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There will be occasions when a large part of your tooth is missing either due to the tooth breaking or tooth decay. On these occasions in order to restore your tooth your dentist may suggest a Crown, Onlay or Veneer as described below. On other occasions you may want to improve the appearance of your teeth which are restored with old crowns, metal fillings or old stained white fillings and this may be achieved with onlays, crowns or veneers or white dental composite in some cases |
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Dental Crown or Onlay says your dentist?
This means that your dentist has decided that there is enough tooth remaining to save it from being taken out/extracted; but that a normal filling, whether white or otherwise will not last very long or will not be strong enough to withstand the pressure it will be put under with everyday use. On these occasions if you want to keep your tooth for as long as possible you will usually have a few options.
1. Crown the tooth - this is where all decay is cleaned out of the tooth, missing tooth structure is replaced with filling material and then the tooth is prepared by trimming it down to make room for a crown (see images below), models of this are made and sent to a dental lab where a skilled technician will make a unique crown which is then returned to your dentist usually after a couple of weeks of wearing a temporary crown; to be placed on your tooth. This can be made from metal only, metal with white porcelain on top or purely from white porcelain. Fees vary depending on a number of factors, the metal crowns may be available on the health service, the white crowns or gold crowns will usually vary from £350 - £1000.
2. Onlay - this is where all decay is removed along with any thin or weak bits of tooth, the same procedure of production is then carried out as for a crown but this will usually only be available in gold or white porcelain. The onlay is then bonded onto your tooth, this has the advantage of preserving more of your tooth as your tooth is not unneccessarily cut down. Fees will generally be the same as a white porcelain crown.
3. CadCam Onlay/Crown - some practices have a facility to make the above crowns and onlays on site while you wait with a ceramic milling machine! this saves you having to wear a temporary crown and having to come back for a second fit appointment as you get same day crowns and onlays This is an excellent service that some dentists offer. Fees will vary but will usually be 15-20% more than a porcelain crown/onlay, if the normal crowns are £350 say then these would be around the £400 mark.
4. Have tooth taken out if you would rather
2. Onlay - this is where all decay is removed along with any thin or weak bits of tooth, the same procedure of production is then carried out as for a crown but this will usually only be available in gold or white porcelain. The onlay is then bonded onto your tooth, this has the advantage of preserving more of your tooth as your tooth is not unneccessarily cut down. Fees will generally be the same as a white porcelain crown.
3. CadCam Onlay/Crown - some practices have a facility to make the above crowns and onlays on site while you wait with a ceramic milling machine! this saves you having to wear a temporary crown and having to come back for a second fit appointment as you get same day crowns and onlays This is an excellent service that some dentists offer. Fees will vary but will usually be 15-20% more than a porcelain crown/onlay, if the normal crowns are £350 say then these would be around the £400 mark.
4. Have tooth taken out if you would rather
Crown, Veneer and other front tooth options
As with the back teeth this will be because your dentist has decided that a white filling; although would look like a tooth again, would not last very long and something stronger is required. The options are
1. Have a Crown following the same procedure as above, the choice of crowns will be again metal only (like the people with gold front teeth), metal with white porcelain on top which will be like your standard health service crown, precious metal with porcelain on top which will be like a standard private crown or completely high strength white porcelain with no metal which will be the most realistic looking option generally speaking. Typical fees will range from £350 - £1000 for these depending on where you go and what option you go for, if offered on the health service then health service fees will apply
2. Porcelain Veneer - this is where there is enough tooth structure left to bond a veneer onto (a thin layer of white porcelain that is bonded onto the front of the tooth) this is the sort of thing that you will see many celebrities and non celebrities have to improve the appearance of their teeth but they can be used to restore front teeth that have big corners missing or have big holes in them. Typical fees unless offered on the health service will be comparable to having a crown as above.
3. Sometimes if there is very little tooth structure remaining but you want to keep the tooth then a crown can still be placed, but the tooth will need root treating first and then a post put inside the tooth to help hold the crown in place when it is bonded in. Your dentist will be able to tell you if this is a viable option and the costs involved. Usual fees for this will be the fee for the crown plus a separate fee for the root treatment and the post, a typical pricing for a front tooth would be £250 for the root treatment, £50 for the post placement and then the crown fee but this may vary greatly. This may be available on the health service where generally a metal post is used and a crown made of metal with white porcelain on top is placed.
