Questions about Dental crowns

chromanoid

thanks toothsmith, thats all i really wanted to know. I didnt know if situation was same as implants.

Don't want them taking tooth out if there are ways to save.

binkyb

I am considering having my front 4 teeth crowned on recommendations for 3 dentists. BUt as raised in this thread previously I am worried about the gum like going grey. At the moment I have two crowns futher back, along the bum of the private one my gume is very greay, not so near the other nhs one. I am not saying this has anything to do with one being private though.
Out of interest why does the gum turn gray? There is no way I want my front 4 teeth crowned if that's going to happen!
Am also considering going abroad for treatment. Have read bad and good things and would welcome opinions. I can't afford the £3k of treatment I've been advised I should have and am having second thoughts after reading this thread (and hearing what private dentists say) re going NHS.

Toothsmith

binkyb wrote: »

Out of interest why does the gum turn gray?

I'm sorry, but this is the only bit of that post I can make any sense out of! A bit of punctuation would help.

The gum around crowns goes grey because of how light passes through the tooth. If the tooth is covered with a material that doesn't let the light through very well, then the tooth underneath the crown looks much darker.

If the edge of the crown is only just at, or slightly above gum level (Which is really the ideal place for the edge to be) then you can sometimes just see a tiny bit of the tooth below the crown, and that bit of tooth will look darker - hence the grey looking gum.

Some materials for crowns make this more likely to happen, such as metal bonded porcelain crowns which let no light through at all (These are mostly used on back teeth, although they can be used on front teeth especially if there is a strong bite, and the patient can't afford the more expensive castable ceramic crowns).

Pure porcelain crowns are cheap to provide and are a bit better when it comes to grey edges, but aren't very strong in a heavy bite.

There are also bad reasons why an edge may not be visible. Sometimes in order to hide the edges, dentists put the edges quite a way below gum level. This can look brilliant, but the crown going so deeply down irritates the gum and eventually leads to gum recession and the tooth looking very long - This is an example of the difference between good and bad dentistry only becoming visible after several years.

Also, edges may not be visible because they are not very close fitting and have caused the gum to become swollen, and the swollen gum covers the edge - again, this is not good, but only becomes a problem after several years.

Poor toothbrushing around crowns can also mean that swelling hides the edge.

I'm not sure which one of these will apply to you without seeing you, but hopefully it will give you an overview of some of the reasons for it happening.

randomdemon

I need a crown for a broken tooth, it currently has temp filling in and I go back on the 27th to get this sorted and a crown decided on then, what is available on the NHS? Our dentist are both NHS and private, I know you can't get the composite on NHS, this doesn't really bother me, i'm just a bit paranoid about the mercury in the amalgam ones. My mum had a gold filling done on the NHS years ago, so are they available instead or only in specific circumstances? Why was she given a gold one instead of amalgam? What is my crown likely to be made of on the NHS?

I have had 2 fillings before, both NHS, both were amalgam but they didn't take and as they were on my very back molars and I still didn't have my wisdom teeth I had them removed but all the while I had terrible migraines and they went as soon as the teeth and fillings did, i'm sure it's just co-incidence linked to the bad teeth, but hence why i'm a bit apprehensive about getting more. I need convincing they are 100% safe I guess. Or what are my chances of getting gold ones on the NHS instead?

My dentist is lovely but so so busy that she hasn't had time to talk it over with me properly yet although I am booked in for an hour on the 27th so have to wait to then to discuss it properly with her.

Would I be better off paying extra for private, even though i'm not bothered about the cosmetics of it? Just money is tight atm and I really don't want to be paying more than I absolutely need to, so much so that I have even considered just having it pulled, which I really do not want.

Thanks in advance.

chromanoid

Hi Toothsmith,

Just a further question - if the majority of the tooth above gumline, such as the outer edges are chipped or broken off, but the root of the tooth is ok, is it the case a post crown would be appropriate? I take it that the whole point of the post is because because there wouldn't be enough tooth above gumline for a normal crown to hook onto?

