NHS dentist vs private

bardering

I went to my dentist recently and I need a crown - It is the third tooth from the front, so quite front of the mouth.. £280 on the NHS or £500 private. The dentist said that I should go private crown for 2 reasons. The first is they shave down less of the tooth for the private option, and the second is that the NHS crown has mental underneath and after a number of years the gum line may recede and show some of the metal.  Is she just doing a sales pitch or are these two points valid? Should i spend more going private?

bardering

anyone????

Torry_Quine

I'm in the process of getting a crown myself. My dentist said that the NHS one which is metal will obviously show but is just as strong and long lasting. The private one is ceramic and so not noticed. No mention of different amounts of tooth preparation. He said it's entirely personal choice 

Toothsmith

I really don't like answering these questions as I have a big 'thing' about NHS dentistry, and that fact that in order to survive with an NHS contract, dentists find themselves having to upsell private stuff to NHS patients in order to keep the books balancing. 

With some, the private article will be a lot better than what they could do on the NHS, in other cases you can be pretty much getting exactly the same thing but paying more for it.

It's down to your relationship with the dentist. Is it a person and a practice you trust to be looking out for your best interest whilst still trying to make NHS dentistry work in that practice for the common good?

Or do you feel that the Blue NHS letters are there to pull people through the door, and then everything suggested and recommended comes with a bigger price tag, and they're still working it like a conveyor belt doing as much as possible as quickly as possible?

Proper private dentistry should be delivered in an environment where options can be discussed properly, time is taken to make sure the right treatments are delivered, and high quality technicians used whenever items like crowns, dentures etc need to be made.

Undervalued

Torry_Quine said:

I'm in the process of getting a crown myself. My dentist said that the NHS one which is metal will obviously show but is just as strong and long lasting. The private one is ceramic and so not noticed. No mention of different amounts of tooth preparation. He said it's entirely personal choice 

I am not a dentist but as I understand it, a metal crown is likely to be stronger than ceramic and generally needs less of the original tooth removed to fit. Obviously it won't look as nice and if the appearance is important to you then must decide if you are wiling to pay extra and possibly accept the other drawbacks that come with ceramic.

mda99das

The metal nhs crown will have a poorer margin fit and more prone to leakage

welshdent

mda99das said:

The metal nhs crown will have a poorer margin fit and more prone to leakage

That really is not true. 

The "NHS" does not make crowns. The NHS does not provide us labs. 

We use the same labs usually. The difference is the level we tick. NHS options get the cheapest because the lab fee for anything higher is more than the NHS pay to do the work. 

The differences are
1. cheaper materials so different metal alloys or cheaper ceramics
2. Less time making them look nice. An amorphic shape may be common. 

What DOESNT happen is automatically poor leaky margins. 

I have taken off a LOT of crowns and seen even more. The quality of fit is in no way connected to the box ticked on the lab prescription. It is usually related to how much care has been taken to give a good preparation of the tooth, an excellent impression and a skilled lab technician. 

bardering

Thanks all for your replies! Because this tooth is at the front, it will be ceramic on top of the metal. She said the ceramic cover will wear away at the gums eventually. I also still don't know if the claim that more tooth will be shaved off to accommodate the NHS crown is true. I hate that they get you in on 'NHS' but then pressure you for private work. Why do we even have the guise of NHS in the first place. 

I am worried that if I go in now at say I want NHS she will be annoyed that I am paying the bare minimum and do a less than job. 

MoodyMand45

My silver precious metal (platinum) crown has served me for 18 years so far without issue, it was installed by an NHS dentist at the time (no idea why it had to be platinum).

Undervalued

bardering said:

Thanks all for your replies! Because this tooth is at the front, it will be ceramic on top of the metal. She said the ceramic cover will wear away at the gums eventually. I also still don't know if the claim that more tooth will be shaved off to accommodate the NHS crown is true. I hate that they get you in on 'NHS' but then pressure you for private work. Why do we even have the guise of NHS in the first place. 

I am worried that if I go in now at say I want NHS she will be annoyed that I am paying the bare minimum and do a less than job. 

An NHS dentist is allowed to offer "optional extras", particularly where the benefit is cosmetic. The NHS will only provide the minimum that is necessary to get you "dentally fit and healthy". Providing that is done properly then fair enough.

What they are not allowed to do is "mis sell" upgrades, nor are they allowed to refuse to carry out procedures that should be available on the NHS, unless they genuinely do not have the skill or equipment to perform the procedure safely. Sadly this happens regularly (well certainly more than occasionally) with root canal treatment where the payment the dentist receives from the NHS makes it uneconomic to perform.

That however is not the patient's problem and any dentist caught playing those games should be reported to the GDC.