Questions about Dental crowns

brook2jack

The dentist has tried to avoid root filling the tooth by trying everything else first. Sometimes (about 25% of the time) a tooth needs root filling after a crown even if there was no problem before.

If the tooth needs root filling then you will have to pay for it as it was not the dentists fault. However if the pain has reduced since fitting the crown root filling may not be necessary only the dentist will be able to tell you.

As to the strength of the crown ,and fillings after... it depends on what tooth it is, what sort of crown etc discuss this with your dentist.

If you had had the root filling to start with the tooth would have needed crowning anyway and from your description it sounds as if the dentist suspected you had a cracked tooth which normally settles with crowning.

Bobble72

Last night part of the back of a crown (front tooth) broke off. Can a crown be repaired and if so how effective is such a repair? Please advise.

coldstreamalways

It's hard to say without knowing exactly what sort of crown it is. You would almost certainly not be able to repair a porelain/metal crown if the porcelain had come away from teh metal substructure. If it is an all porcelain crown, it may be possible to use white filling material to fill the space left by the fracture.

Your dentist should look at what cause the crown to break as many causes of this will (without change in design) just cause the filling to break in the same way.

TBH I would only repair a crown as a short term measure as the wholt thing will probably break in the future, if you are happy to accept the risk then that would be ok. If (as when my crown broke) you're getting married in 3 months and don't want to risk the whole thing breaking the day before, I would probably get it replaced.

Hope that helps, excuse typing, have puppy trying to help!!

Toothsmith

As Coldstream said, it will depend on the crown, and just how much has broken.

There are systems that can re-bond porcelain to the underlying metal, but they are expensive to use and you're unlikely to get it done on the NHS, as replacement of the crown would be more cost-effective.

The systems are more useful in fixing bigger things like bridges that would be very expensive and damaging to replace.

If it's just a porcelain crown, (and at the front there's a good chance it is). Then replacement would probably be the only option.

worriedaboutteeth

Hey, I'm down in Portsmouth (uk) at the moment for Uni and I got dropped onto some pavement at night on Wednesday and smashed my front left tooth (number 9 I believe?) It shattered the bottom and was cut in two about half way down.

Thursday morning I managed to get an emergency appointment with a local dentist that I found and he got me booked in the next day (yesterday) to start prep work on a dental crown.


So Friday I went for the prep work. As he started the procedure he found the tooth was split a little up as well and said I was lucky to be able to save it. The whole procedure is going to cost £198 (standard NHS price for crowns?)

Knowing nothing about crowns at all I was going purely by his advice, I told him I didn't mind paying more to get the very best and wanted it to be as realistic as possible. So he advised me to get a metal bonded porcelain crown. He put a temporary cap on, which looks horrible and has started to come loose already... This is one day later, he's closed on the weekends too.

I've also been reading that because NHS Dentists only get £198 flatrate for a crown procedure they're forced to order in cheap crowns to pull a profit...




But what's on my mind is, I've been looking up dental crowns today and it seems that metal bonded ones are not a good choice at all for a front tooth because, while they might look OK on paper they look horrible in your mouth. They're darker because they don't let the light shine through and you can spot the difference. And most peoples gums recede which shows up the join of the metal / dark grey line or something.

I don't want to be ashamed of smiling in the future.

What exactly are the options crown wise? There's porcelain, metal bonded porcelain and I've heard about some "ceramic mould" thing?

I don't mind paying more to make sure I get a good tooth (I'm not rich, but it's my front tooth so I will pay out the !!! to sort it). but I know nothing about dentists or good places or the different options. Apparently there's even different levels of quality in those choices of porcelain ...

I'd like a crown that's stable obviously, snapping off at the slightest movement or normal food chew wouldn't be fantastic. However, I don't mind being careful with the tooth at all. I won't be tucking into blocks of toffee -- only reasonable food, meat, pastas etc. I don't smoke either.

But most importantly I want the tooth to look 100% real, not a single flaw. definitely not looking a different colour in light or growing to have some dark line on the gum within a year. I want to be happy to be able to smile again.

Please, any advice would be great!

Toothsmith

Matching up a single central incisor is about the hardest job there is.

The pair of the tooth is right next to it, and nomatter what system you go for, because it's not natural enamel and dentine, it will NEVER look exactly the same in all light conditions and close up.

You can get it very very very close, but not exactly the same.

I think you need to get in touch with the dentist ASAP, because if the bonded crown is made and put on, then it will be even more damage getting it taken off. Plus you'll be charged for it! You need to either discuss alternatives with this dentist, or get the treatment stopped before more expense is incurred and find a dentist who will do a nice ceramic crown for you.

Bonded crowns are certainly strong crowns, but as you have said, not always the best looking. It will depend on what your teeth look like, (Some teeth are naturally quite 'solid' looking, and bonded crowns match fine) and how heavy your bite is (Some people crack more 'cosmetic' crowns really easily).

worriedaboutteeth

Toothsmith wrote: »

Matching up a single central incisor is about the hardest job there is.

