Questions about Dental crowns

alison999

to get something done on the nhs there has to be a clinical need for it. did you ask why hes saying you cant have it done now but agreed to it last year? and why didnt you get them done last year when he'd ok'd it?

saucygirl

Thx for the reply. I did ask him - he said the dentists are losing money on nhs. Last year, when he said it could be done on the nhs he was persuading me very strongly against it & wasn't happy to do it, he said it wouldn't be a very good job as anybody would be making the crowns & it would be better done privately coz then we'd know who'd made them. He said today I could go to another nhs dentist & they'd be able to do it on nhs, but they wouldn't want to treat me again as I'd have cost them money. My current dentist does pick & choose his patients since the new regulations came in & I'm still not sure if he was implying he wouldn't treat me in future because I've asked about my crowns.

Toothsmith

As Alison said, the NHS is there to provide dental treatment that is necessary. If your crowns aren't decaying around the edges, then replacement isn't necessary. How they LOOK is a cosmetic issue.

What the dentist is doing though is completely against the wording of his NHS contract. He cannot pick and choose what he does on the basis of cost. It must be on the basis of need.

If he said last year that he could replace them on the NHS, then I would take that further with the PCT.

If he agrees to do them on the NHS, then the quality of the treatment is still HIS responsibility. He can't stick something on, say "Oh - that's cr£p" and excuse it by it being NHS. He can still be sued if he provides bad treatment.

In reality, that means that if the crown is a poor fit, or keeps falling off, then it's a bad crown and he should make a better one.

If the colour doesn't quite match, or if it looks slightly different to the others, that isn't a function issue, and is probably because it was made by the trainee technician for the sake of cost. That is acceptable to the NHS.

On the whole though, if this dentist didn't like the NHS contract, he shouldn't have signed it and he should have taken his chances in the world of fully private dentistry. If he's taking a big cheque from the taxpayer every month, he should play by the rules that go with that money.

alison999

I agree with Toothsmith, the only thing I can add is that lab technicians (sp?) do take more time when making private crowns/bridges/dentures etc, they also charge the dentist more for this but the outcome can be well worth it. £380 seems a good price PER crown, if you were only having one done Id say save a bit more and opt for the private one but as its two i understand it is really expensive.

If you do CLINICALLY need them doing, have another chat with your dentist, tell him you understand that working on the nhs may be difficult but as a nhs dentist he must provide all treatment that his patients CLINICALLY require on the nhs.

hethmar

saucy, if you can possibly afford it, do have them done privately and not by this man who sounds most unsympathetic. My private crowns, you honestly couldnt tell the difference - my old NHS was an embarrassment. The porcelain on my private ones even have little indentations that match my own - they look so natural that people are always complimenting me on my good teeth (! - I dont tell most of them the truth). So please do try to get the best it will give you so much more confidence.

Good luck.

absfabs

Had a root canal filling on a broken tooth last year, dentist suggested it would need a crown, but to wait at least 6 months to make sure everything had settled down.

Now I have been given the options of a metal NHS crown for approx £200 or a white one for £250. I asked if the metal one would be a gold as I had one of them >10yrs ago and it's lasting well. Was told no, too expensive on the NHS, it would look similiar but "not so goldy".

Should have asked for pictures, but of course didn't think of this at the time. It's for a first molar, so would be visible only when laughing out loud :rotfl: :rotfl: or very wide smiles .

I'm not sure what to do, the price difference is not very big, but money isn't ample at present. If it was a front tooth, of course I would go for the white/tooth coloured crown, but the gold crown I already have in same position opposite really doesn't bother me.

Any ideas if a new NHS one would look worse?

Toothsmith

It will be a non-precious silver coloured one.

Very 'soviet' in appearence.

Having to provide these on the NHS was the reason I left the NHS is 1998.

absfabs

Thanks Toothsmith.

Any difference in durability?

Is the white coloured one some plastic or porcelain?

saucygirl

Thank-you so much everyone for your replies & very helpful & reassuring comments. I do feel I should have them done privately & probably elsewhere as he hasn't left me feeling too confident how they'll end up now if he does them, which is bizarre considering my son & I have always been really happy under his care, although I've only ever had a filling done by him, thinking about it, but we've always felt confident of his work. These new regulations seem to changed a lot of things, him included & not for the better unfortunately.

If I was to have them done elsewhere, am I able to return to him for the standard yearly check-ups or not thou'?

Toothsmith

No - it's a metal alloy with no precious metals in it. Nickel and tin mainly I think.

Bear in mind that most people who can't wear certain earrings, can't wear them due to tolerance problems with the nickel.

Most people who develop white marks on their tongues next to 'mercury' fillings - it's nothing to do with the mercury, but the nickel that's in the filling material as well.

Durability is probably OK - it's biocompatability that's the possible problem.