Crowns

NHS Crowns

An NHS a crown comes under a band 3 treatment. A crown is usually done to restore a broken, damaged or weakened tooth to give it strength and protection, they are done to protect teeth that have had root canal treatment and also to support a fixed bridge. There are different materials which can be used for crowns on the NHS depending on the tooth and need of the crown, the dentist will decide what is clinically necessary and discuss this with the patient before starting the preparation. The materials available on the NHS mostly used are metal alloy, usually silver in appearance to be placed on molar teeth, and porcelain bonded to metal used for front teeth or those that are more visible. Other materials are available but can be considered to be more cosmetic and can de discussed with the dentist as to whether this these materials could be offered as a private option. Please see below an example of a metal crown and a porcelain bonded to metal crown.

To complete a crown it usually takes 2 appointments, the first one is for the preparation of the tooth and usually takes around 1 hour, during this appointment there will be impressions taken, the tooth will be filed down to leave enough room for a crown, and a temporary crown will be placed on the tooth. The second appointment will be where the crown is fitted, this will take around 30 minutes to remove the temporary crown, the dentist will try in the permanent one to ensure that it fits and the patient is happy with the appearance. If the patient and dentist are satisfied, the crown can then be permanently cemented. The bite is checked and any adjustments needed can be made at this point.

porcelain bonded to metal crown

metal crown

Advantages of an NHS crown

  • Provides support to a tooth that has been damaged by decay

  • Protectus a tooth that is worn to prevent any further damage

  • Provides protection to a crown that has been root treated

  • A crown can hold together a severely cracked or broken tooth

  • Can improve the appearance of teeth

Disadvantages of an NHS crown

  • The tooth needs to be prepared for a crown which means filing away natural tissues

  • Can cause sensitivity to hot and cold which should subside after a few weeks

  • Can cause sensitivity when biting down on the crown, which may mean that the crown is too high, if this happens the dentist can check the bite.

  • Porcelain crowns can sometimes chip and can expose the metal underneath, porcelain cannot be replaced without replacing the whole crown but the crown can possibly be repaired with composite

  • Crowns can become loose allowing bacteria to form underneath causing decay.

  • The crown could also fall off in the mouth if it becomes loose, if this happens and you can save the crown it may be possible to recement it.

It is important to weight up the advantages and disadvantages for individual crowns with the dentist to decide together on what the best treatment for the tooth is.