Gold content of dental crowns

bereft

I've been offered a choice of crown by my dentist - "NHS" gold crown at £204 which he says will be 33% gold in the alloy and "private" gold crown at £450 which will have twice the gold content. I can afford either but I am not sure what the practical difference would be. The same dentist would be doing the work and the same lab would be making the crown. What's the benefit (to me!) in the 'superior' option?

brook2jack

In general the higher the gold content the less the crown will tarnish and the better the fit at the margins, and overall fit. The impression technique and trays used by the dentist may be different. In general the dentist will spend double or more the time on a private crown than nhs.

Also the lab should spend alot longer making it and more experienced technicians make the crown so it will look more tooth shaped and be a better fit. The lab bill for a good gold shell crown can be five times the cheapest nhs equivalent.

I personally think gold crowns are amongst the best and longest lasting restorations when done well.

bereft

Thanks for the info. Personally I find a lot of that mildly scandalous. I wouldn't expect any serious tarnish on a dental-grade crown, nor would I expect a dentist to take anything other than the right amount of time to do the fitting - I appreciate that NHS jobs at fixed cost may be difficult to earn money on but I can't see that doing the job badly is good for business in the long run. As for the time spent making the crown - well I have to admit I assumed it was all machined rather than requiring individual decisions by technicians but either way the procedure ought to be the same regardless of the precise composition. I'm sure this isn't how it was intended but it almost comes across as "pay more than twice the cost or what you receive will not be up to the task and I won't bother fitting it properly".

brook2jack

You may be interested in viewing this which details some of the stages of making a crown.http://www.squidoo.com/how-are-dental-pfm-crowns-made

The lab bill for a really top quality crown can start from £400 and go over £1000. It takes many hours of skilled work to produce a crown.

All materials in the mouth degrade. After all your own tooth failed and that is the hardest most durable part of the body. No material we produce can take the extremes of pressure (more force than an elephants foot) temperature, acid attack and moisture produced in the mouth better than your own tooth.

Too high a gold content and the crown will wear away, lower gold content and you have an alloy that tarnishes easier and is not as easy to burnish (polish) onto margins.

As a nhs dental surgery will cost from £130 ish an hour to run it is impossible to spend the same time that is spent on private treatment , and impossible to offer the same choice of treatments and types of lab work.

Some nhs treatments will always run a loss eg root treatment with associated check up ,x rays and other fillings brings in approximately £63 yet the single use root treatment instruments alone cost £35 . This is the inherent problem with providing nhs treatment , good dentistry is very expensive to provide and the current system means many treatments result in a net loss to the practice.

bereft

Thanks, brook2jack, that's an interesting link.

I'm in no way suggesting the cost of these treatments is unreasonable - it seems to me that it is skilled and somewhat unpleasant work and I'm all for people making money doing it.

I'm just surprised at the idea that all I am being offered is a difference in materials and yet it is being suggested that all the people involved will do their work better if I pick the more expensive alloy.

If there's no significant difference in the performance of the crowns themselves I'd go for the cheaper material formed and fitted properly but that isn't one of my options apparently.

welshdent

The dentist wont just bodge it on because you are being "cheap" ;-). But the lab will not spend as
Much time on it. We have a fixed price paid by the nhs and that has to cover the costs of the treatment (often it doesn't). When we personally out of our own pockets fund the lab fee for a crown then my personal priorities are is it safe and will it function. When we provide multiple units for the same fixed price that consideration is more pressing because I frequently lose a lot of money providing the necessary care. As
Long as it is safe an functional I will get my lab to make the cheapest item I can get. There is a marked difference between nhs and private lab work. Would you percieve that difference? Would you care? No idea. What I do know is I have seen good quality hold crowns with appropriate alloy ratios still looking as good as new 30 years after they were fitted.

bereft

Thanks, Welshdent - it's much appreciated having real practitioners on this board and getting a proper insight into how the system works.

As this is a central London surgery and as they really need to fund some training for at least one of their assistants and as I can afford it I think I'll feed the extra money into the system - if gold really is the last safe haven for wealth it may end up as the smart move anyway!

Toothsmith

bereft wrote: »

Thanks, Welshdent - it's much appreciated having real practitioners on this board and getting a proper insight into how the system works.

As this is a central London surgery and as they really need to fund some training for at least one of their assistants and as I can afford it I think I'll feed the extra money into the system - if gold really is the last safe haven for wealth it may end up as the smart move anyway!

Only if your relatives have a word with the crematorium staff!

lou49

Goodness, this is so timely! I've just had a back (crowned) molar extracted and got the dentist to give me the tooth to bring home as I was wondering about the value of the gold! Seriously, though, would it be worth anything? It was done privately and looks like about 2.5ml of metal.

Thanks again dentists!