I just want to ensure i don't have a tooth removed that could be saved.

Thanks

Toothsmith

You only really need 2-3mm of tooth above the gum to be able to make a decent crown.

To put a post into a root, you first need to root fill the tooth (although I've sen a fair few where this essential step has been overlooked! :rolleyes:).

Root filling a tooth makes it more prone to fracture (The root breaking in this case) which would then be the end of the line for the tooth.

There are many pros and cons that the dentist, on consultation with the patient, need to weigh up before deciding the most appropriate way to go. It's rarely 'black and white'.

chromanoid

Thanks Toothsmith

Have seen the dentist and i am pretty worried.

She took x-rays - said both teeth could probably be crowned (porcelain bonded to metal .. am worried about the metal showing but the upper chipped tooth is at side back so she said shouldnt show anyway) - but in the x-ray of the lower tooth she said one of the roots has infection and the bottom of it isnt visible - so if she did the root canal and couldnt find the root she would have to pull the tooth straight awat. Infact she said a lot of my roots on some teeth were hard to see in x-rays.

Its one of my main back teeth, dont wanna lose it. If shes unsure i would rather get someone who knows what will happen before they do it and skilled enough if its tricky, or worst case save for an implant if it really had to come out.

It wasn't the most updated dentist, just my old family one, and they just had a standard old X-Ray. I wonder if maybe i go to a better dentist who has the digital or panoramic x-rays it might be better for them to see? I am currently on NHS as claim working tax credits but i would be prepared to save and pay for better treatment and not lose my teeth if thats the better option.

Toothsmith

Ask for a referral to a specialist endodontist if you want the best chance of saving the tooth.

Being referred somewhere by your own dentist is a better way than finding one yourself. Choosing the dentist with the flashiest toys isn't always a guarentee that the dentist is any good!

Capitano

I wonder if someone could clarify the 2 month rule. My NHS dentist has said that I need to have a program of having several crowns fitted as it is now difficult to keep patching up my teeth. I asked how much this would cost, and his reply was £198 per crown. He suggested that if money was tight I could have one done every 3 months. I understand that fitting a crown involves two appointments within a couple of weeks of one another, the first to measure up etc etc and the second to fit the crown. Under the two month rule both appointments are covered by the single fee.

My question is - if I had TWO crowns done within the 2 month period, would this cost £198 or twice that? Ie is the cost on a per crown basis or on a max cost of £198 per 2 months basis? And, if I could get 2 two crowns for £198, would the dentist lose out financially or is he reimbursed by the NHS?

Toothsmith

Capitano wrote: »

I wonder if someone could clarify the 2 month rule. My NHS dentist has said that I need to have a program of having several crowns fitted as it is now difficult to keep patching up my teeth. I asked how much this would cost, and his reply was £198 per crown. He suggested that if money was tight I could have one done every 3 months. I understand that fitting a crown involves two appointments within a couple of weeks of one another, the first to measure up etc etc and the second to fit the crown. Under the two month rule both appointments are covered by the single fee.

My question is - if I had TWO crowns done within the 2 month period, would this cost £198 or twice that? Ie is the cost on a per crown basis or on a max cost of £198 per 2 months basis? And, if I could get 2 two crowns for £198, would the dentist lose out financially or is he reimbursed by the NHS?

He is speaking complete bo()ocks, and milking you and the system.

If you NEED several crowns then you are entitled to them in ONE treatment for ONE charge of £198.

He is not doing you a favour by doing one every couple of months, he is maximising the funding points he can milk out of your mouth.

This deserves a very strong complaint to your PCT as he's not just going to be doing this to you.

I would ring up the practice and make it very clear that you are aware that the rules state that you are entitled to any number of crowns for a single 3198 charge, and that you will complain if he doesn't provide them.

If he then agrees to provide them, then get them done (although frankly I wouldn't trust this character with my lunch, never mind my teeth) and complain afterwards.