2. Porcelain Veneer - this is where there is enough tooth structure left to bond a veneer onto (a thin layer of white porcelain that is bonded onto the front of the tooth) this is the sort of thing that you will see many celebrities and non celebrities have to improve the appearance of their teeth but they can be used to restore front teeth that have big corners missing or have big holes in them. Typical fees unless offered on the health service will be comparable to having a crown as above.
3. Sometimes if there is very little tooth structure remaining but you want to keep the tooth then a crown can still be placed, but the tooth will need root treating first and then a post put inside the tooth to help hold the crown in place when it is bonded in. Your dentist will be able to tell you if this is a viable option and the costs involved. Usual fees for this will be the fee for the crown plus a separate fee for the root treatment and the post, a typical pricing for a front tooth would be £250 for the root treatment, £50 for the post placement and then the crown fee but this may vary greatly. This may be available on the health service where generally a metal post is used and a crown made of metal with white porcelain on top is placed.
Cosmetic Dentistry to improve single tooth aesthetics
On these occasions the decision of what to do to improve the look of a single tooth lies entirely with you.... the patient .....(as with any decision about your teeth). Your dentist wants you to know all of the options along with the benefits and drawbacks of each so you can make the right decision for yourself. Generally your dentist is looking for the simplest way to reach your goals which preserves the most amount of tooth structure
- All of the options above will still apply for back and front teeth, or if it is a case of repairing a small hole, replacing a small discoloured white filling or replacing a small to medium sized metal filling then a new white filling can often be used to meet your needs
- One of the main decisions to make, especially with discoloured teeth, is whether you want to get rid of the discolouration permanently and completely but at the risk of having to remove more tooth structure to do so or whether you would accept a compromised result or a result that needs more maintenance but where more or all of the tooth can be preserved and so in the long term you will have a lower risk of eventually losing that tooth
- Say for example you have one very dark front tooth, would you rather
- Whiten it with whitening gels to lighten it knowing that this may need redoing every couple of years and may fade over time
- Have some of the front of the tooth trimmed away to place a thin veneer which will mask the discolouration but requires some tooth structure removal and may require a lot if the tooth is very dark, or
- Have a crown placed on the tooth to improve the appearance but at the expense of cutting away a lot of tooth structure.
- All dental work will generally need replacing at some point as nothing dentists do except taking teeth out can be classed as permanent. So this should be a part of your decision and is the reason why we suggest having as little treatment as possible to meet your needs fully. Good maintenance of dental work by you, the patients, however, will mean what we do for your teeth will last as long as possible
- if you dont keep your teeth brushed and mouth clean then you will still get decay around crowns, veneers, onlay and fillings as you would your natural teeth and this will reduce their life span.
Cosmetic Dentistry options for all teeth
Here things get a little more complicated generally, but only because you have all the options above for each tooth. the main decisions you need to make are below, you can even write these down and give them to your dentist which will help them when treatment planning your case. There will be a lot of options in general so consider the following points carefully. You can download the sheet by clicking on the button below to fill out and give to your dentist....
- Remember as a prerequisite you should have all decay and gum disease treated prior to having any cosmetic treatment, your dentist will usually insist on this but it may be incorporated into the cosmetic treatment plan.
- What do I want to change about my teeth if I could change anything? (make a list of everything relevant no matter how small)
- What is my realistic budget for treating all of my teeth? Many dental practices will offer 0% finance on higher fee cases which may be worth considering if you do not have the money saved but still want the treatment doing. If you think crowns or onlays might be chosen then £400 per tooth is a reasonable guide but check fees at your own dentist to help you budget if you would like.
- TIMING: What is the time scale in which you want treatment completed by, how often are you able to attend for appointments and how long can you stay for appointments each time?
- Would you want any teeth replaced with implants or fixed bridges, or would you consider a removable option such a denture? (see missing teeth section)
- Would you be willing to wear a fixed or removable brace to move teeth (see straighten teeth section) to save them from having to be cut back extensively just to place veneers and crowns?
- Would you be able to sit through a number of hours of treatment to get the best result or would you accept a compromised result that can be carried out more quickly and more easily?
- Would it make a difference to your decision if you could be sedated/more relaxed during treatment (see sedation section) as you should let your dentist know this if it is something you are considering.
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