Dental advice please!

Murf2020

Last week the front of my tooth chipped off (the second premolar) and a large filling fell out. I saw the dentist on the NHS yesterday who gave me three options:
1) large silver filling £210
2) large white filling £210
3) full porcelain crown £709

She said 1 and 2 are not good options as there is so much to fill and no front of the tooth at all it will be hard to fix permanently.
I asked about a crown on the NHS and she said for a mixed metal and porcelain crown she would have to remove too much tooth to fix it in. 
I can't see anything about this when I have looked at pros and cons of crowns  on Internet. 
My question is: should I be offered a crown on the NHS? Is this true about the NHS crowns not being suitable in some cases?
I am worried there is some financial influence on her advice and have two small children so no spare money at all for this!
Any advice would be gratefully received. 

Undervalued

Murf2020 said:

Last week the front of my tooth chipped off (the second premolar) and a large filling fell out. I saw the dentist on the NHS yesterday who gave me three options:
1) large silver filling £210
2) large white filling £210
3) full porcelain crown £709

She said 1 and 2 are not good options as there is so much to fill and no front of the tooth at all it will be hard to fix permanently.
I asked about a crown on the NHS and she said for a mixed metal and porcelain crown she would have to remove too much tooth to fix it in. 
I can't see anything about this when I have looked at pros and cons of crowns  on Internet. 
My question is: should I be offered a crown on the NHS? Is this true about the NHS crowns not being suitable in some cases?
I am worried there is some financial influence on her advice and have two small children so no spare money at all for this!
Any advice would be gratefully received. 

Are you sure that 1 and 2 are the NHS price? It doesn't tie up with any of the three charge "bands" in England.
Hopefully one of the dentists will respond but, as I understand it, an NHS metal crown involves removing less tooth than a more attractive looking porcelain one. If you want a nice looking porcelain one for cosmetic reasons then yes, fair enough, private charges would apply.

Toothsmith

I's pretty much agree with Undervalued.
Metal crown takes away much less tooth. I'd recommend a nice gold one privately though, rather than non-precious NHS version - but NHS metal one is OK if funds are tight. White options are more destructive - and generally more brittle, so more prone to break.
I'd also agree that options 1 & 2 do not sound like an NHS option in any of the UK countries.

Undervalued

Thanks TS.

As I understand it, any treatment involving filling(s) on the NHS, however complex, is Band 2 which costs c. £65 and that includes any Band 1 work done in the same course of treatment such as the initial checkup.

Any treatment involving crown(s) or dentures moves you into Band 3 which costs around £250 from memory. Again this includes any Band 1 and Band 2 work in the same treatment plan.

So something isn't right here apart maybe from a fancy porcelain crown done privately for 700 quid!

Toothsmith

Thats certainly true for England. Wales has a similar system, but slightly different charges. Scotland is still a 'fee-per-item' service like England was pre-2006, but there is a maximum charge for one course of treatment. I'm no expert on any NHS charge scheme, but I'm pretty sure the Scottish maximum charge is more than £210, but no individual filling should get anywhere near that. What might do though is a root filling and a filling. Patients often would call that 'a filling' despite it being 2 individual items, one of which is quite complex. 

I have no idea off the top of my head what sort of system NI operates, but I have a feeling that's a FPI type system too.

Undervalued

Scottish NHS charges are copied below.......

As you say, no filling (even with a root canal charged separately) gets anywhere near £210!
So, either the OP has misunderstood what the dentist has told them or they are being quoted entirely for private work. Also, unless there is some new wonder crown material they have either misunderstood that bit too or, perish the thought, they are being spun a line!!

Treatment	Cost
Examination	no charge
Two small X-rays	£5.12
Simple gum treatment(scale & polish)	£11.68
Small amalgam (silver) filing	£7.96
Large amalgam (silver) filing	£20.40
Root canal treatment (front tooth)	£43.00
Single crown (front tooth)	£77.36
Simple extraction (one tooth)	£7.32
Complete (upper and lower)dentures	£161.52

Murf2020

Yes I hadn't considered that, why are they charging me £210 for a filling?! I'm in England so yes I expect NHS charges to be in those three bands. I think they are trying to push me to do any of the options through private. They have written these quotes on my treatment paperwork. I feel like reporting it.
Thank you so much for this. I am going to call, be assertive and say I would like the NHS crown.
The filling I had was dark so I am used to that tooth looking a little darker and it didn't bother me as so far back.