NHS Dental Work - Crowns

legopony

Hi all,

I hope someone out there can give me some advice. Last March I had a root canal at the dentist and he advised me to have a crown fitted after this as the tooth would be weakened.

He told me that if I wanted a white crown I would have to pay him privately as the NHS only offer gold coloured crowns. As I didn't fancy a gold tooth I had to pay £350 purely for the crown and fitting.

My work-mate went to her NHS dentist last week and was advised she needed a crown but her dentist is giving her a white crown on the NHS and it's only costing her just over £200 including her check-up etc.

I'm a bit confused as to why her crown is available on the NHS and why mine wasn't, have the rules changed? Or is my dentist just making extra money out of me?

Any advice appreciated!

Polly.

JCP

Is it possibly related to the position of the tooth in the mouth?
I think the NHS pay for white crowns for frontish teeth (maybe 6 each top and bottom) and gold for side/back teeth.

I'm sure that Toothsmith will be along at some point to give an accurate answer.

Toothsmith

There is no 'rule' on what materials can or can't be used on the NHS. (Other than the fact it must be licensed for dental use - but that's a general rule, not an NHS one)

All the NHS says is that a patient must be offered the most appropriate treatment for their problem on the NHS. It's then down to the interpretation of the dentist.

A dentist could, if they wanted, restore every gap in a patient with an implant, replace every filling in a mouth with white filling and provide the most expensive types of crown possible on the NHS.

But he would be paid exactly the same amount of money for this treatment as the dentist who took out every remotely dodgy tooth, and replaced them with a plastic denture.

The only difference would be that dentist A would be out of business in a week, wheras dentist B would be operating a very profitable business.

Dentists can draw the line at what they will and won't provide on the NHS themselves, and it can vary quite a lot from dentist to dentist, and it can also vary a bit from the same detist on different patients.

The only rule is that it must be a clinical decision, and a dentist can't ask an NHS patient to pay privately for something he feels you 'need'. There must be some way of getting you dentally healthy through the NHS.

This can lead to some very grey areas. The 'Need' to see a hygienist privately is one that has quite a long thread on this board. The 'Need' to have a root filling - particularly on a back tooth - when extraction is being offered as the NHS option.

In your case, there is no clinical need to have a tooth coloured crown. In fact, it could be argued, if it's a back tooth, that a metal one is functionally better. Your friend's dentist might have a bit more relaxed attitude about the types of crown he will provide - but her situation might well be completely different to yours as well.

legopony

Thankyou for being so helpful. From what I can gather my friend's crown is in the same position but on the top set rather than bottom as mine was.

I thought there would be a loophole somewhere which allowed this. Oh well!

Thanks again,

Polly.

welshdent

It really does come down to your dentist and the fees they need to pay their lab. Sometimes, if the metal crown is more expensive (esp with gold prices rocketing) the white crown may be cheaper ... but make no mistake, either way you are getting a bog standard cheap crown. Not one I would accept in my mouth believe me. All we have to do is make you dentally fit within a cash limited budget. We have to pay directly to have the crown made and as such most will get a crown that is safe and effective .... but cheap. I would NEVER have an NHS white crown. To me they usually look a bit pants compared to others I have seen. I would have a metal one though if I just wanted something functional ... I wouldnt because I am fussy. I have however had some bad experiences when I have provided a white crown on a back tooth as a gesture of good will to people. Their lack of appreciation and expectation of the world tends to sour your judgement. I used to do them a lot as my lab fee was not drastically different but now I wont because they arent worth the hassle anymore tbh. Very occasionally i do one but in special cases not standard.

annie_d

I have recently paid £1500 to have three upper front teeth re-crowned (27 years of "old" crowns) and I am THRILLED with the result. I actually cried when my dentist held the mirror in front of me. I don't have a lot of money but really, teeth matter more than.....well, after paying the bills, more than anything. My advice to anyone would be to pay to have front crowns done privately if at all possible.

PS...i had my teeth whitened first before the new crowns. That was £325 but it meant i could have whiter crowns ( not ridiculously white a la Simon Cowell, just hmmmmm "younger looking")