (3-5 Days)

Your permanent crown is handcrafted in the dental laboratory. The metal substructure is cast and the porcelain is layered and fired to create a strong, natural-looking restoration. You can eat and function normally with your temporary crown, just avoid sticky or very hard foods.

Appointment 2, Fitting (30-45 Minutes)

Your temporary crown is removed and the permanent crown is tried in. Your dentist checks the fit, bite, colour, and shape, making any adjustments needed. Once you are happy with everything, the crown is permanently cemented into place. You leave the clinic with a strong, natural-looking restoration.

Recovery and Aftercare

Once your permanent crown is cemented, there is no recovery period. You can eat and use the tooth normally straight away.

Immediately after: If anaesthesia was used during the fitting appointment, avoid eating on that side until sensation returns (1 to 2 hours). Once the numbness wears off, you can eat normally.

First few days: Your tooth and gum may feel slightly sensitive as they adjust to the new crown. This is completely normal and settles within a few days. If your bite feels uneven, contact your dentist for a minor adjustment.

Ongoing care: Treat your crown like a natural tooth. Brush twice a day, floss around the crown daily, and keep up with regular dental check-ups. Good oral hygiene prevents decay at the junction where the crown meets the natural tooth.

Longevity: A well-made metal-supported porcelain crown typically lasts 10 to 20 years, and many last even longer with good care. Avoid using your teeth to open packaging or bite very hard objects (ice, bone, hard sweets), as this can chip the porcelain.

Risks and Considerations

PFM crowns are one of the most well-established and reliable dental restorations. Risks are minimal.

Sensitivity: Temporary sensitivity to hot and cold is common in the days after crown placement, especially if the tooth was alive (not root-treated). This usually settles within a week or two.

Porcelain chipping: In rare cases, the porcelain layer can chip if subjected to excessive force. The metal substructure remains intact, and the porcelain can often be repaired. Avoiding very hard foods reduces this risk.

Metal margin visibility: Over time, if the gum recedes slightly, a thin grey line at the gum margin may become visible where the metal substructure meets the tooth. This is a cosmetic issue rather than a functional one, and is more noticeable on front teeth, which is why all-ceramic crowns are often preferred for the smile zone.

Allergic reaction: Very rare. The metal alloys used are biocompatible, but patients with known metal allergies should inform their dentist. Alternative alloys or all-ceramic crowns can be used.

Decay: The crown itself cannot decay, but the natural tooth underneath can if oral hygiene is poor. Good brushing and flossing at the gum margin is essential.