NHS dentist crown vs Private Onlay

IQHand

Had Root canal 10 years ago on a bottom right molar, and then a filling placed on top , it has worn down. An x ray yesterday at the dentist showed that something needs to be done. the dentist of course recommended a private onlay which would cost £800, or get a crown via the nhs which would cost £250 . However, i see the nhs band 3 offer onlays so when i rang up the dentist i was told i can’t have a metal onlay as there isn’t enough tooth ( apparently NHS only offer metal onlay) , but there is enough tooth to have a onlay made of the material they offer privately is this true, how can this be  ? as it’s the same procedure so why can one be done and not the other. An urgent response would be much appreciated as its stressing me out.

brook2jack2

A metal onlay relies on mechanical retention, ie there needs to be enough tooth left to hold the onlay  on. Zirconium/lithium silicate etc onlays  are , essentially "glued " on so you don't need to cut tooth down to provide the right shape to keep the inlay on. 

If there is not much tooth left a metal onlay will not stay on because it cannot be chemically bonded on to the tooth ( it is a gold alloy). Other materials allow bonding so can be used when there is not as much tooth left. 

IQHand

brook2jack2 said:

A metal onlay relies on mechanical retention, ie there needs to be enough tooth left to hold the onlay  on. Zirconium/lithium silicate etc onlays  are , essentially "glued " on so you don't need to cut tooth down to provide the right shape to keep the inlay on. 

If there is not much tooth left a metal onlay will not stay on because it cannot be chemically bonded on to the tooth ( it is a gold alloy). Other materials allow bonding so can be used when there is not as much tooth left. 

I see, thanks for the informative and quick response. Obviously the onlay would be around £800 which is quite a bit of money. Would this be something you recommend, just for some context i am relatively young and its the second to last bottom right molar which is not very visible. To your knowledge is the NHS crown silver? 

IQHand

IQHand said:

brook2jack2 said:

A metal onlay relies on mechanical retention, ie there needs to be enough tooth left to hold the onlay  on. Zirconium/lithium silicate etc onlays  are , essentially "glued " on so you don't need to cut tooth down to provide the right shape to keep the inlay on. 

If there is not much tooth left a metal onlay will not stay on because it cannot be chemically bonded on to the tooth ( it is a gold alloy). Other materials allow bonding so can be used when there is not as much tooth left. 

I see, thanks for the informative and quick response. Obviously the onlay would be around £800 which is quite a bit of money. Would this be something you recommend, just for some context i am relatively young and its the second to last bottom right molar which is not very visible. To your knowledge is the NHS crown silver? 

How long can i expect the two different options to last? thanks again

brook2jack2

No dental treatment lasts forever , how long it lasts depends on your diet and cleaning habits , bearing in mind this is already a heavily damaged and compromised tooth. Average time for an onlay  to last is 10 to 15 years , however I have seen work last 50 years and work fail after 50 days. 

A metal crown on the NHS would be silver . Without seeing you, your x rays , your bite and diet it is impossible to recommend anything. 

mda99das

There is another issue and that is the marginal fit. Due to the constraints labs that offer NHS crowns will be using trainee technicians or outsource this to China. This is just simple economics, you get what you pay for. Things have changed and there is a difference in the quality of the marginal fit between an NHS and Private crown. The NHS crown will also need to have the bite adjusted as very rarely is the occlusion spot on.