Same-day crowns vs lab crowns: a working dentist’s view
A same-day crown saves the patient a visit, and a lab crown brings a technician’s hand. Here is how a practice that does both decides which to use.
By the Tusko team
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A same-day crown and a lab crown are two good answers to different questions. One saves the patient a visit. The other brings a technician’s hand to the work.
A practice with a mill does not choose one for good. It chooses case by case.
This guide sets out how each route works, what each gives the patient, and how a practice that does both decides.
What each crown gives the patient
Two columns compare the crowns from the patient’s side. A same-day crown means one visit, one anaesthetic, no temporary and the finished crown in place before the patient leaves, at the cost of a longer visit. A lab crown brings a technician’s skill, a wider choice of materials, time for a hard case and a custom shade visit for a front tooth, at the cost of two appointments with a temporary in between.
A same-day crown
Saves the patient a visit
- Yes: One visit
- Yes: One anaesthetic
- Yes: No temporary
- Yes: The finished crown in place before they leave
- No: A longer visit, with a wait while the crown is made
A lab crown
Brings a technician’s hand to the work
- Yes: A technician’s skill
- Yes: A wider choice of materials
- Yes: Time for a hard case
- Yes: A custom shade visit, for a front tooth
- No: Two appointments, with a temporary in between
How each route works
| Step | Same-day crown | Lab crown |
|---|---|---|
| Preparation | The tooth is prepared and scanned | The tooth is prepared, then scanned or impressed |
| While the patient waits | The crown is designed and milled in the practice | A temporary is made and fitted |
| Who makes it | The dentist and team, with a mill | A dental technician, at a lab |
| Time to the final crown | The same visit | The lab’s schedule, plus delivery |
| Seating | Before the patient leaves | At a second appointment |
Dr. Joel Gaudet, the dentist who founded Tusko, does both in his own practice. He mills same-day crowns, and sends front teeth, implants and dentures to labs.
He is direct about the appeal of one visit:
“Nobody wants two needles if they can do it in one.”
Dr. Joel Gaudet, Wave Dentistry
Labs still make a great many crowns. In a 2017 survey of 1,777 US dentists, 88% said a commercial lab made most of theirs, and 9% used in-office milling.
What a same-day crown gives the patient
One visit. No second appointment, and no second afternoon off work.
One anaesthetic. The tooth is numbed once.
No temporary. There is nothing to come loose over a fortnight, and nothing to avoid chewing on.
An immediate result. The patient leaves with the finished same-day crown in place.
For a patient who travels far, or finds dental visits hard, those four things can decide it.
There is a cost in the chair. The one visit is longer, and the patient waits while the crown is made.
What a lab crown gives the patient
A technician’s skill. A ceramist can layer porcelain and build in the small variations that make a tooth look natural.
A wider choice of materials. A lab works with materials and methods that a chairside mill does not.
Time for a hard case. A technician can study the scan, ask a question and take a second look.
A custom shade visit. For a front tooth, the patient can be seen by the person making the crown.
A lab also sees many more cases of each kind than a single practice does, and that shows in the unusual ones.
The patient pays for this in visits. There are two appointments, with a temporary in between.
Where each one fits
No rule suits every dentist. This table shows how the choice often falls.
| Situation | Often chosen | Why |
|---|---|---|
| A single back tooth, straightforward | Same-day | The shape is simple and the shade is forgiving |
| A front tooth beside a natural one | Lab | Matching it needs layering and a trained eye |
| A bridge, or several teeth together | Lab | More design, and more to check |
| An implant crown | Lab | Parts and connections add steps |
| A patient who cannot return easily | Same-day, where the tooth allows | One visit is worth a great deal |
| A very full day at the practice | Lab | A long appointment may not fit |
The first row and the second are the clearest. The rest depend on the dentist’s experience with their own equipment.
What a dentist weighs for each tooth
- How visible the tooth is when the patient smiles
- How much room the bite leaves for the material
- What the crown will bite against
- Whether the patient can easily come back
- How full the day already is
No single answer decides it. A back tooth in a patient who lives two hours away points one way, and a front tooth in a patient next door points the other.
What it does to the schedule
A same-day crown changes the shape of the day.
Two shorter appointments become one long one. The room is in use for the whole of it.
The dentist is busy for the design, and free while the crown is milled and finished.
That can work well. A dentist can see a hygiene patient or a short visit in the gap.
It can also crowd a busy day. Three long appointments in a row leave little room for an emergency.
Some practices keep same-day crowns to certain half-days, so the long visits do not land on the busiest ones.
A lab crown spreads the work. The cost is the second visit, and the risk that the case is not back for it.
How to protect chair time when lab cases run late covers that risk.
What it asks of the team
Same-day work moves the lab’s job into the practice.
- Design. Someone has to design every crown. That takes training, and practice.
- The mill. It needs burs, blocks, cleaning and calibration.
- A backup. On a day the mill is down, cases need somewhere to go.
- Remakes. A crown that does not fit is made again on the spot, in the practice’s time.
Check who may design and finish a restoration in your province. That is a question for your regulator.
A lab crown asks for something else: a complete Rx, a good scan and a date. Our dental lab prescription checklist covers the first.
What each one really costs
The lab’s fee is the visible cost of a lab crown. The second appointment is the hidden one.
The block is the visible cost of a milled crown. The equipment, the design time and the longer visit are the hidden ones.
Neither is cheaper for every practice. In-house dental lab vs outsourcing shows how to work out a break-even point.
Why a practice that mills keeps its labs
Buying a mill does not end a practice’s work with labs. It changes which work is sent.
The simple cases stay in the building. The cases that go out are the harder ones: front teeth, bridges, implants and dentures.
That makes the lab relationship matter more. Every case sent is now one where the detail counts.
Designing crowns yourself also shows how much a thin Rx leaves out. Dentists who mill tend to write a fuller one.
- Send more with each case: photos, the stump shade and a clear Rx
- Tell the lab which work you now keep, so it can plan
- Keep one lab for the work it does best, and say so
Shade communication with your dental lab covers the front-tooth cases in particular.
Keep track of both kinds
A same-day crown needs no tracking. It is finished before the patient stands up.
Everything else does. A lab crown has a date, a temporary and an appointment waiting on it.
Work that is milled or printed for a later visit sits in between. It never leaves the building, and it can still be forgotten.
Note on the list which route each crown took. After a few months it shows where each one worked best.
Put every case that is not finished the same day on one list. How to track dental lab cases in your practice covers how.
For the lab cases, Tusko keeps the Rx, the scans and every message on one case that the practice and the lab both open.
See how it looks for practices.
Does a same-day crown need a temporary?
No. The crown is designed, milled and seated in the same visit, so there is nothing to wait for and no temporary to wear.
How long is a same-day crown appointment?
Longer than a preparation visit, because the design and the milling happen while the patient is there. It replaces two appointments with one. Ask the practice what it books for the visit.
Why do practices with a mill still use a lab?
Because some work needs skills and materials a chairside mill does not offer. Front teeth with custom shading, longer bridges and many implant cases are common examples.
Is a milled crown as good as a lab crown?
That depends on the tooth, the material and the case, and it is a judgement for the treating dentist. Both routes use ceramics made for the purpose.
Sources
Related guides
An in-house dental lab pays off with steady volume, someone to run it and a use for the speed. Here is how to weigh it against sending work out.
A few consistent photos tell a dental lab what a scan cannot. Here is the set to take, how to take a shade photo, and how to send them with the case.
A smile trial lets a patient see and feel planned veneers before any tooth is prepared. Here is how the mock-up is made and what the lab needs.