Dental Treatment Abroad

morg_monster

If I was THAT scared of the dentist, I would want to be reassured in English not Polish or broken English!!
And you know if you just have a basic NHS checkup and they don't have to do anything special it is only £15 or so.
No offense but if you can't afford £15 for a checkup you might want to put your tooth whitening plans on hold until you are a bit more flush?! They always sell those kits in Boots!

misscomickat

I can't afford to have whitening or cosmetic treatments in the UK, that's what I meant. I'm also not registered with an NHS dentist here as I moved house and can't find one.

Many Poles speak very good English and I can speak some Polish so the language thing does not concern me.

moneylover

Toothsmith wrote: »

When did you last see a dentist?

If you want them straightened by orthodontics (Braces) then it's a 2 year job.

If you want them straightened by hacking off the enamel to put veneers & crowns on, then be prepared for an awful lot more maintenance/problems over the rest of your life than you would have if you just left them alone.

I was under the impression that veneers last about 15 years?

Toothsmith

It depends what you mean by 'last'.

Yes, the bit of porcelain could physically stick to your tooth for 15 years (Although I would have said that 8-10 is a better average figure) but I would very much doubt one would last that long without any staining at the edges, chipping, cracking or some other general wear-and-tear that meant it didn't look anywhere near as good as the day it was fitted.

If the reason for having it done is 'cosmetic' then will that patient be happy with chipped, stained veneers for 3-4 years before they actually 'need' replacing, or will the more likely replacement cycle be every 4-5 years?

I feel there are a lot of people out there having these treatments thinking they will be a once only affair. They're not.

Someone aged 25 having 6 veneers on their upper front teeth could well have them replaced 10 times in a lifetime - and there ain't enough tooth to do that!!! Which means that perfectly healthy teeth, that could have lasted a lifetime, won't. And all for 'cosmetic' reasons.

mjmal51

Toothsmith wrote: »

When did you last see a dentist?

If you want them straightened by orthodontics (Braces) then it's a 2 year job.

If you want them straightened by hacking off the enamel to put veneers & crowns on, then be prepared for an awful lot more maintenance/problems over the rest of your life than you would have if you just left them alone.

I can see the argument against veneers for purely cosmetic reasons, but surely this does not apply to modern porcelain crowns? I've had two crowns for 30 years and show no signs of wear, chips, etc. The only problem is that the metal core black line is now beginning to show at the gum. Also they have not needed any more maintenance than the natural teeth.

Toothsmith

mjmal51 wrote: »

I can see the argument against veneers for purely cosmetic reasons, but surely this does not apply to modern porcelain crowns? I've had two crowns for 30 years and show no signs of wear, chips, etc. The only problem is that the metal core black line is now beginning to show at the gum. Also they have not needed any more maintenance than the natural teeth.

Crowns are more destructive than veneers, as they take tooth off from all round the tooth, whereas veneers just shave a little bit oiff the front.

So, no, I wouldn't recommend crowns for purely cosmetic reasons either.

Crowns are a very good way to repair teeth that have big fillings in them, or accident damaged, but I wouldn't want to crown a perfectly healthy tooth.

The type of crown you describe, the porcelain bonded to metal type is pretty bullet proof. It's problem is that because the metal layer has to be hidden, the porcelain can't have much colour depth, and they never quite look like real teeth. Plus, you have to take off enough tooth for the metal layer, and then enough tooth for the porcelain layer, and you end up taking off about 1 1/2 -2mm of tooth all the way round, which is a fair proportion.

In long term studies, 20% of this type of crown are found to be non-vital after 5 years. that means that in 1 in 5 of teeth treated like this, the nerve of the tooth has died. This doesn't always give symptoms straight away, but it means that either the tooth will just snap off, or it will blow up into an abscess at some point in the future, unless a dentist spots the problem on an x-ray in advance.

The same death rate is observed in the simpler, but less strong porcelain jacket crowns.

The modern dentine-bonded ceramic crowns have a much better nerve survival rate. Very few of them seem to die after 5 years. The jury is still out as to whether this is because less tooth is taken away, or whether it's the way the tooth is cemented on. By bonding the crown to the dentine of the tooth, a chemical seal is formed which is much less permiable to bacteria than the cement used for more conventional crowns.

Personally, I now seal all cavities I drill, and crowns I prepare with dentine bonding agents before filling them, or sticking crowns on, just in case it's the seal that is the important thing, but then, I'm private and have the time to faff about like this!

30 years is a very good survival time, and so conditions in your mouth must be very good. Bear in mind though that the 8-10 year quoted survival times are the averages, and averages are made up of people who's crowns have lasted for ages, and those that haven't. No-one can be 100% sure when doing the treatment whether it will be a long lasting one, or a shorter one.

Having a dentist who has seen you regularly, and has built up a bit of knowledge of how your particular mouth works will have the best chance of guessing correctly whether a treatment is suitable or not - which is why I hate the idea of people popping off for a couple of weeks to have their teeth sorted out abroad.

There is no way a dentist who has never seen a patient before cn plan anything really complex. If they do, it really is trusting to pure luck for it all to survive.

mjmal51

Thanks Toothsmith for the comprehensive reply. Forgot to mention that the 2 crowns I have are on baby teeth which were getiing worn in my twenties, am now in my late fifties, so looks as though I must just be lucky with conditions. As the crowns were done an age ago the materials used is not the most natural looking so was thinking about replacing with new cerec.

Toothsmith

mjmal51 wrote: »

Thanks Toothsmith for the comprehensive reply. Forgot to mention that the 2 crowns I have are on baby teeth which were getiing worn in my twenties, am now in my late fifties, so looks as though I must just be lucky with conditions. As the crowns were done an age ago the materials used is not the most natural looking so was thinking about replacing with new cerec.

It's more than lucky, it's verging on the miraculous!!!!

If I was crowning baby teeth for a 20 yr old patient, even with modern materials, I'd be very cautious about promising anything longer than 5-6 yrs!!! But then it's much better to be proved wrong that way round, than promising they'll last for ever and them falling off after 3 yrs!!

Cerec isn't a personal favorite of mine, but there are dentists who are very fond of it, and so that is just a personal preference rather than any reasoned dislike.

It will certainly look an awful lot nicer than bonded porcelain with edges showing.

I completely agree that having them changed is probably better than leaving alone crowns that don't look their best anymore, but please be aware that the act of changing them could always be the last straw for the teeth.

Even if the worst came to the worst though, and they were lost, it wouldn't be too hard to do some sort of adhesive bridge to replace them I shouldn't imagine.

givememoney

From personal experience of veneers I would say `don't go there`.

I had two lower front teeth that had the nerve removed some years ago and they had turned grey.

I thought, in my ignorance that veneers would be the answer. I thought they just sort of stuck them on your teeth. What I didn't realise as stated by the Toothsmith, they would hack away most of the tooth to do so.

My regular dentis who normally seems to perform quite well administered these veneers which promptly fell off leaving me with fangs. She reapplied them and then reapplied them again. In the meatime I swallowed one. One of them stayed on for about 6 months and then fell off.

After many months of toing and froing to the dentis she eventually fitted crowns which have thankfully stayed in place.

Toothsmith

Veneers can be done quite thin, but if the tooth underneath is discoloured, then you need a thicker bit of porcelain to hide it.

Lower incisors can be a nightmare too, as they are such fiddly little teeth to start with.

Nowadays, probably internal bleaching would be the treatment of first choice.

Taking out the filling in the back of the tooth where access to the nerve was gained for the root filling, and then using tooth whitening agents in that space to get the tooth back to it's original colour. (Or as near as possible).