 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Dentistry / December 2006NHS vs Private crowns
My dentist recently advised me that a previously heavily repaired tooth which is showing signs of decays again would be better replaced with a crown. I have no objection with his reccommendation but I now have to make a choice. The location of the tooth, although not a front one, makes it eligible for ceramic finish. I have to decide whether to have a NHS crown or a Private one. There is obviously a significant cost difference between the two and before making my choice I would like to known if ther are differences in terms of design, quality, confort and long term reliability. Or are they simply the same ? Thank you very much. The main priority of the NHS is to provide lost function rather than aesthetics. The crown you're going to get on the NHS is porcelain bonded to a non-precious alloy, which is the cheapest kind. Since the technician making the crown is paid a very small amount for it (typically £25-35), he's not really going to spend too much time with cosmetic concerns like excellent shade matching or high anatomical detail. But if you're looking only for function/protection, you could be served by a NHS crown. Privately, you could get the option of porcelain bonded to high noble alloy or even an all-ceramic crown. When it comes down to all-ceramic crowns, there are several different systems in the market; your dentist can advise you one the ones actually used by him/her. Regards, George > The main priority of the NHS is to provide lost function rather than > aesthetics. The crown you're going to get on the NHS is porcelain [quoted text clipped - 11 lines] > Regards, > George Thank you George for your response. I appreciate now where the cost difference comes from. However I would like to know what the disadvantage of a non precious alloy is in term of strength and durability if any. I accept that esthetical quality of the finished crown may not be as good as a porcelain bonded to high noble alloy or all ceramic crown. Most grateful for your answers. Regards Nonsuch >> The main priority of the NHS is to provide lost function rather than >> aesthetics. The crown you're going to get on the NHS is porcelain [quoted text clipped - 23 lines] > Regards > Nonsuch I've used precious alloys; I've used nonprecious alloys. IMO, the esthetics of the finished crown are almost entirely the talent of the ceramist. I haven't noticed any significant difference in durability between precious and non-precious alloys. Some patients are sensitive to one or another component of dental casting metals. In the early days of non-precious alloys, nickel was used, and this is a common allergen--plus it tarnishes green at the gumline. I don't think you'll find significant nickel in casting alloys anymore. One more issue, and a personal one to one of our regular posters, is that some non-precious alloys still contain beryllium, which is a severe health risk for laboratory technicians. Dentists who allow their labs to use these alloys are allowing an unacceptable practice. Steve Strength and durability, nil. However, there are more concerns that come to mind with any treatment that is 'cheap' compared to treatment that is more expensive. How many corners are being cut? 1. Is the initial preparation shaped and the margins clear? 2. Was an accurate impression taken of the preparation? 3. Was the crown fabricated to precisely fit the model? 4. Are the contacts and occlusion adequate? 5. What cement is used to place the crown? Spending a lot of money doesn't mean that everything will be done right, but doing things 'on the cheap' increase the chances of shoddy work. With crowns, you are paying a lot more for labor than materials, so if you cut your labor cost dramatically, something has to give. JMO, D disadvantage of a non precious alloy is in term > of strength and durability if any. > Regards > Nonsuch Hello again, The non-precious alloy is as you can imagine significantly cheaper for the lab to use, especially with the cost of gold skyrocketing recently. But more importantly, by paying a higher fee you are actually buying time from both the dentist and the dental technician to focus on producing a decent crown for you to use, one that has a proper shade, aesthetics, well-fitting margins and appropriate shape to protect the tooth, give you a comfortable bite and maintain the health of your gums around it. The low cost/high demand NHS services have created an enviroment of "drill&fill", something like a conveyor belt in a factory where patients are treated quickly. Even with a good dentist in charge this can lead to "hit&miss" treatments. I'm not saying a NHS crown will not work for you, there is a good chance it might be ok, but there is also a chance it might be less than ideal. My advice to my patients is to go for the nicest thing that is within their means, pretty much like when buying a car. Buying the most expensive private crown could be a poor decision if you don't have enough money to pay your mortgage next month. With Christmas almost upon us I guess it's going to be a tough decision! Regards, George Another consideration is what (if anything) will 'saving money' *now*, *cost* you later? I've seen a lot of cases of HMO dentistry that has ended up costing the patient thousands of dollars to repair later. Some cases even lose teeth, not just the cost of correct repairs. I have no direct knowledge of NHS, but it sounds quite similar to the HMO schemes in the US. Sometimes you get what you pay for and sometimes you get less. D Buying the most > expensive private crown could be a poor decision if you don't have > enough money to pay your mortgage next month. With Christmas almost > upon us I guess it's going to be a tough decision! > > Regards, > George Another consideration is what (if anything) will 'saving money' *now*, *cost* you later? I've seen a lot of cases of HMO dentistry that has ended up costing the patient thousands of dollars to repair later. Some cases even lose teeth, not just the cost of correct repairs. I have no direct knowledge of NHS, but it sounds quite similar to the HMO schemes in the US. Sometimes you get what you pay for and sometimes you get less. D Buying the most > expensive private crown could be a poor decision if you don't have > enough money to pay your mortgage next month. With Christmas almost > upon us I guess it's going to be a tough decision! > > Regards, > George |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2008 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.