Dental Crown Treatment
A dental crown (also known as a cap) is a protective shell which a dentist manufactures and places over damaged teeth to strengthen them.
Why do I need a Crown?
A crown is used in situations where the structural integrity of a tooth has been weakened. This is frequently as a result of extensive decay, the need for a large filling, or accidental damage. Crowns are also used as part of the bridgework process; they are the method by which a bridge can be fixed in place.
Alternatives to Crowns
In some cases, damage to a tooth can be repaired by a cavity filling, but this is only possible when the tooth retains a viable structure. It is likely that the dentist has decided the tooth is beyond this stage if he or she is recommending a crown. The crown offers many advantages over the cavity filling, but one of the principle ones is that the crown is designed and manufactured away from the consulting room. With a filling, the dentist has to create and shape the material directly in the patient's mouth, meaning that they have less control over how the tooth ends up appearing; the crown, on the other hand, is shaped to fit the tooth, jaw and patient's bite perfectly.
Diagnosing the need for a Crown
Your dentist will usually treat a decayed tooth with a filling first (this is known as intracoronal restoration)- he or she will only diagnose the need for a crown if the tooth's structure is so damaged that extracoronal (literally, "outside the tooth") restoration is the only possibility. This will be determined during the initial consultation.
What is involved in fitting a Dental Crown?
Firstly, the dentist prepares the tooth concerned, by shaping it so that the crown can be fitted. This may involve removing some of the outer surface, or building up the core of the tooth with filling material. In cases of serious damage, it may be necessary to insert a post into the tooth so that the crown can rest upon it and remain stable.
After the tooth is prepared, an impression of the patient's teeth is taken, so that the bite can be measured accurately. The colour of the surrounding teeth can also be noted so that the crown can be made to match (in cases where a porcelain crown is being used). The patient then makes a second appointment while the crown is designed by a dental technician- the dentist may provide a temporary crown while the final one is being prepared.
There are many different types of crown available, depending on the location of the tooth or the patient's preference (please note that not all of these choices may be available through the NHS). The following are some of the options:
- Porcelain bonded to precious metal crown.
- All-porcelain crown: made from porcelain alone. Excellent aesthetic results and very suitable for front teeth.
- Porcelain and composite crown: made from a combination of two different materials. Can look the most natural in certain cases.
- Glass crown: made from glass alone. Excellent, natural appearance.
- Precious metal crown: made from gold and palladium. Very strong and hard-wearing but have poor aesthetics (they're visible in your mouth just as amalgam fillings are).
When the crown is manufactured, the dentist will check that the colour matches (if applicable), and set it in place using dental cement.
Cost of Dental Crowns
In Britain, dental work can be carried out through the NHS, or the patient has the option to go for private treatment at a higher expense. In September 2007, fitting a crown on the NHS cost £194, though this is unlikely to include crowns made from some of the more expensive materials. Our figures indicate that the average cost of fitting a crown through private treatment is £391.
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"Someone wanted my opinion on dental charges that had been quoted. I felt the quote was right based on the changes I knew the government had imposed. Your dental web pages have been very informative and I have passed on the web address so that the person can make a personal check - which I am sure will allay any fears and, from the various information available, provide answers to other queries. A very informative site!"
"I work in a dental laboratory and make minimum wage, why because we get paid peanuts, we work long hard hours and to make any money we have to make crowns and dentures as fast as possible which always lets down the quality. Now most NHS work is being sent abroad to China, India, Philippines etc, because the dentists can get the laboratory work cheaper - do they pass on the savings to the patient - is the patient getting the best crown (or do you know what you are getting)? Lots of questions, but I keep hearing people say they are being fleeced because dental care is costly, well supply cost is high to the profession, normally surgeries have to pay higher leasing rates because the surgery has to be near the town centre etc. But I am quite amazed that people do not blink at paying £5.00 for a pack of fags 5-6 times a week or spending £200 on a new outfit or £100 at the beauty salon etc, but spend money on your teeth, or health, oh my we are being fleeced. How about take out dental insurance. I love being a dental technician, but I am giving up this profession because I cannot support my family, thank you NHS and thank you all who feel they are being fleeced."
"What cosmetically, is the difference between a nhs crown and a porcelain crown? need my front tooth done and want it to look as natural as possible"
"the dentist told me i need acrown before that i need a root filling the pain releaf did not work, to me indecateing an infection in the gum he sent me to a private unit which would cost me 500 pounds bit of a scam me thinks"
"I was quoted £332 for a crown by my dentist, who seemed to feel this was cheap. This was confirmed by another local practice who said they would charge £450! I do not feel this is cheap, nor acceptable, but considering NHS dentists are now so few and far between something I have had to accept. I plan to put myself on the waiting list for a practice who is accepting NHS dentists. It's not as if my dentist (Dr Raspberry we call her) is very nice anyway."
"i\'m on maternity exemption at the moment & need a crown. I asked to have one that wasn\'t gold as it\'s partly visible but was refused. Is this correct, are there no alternative materials used on the NHS ????"
"Please help me. I had root canal treatment over 18mths ago and have not had any problem with it other than the tooth coming away. Here's the catch the dentist who performed the treatment was recently struck off as he was exposed by The Sun newspaper for practicing without disclosing his HIV status. I visited the surgery today and say another dentist that basically slated the work of the previous dentist and said that I need further root canal treatment plus a crown which I would have to do privately at a cost of £344.60. Is this right as I cannot afford such extortionate charges."
"Juliet, I think you should find a cheap dentist (or even see if you can get in at your local dental hospital for treatment - if you sign up for a university hospital or dental school and agree to be worked on by dental students, you can have work done for absolutely nothing. I work at and have dental work done at Leeds Dental Institute by the students for free and they're very competent. The alternative is to find a cheaper dentist who will agree to prep your tooth, make an impression and fit the crown if you buy your own direct from a dental lab. I do work experience at York Dental Laboratory and they charge only around £30 for a standard NHS porcelain/metal crown. It's the dentists that just like to take their cut, that's how they get so rich."
"Help! I've just been told I 'need' a crown for a broken back tooth and have been quoted £198 on the NHS! I'm not in any pain and had no idea there was a problem until this routine check up! I feel I've been 'had'. The dentist (part of a practice & he couldn't speak very good English) has never seen me before and has taken it upon himself to reject my timid suggestion of finding other, cheaper treatments, in favour of fleecing me for something I do not need nor can afford! Needless to say, I refused the treatment, saying it would be cheaper to extract the tooth, if and when, I felt it necessary. I was made to feel ashamed and stupid when he requested my refusal was to be noted on my records! "