NHS inlay/onlay vs gold resortation

jojobirdy

I require a inlay and onlay for a 1st Molar. I have been provided 3 options

1) Emax - White ceramic restoration which i doubt will choose as cermaic can wear down opposing enamel cost of £475
2) NHS - chromium and Nickle cost of £256.50
3) Gold - cost of £600

I am undecided between gold and NHS - Research says gold is the best. There isnt much info on chromium and Nickle except that there is a higher risk of being allergic to the non-noble metal and possible toxins.

What are the benefits of non-noble metals for NHS inlay/onlay? Particulary Nickel and Chromium vs gold.

Is there any difference using these materials for resortation work and how they wear compared to gold?

The reason i ask is i have been quoted £600 for gold inlay and onlay. If the NHS band 3 of chromium and nickle for £256.50 is nearly just as good as gold or there is not much difference in qualities then i shall opt for NHS.

If there are significant benefits for Gold then i shall choose this as i guess whilst this will be more expensive short term but if the benefits and longevity are good then this could save money long term.


Any advice or experience would be greatly appreciated.

Thank you

Toothsmith

I always try to push gold restorations on back teeth.

If I needed one, I would have gold. No question

jojobirdy

Thank you for your response

Can I ask why you would choose gold?
Due to extractions for braces in my teens I only have one premolar and the 1st molar which requires the restoration was initially further back in my mouth before it was moved next to the pre molar so it’s quite a big tooth with quite a big resortation needed. I do have a overbite so this wouldn’t be seen when I smile but might be on show when I laugh and talk. Would you still apply gold to this tooth which is partly on show and not quite at the back?

jojobirdy

Last question which I forgot to post in my reply. does £600 seem reasonable/standard for a gold inlay and
Gold onlay?

Toothsmith

Gold is the most biocompatible material (It is very well tolerated by the rest of the body). To make a gold restoration, you have to remove a lot less natural tooth than you do for other types of restoration.The less of your own tooth you lose in any procedure, the better.

The downside of gold is that it's - gold! So how it looks and how you feel about how it looks is an important consideration too. This is a discussion you need to have with your dentist though (who should also have told you about the pros & cons of each)

£600 sounds quite a reasonable price assuming it's going to be done well! I'm a little cheaper than that, but I'm probably in a lower cost area. Also - as I don't do any NHS - I've not got a loss-making side of my practice that I have to subsidise

jojobirdy

Where are you based? If commutable.. are you accepting new patients?

Toothsmith

Very kind to ask, but if I used this place to tout for patients, id very soon be kicked off.

I'm sure the dentist you're seeing is perfectly capable. If you're in any doubt then look around at other local places, but don't get hung up on looking for an 'NHS' place. You're always likely to be 'upsold' private options anyway.

Davy1956

Hi,

I’ve been told after NHS inlays have been fitted that 20% of patients experience a lot of sensitivity to hot & cold drinks - does that sound right?

I was also told that if there’s a problem with the inlay the tooth will have to be removed - is that true?

Thanks

welshdent

The likelihood or not of sensitivity is NOT related to the payment scheme used so I would say that is inaccurate. I have not got the time to check the literature but ALL non root filled teeth have a chance of developing post treatment sensitivity. The more conservative or minimally prepared the tooth the less chance of developing problems so too the smaller the decay or cavity there in the first place. 20% of non root filled teeth that have full coverage crowns placed on them can develop nerve death/ Bit again. The payment system has no bearing on this. A minimally prepared metal crown such as gold will have a lower risk. More aggressive zircona based ceramic crowns are higher. NHS doesnt automatically mean good or bad. It means compromises on what you may or may not get and restrictions of the materials you can have used on you.

Davy1956

Thanks so much for the reply - very useful information.

I was also told that a private inlay (costing between £350 - £600) is stronger than an NHS inlay and the private inlay would last longer - is that correct?

What are NHS and private inlays made of?

Many thanks