Is crown the most suitable treatment due to the risk of fillings falling out?

Q. Hi Dr. Solanki, I’m a bit clueless when it comes to dental treatments to be honest. I had an absolute butcher of a dentist in my teens which resulted in me having to go along to the hospital to fix all of the random holes she’s drilled into my teeth. (Of course they were filled with lovely silver fillings and I now have a hideous metal mouth). She also hit nerves left right and centre so as you can imagine I wasn’t in a hurry to go back. I haven’t seen a dentist for quite a few years now – I was holding out until I’d finished university, at which point I planned to get the whole works privately. However, yesterday evening (ironically, I was chewing a piece of gum to freshen my mouth a bit before I could get home to brush my teeth) quite a substanial piece of tooth broke off. It came from a molar which consists mainly of amalgam filling actually. There is no pain but as the filling is quite exposed and at risk of falling out I realise I need to get it seen to asap. I know it’s difficult for you to say without seeing the tooth but do you think a crown is likely to be the most suitable treatment here? If so, I want to get the best looking and most durable type, which I’m led to believe is a CEREC one, is that correct? I know I will need some other teeth seen to as well, for which I’d like some white fillings. My problem is that this is all a bit costly for someone on a student budget! If I were to register as an NHS patient at a surgery which provided these services would I pay only for the treatments not available on the NHS (ie not have to pay full examination charges etc) or would I have to pay the same as a fully private patient? Sorry this email is so long, but as I said, I really don’t have a clue. Many thanks!

A. Hi many thanks for your email, the tooth which has broken sounds as if you may need a crown, a crown is usually advocated if the filling is over half the size of the tooth.

Secondly you can register with an NHS dentist and the options that are not available on the NHS will be available on a private basis but just at a higher cost.

CEREC is an option but if we look at data the best type of crown on a molar is a gold crown followed by a porcelain bonded to metal. If you want an all porcelain crown on a back tooth i would recommend a material called zirconia.

Dr Kailesh Solanki Kissdental – UK Practice of the Year 2007 157 Woodsend Road, Flixton, Manchester, M41 8GN.2 New Street, Altrincham, Cheshire, WA14 2QS. 13 Stanley Street, Manchester, M8 8SH. Web: www.kissdental.co.uk Tel: 0161 748 5250 View My Profile Dr Solanki

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