The pair of the tooth is right next to it, and nomatter what system you go for, because it's not natural enamel and dentine, it will NEVER look exactly the same in all light conditions and close up.

You can get it very very very close, but not exactly the same.

I think you need to get in touch with the dentist ASAP, because if the bonded crown is made and put on, then it will be even more damage getting it taken off. Plus you'll be charged for it! You need to either discuss alternatives with this dentist, or get the treatment stopped before more expense is incurred and find a dentist who will do a nice ceramic crown for you.

Bonded crowns are certainly strong crowns, but as you have said, not always the best looking. It will depend on what your teeth look like, (Some teeth are naturally quite 'solid' looking, and bonded crowns match fine) and how heavy your bite is (Some people crack more 'cosmetic' crowns really easily).

What's the difference between a straight porcelalin crown and a ceramic crown? Are there different levels of quality for ceramic crowns? How can I find the difference and a good dentist for this?

I've read there's different bonding techniques to make porcelin stronger? Again how can I tell... If I talk to my dentist I'm sure he'll say "okay go with the porcelin" -- that dosen't mean he'll do a good job with it though.

The temporary cap has also come loose and I'm having to keep balancing it on my tooth which makes eating next to impossible. :S

welshdent

To be honest its probably a bit difficult to convey the differences on a forum such as this. Its not just the appearance you need to be considering. Ceramic crowns are often far more destructive to the underlying tooth than say a PBC or some pjc's. Your dentist would know what lab they use and what that lab is good at so we wont know what you have available in terms of intricate details. In my experience a straight porcelain crown will have a slightly chalkier look than all ceramic but how important that is depends on tooth prep, lab tech skill, tooth involved, underlying tooth colour etc etc. Not sure what you have read with regards to bonding techniques so its hard to comment other than to say you do not bond porcelain to make it stronger. You bond porcelain to adhere it to the underlying tooth. You do sound like you have very high aesthetic demands so I would really speak to your dentist and explain your concerns and. If necessary to refer to someone that takes on these types of situations. To be honest though I do think its sounds like you are being a little unfair towards your dentist. They have taken a lot of time an effort to learn how to do their job so I am sure they are very capable. Just because they are seen as "NHS" doesnt make them incompetent and doing "nice" dentistry. A lot of how a crown looks isnt even related to the dentist. The lab technician is the guy that makes it. Tempories often come loose. They re designed to be easily removed. They just keep the prep safe and clean whilst managing sensitivity and giving you something resembling aesthetic.

You could ask to go to the lab for a shade to be taken to get as good a match as possible by the way.

worriedaboutteeth

welshdent wrote: »

To be honest its probably a bit difficult to convey the differences on a forum such as this. Its not just the appearance you need to be considering. Ceramic crowns are often far more destructive to the underlying tooth than say a PBC or some pjc's. Your dentist would know what lab they use and what that lab is good at so we wont know what you have available in terms of intricate details. In my experience a straight porcelain crown will have a slightly chalkier look than all ceramic but how important that is depends on tooth prep, lab tech skill, tooth involved, underlying tooth colour etc etc. Not sure what you have read with regards to bonding techniques so its hard to comment other than to say you do not bond porcelain to make it stronger. You bond porcelain to adhere it to the underlying tooth. You do sound like you have very high aesthetic demands so I would really speak to your dentist and explain your concerns and. If necessary to refer to someone that takes on these types of situations. To be honest though I do think its sounds like you are being a little unfair towards your dentist. They have taken a lot of time an effort to learn how to do their job so I am sure they are very capable. Just because they are seen as "NHS" doesnt make them incompetent and doing "nice" dentistry. A lot of how a crown looks isnt even related to the dentist. The lab technician is the guy that makes it. Tempories often come loose. They re designed to be easily removed. They just keep the prep safe and clean whilst managing sensitivity and giving you something resembling aesthetic.

You could ask to go to the lab for a shade to be taken to get as good a match as possible by the way.

I don't intend to sound extreemly negative towards NHS dentists, a bad dentist could be with the NHS or private. But with a dentist who's on a budget, he will be getting the cheapest viable option otherwise they'll be hemoraging money.However, I just don't have a clue what he's like. :S

Are there major labs for crown creation in south england? if so what are the names of the better ones?

Thanks for the information though, it seems it would be best to get a porcelalin crown from my current dentist and if it needs to be changed later it won't have damaged the tooth underneath. It'll also be the most realistic looking one for me?

PBC = porcelalin bonded crown?
PJC = porcelalin ? crown?

Really apreciated!

welshdent

Yep thats right re PJC and PBC ... lab wise ... we normally have one we use and they would service a lot of practices, private and NHS so I am sure they would be able to provide a range of materials