Crowns, Bridges and Veneers

A dental crown is essentially a cap that covers a damaged or heavily restored (filled) tooth. Dentists use crowns to restore the shape, size, and function of a tooth. Crowns also improve the appearance of teeth that are discoloured or misshapen. They can be made from different materials like metal, porcelain, or a combination of both.

There are several reasons why someone might need a crown. These reasons include:

• Protecting a weak tooth from breaking
• Restoring a broken or worn-down tooth
• Covering and supporting a tooth with a large filling
• Holding a dental bridge in place
• On certain teeth after it has been root-filled to provide additional support.

Under the NHS, the type of crown you get is usually decided by what is clinically needed for your dental health.

Private vs. NHS Dental Crowns

NHS crowns focus on function and clinical suitability, so in most cases this means front teeth are tooth coloured and posterior teeth are a metal crown (which looks all silver in colour).

Private crowns offer a wider choice and aesthetics. Private crown costs can vary a lot. They usually start at around £475. The cost depends on the material and the complexity of the treatment.

Private crowns can have more detail put into them and can be made from a variety of materials:

• Traditional bonded crown which has a precious metal base with porcelain as it upper layer making it appear tooth coloured. These crowns are hard wearing and suit a variety of locations for both front and back teeth.
• Metal free, tooth coloured crowns such as zirconia or emax. Both zirconium and E-MAX crowns are all ceramic crowns which can be a more preferable type of crown due to their aesthetic appearance. Both are durable, but are more prone to cracking than ceramic metal mix crowns. Zirconium and E-MAX crowns are translucent in colour, which ensures the closest colour match to your natural teeth.

Their colour also reduces the visibility of the crown/tooth junction near the gum lines. Since they are made of ceramic, there is no risk of metal allergic reactions. Zirconium and E-MAX crowns are lighter and thinner than traditional ceramic metal mix crowns which means  sometimes less of your tooth is required to be removed for the crowns to fit.

Zirconia crowns are better suited to front teeth as in heavy loads they can chip. Emax crowns are more durable, but more costly.

-Full gold (the price is individually tooth costed depending on the amount of gold that is needed to make the crown).

Private bridges can allow greater scope for improved aesthetics from the bridge and a choice of materials used.

A dental bridge can be a solution for gap in your mouth, due to a missing or extracted tooth.

It involves replacing the missing tooth with a ‘false tooth, which can be supported by the natural teeth on either or just one side of the gap, depending on the location of the missing tooth and how healthy the teeth next to the space are.

A bridge can offer an alternative option to an implant for replacing a missing tooth.

There are two main types of dental bridge.

• A cantilever bridge, consists of one or two crowns made of either precious metal with has porcelain bonded to it, or a metal free material, which are permanently cemented to your natural tooth/teeth either one or both sides of the space, with the false tooth in the middle.
• An adhesive bridge is a false tooth with a metal wing attached to it. This wing is then bonded to the inner surface of the supporting tooth.  The advantage of an adhesive bridge is that less tooth preparation is needed of the supporting tooth. A disadvantage is it is bonded to your tooth and if you have habits like biting your nails, or eating very hard food, it can become unstuck and need reattaching.

Dental bridges offer a solution for missing teeth. Unlike dental implants, bridges can replace missing teeth without surgery. With porcelain finishes available, your new tooth could be almost indistinguishable from the natural teeth surrounding it.

Many people feel that with the gap filled, that their confidence is boosted in their smile and it can also make day to day activities such as eating and talking easier. By replacing a missing tooth, you can also help to protect your remaining teeth. This is because when you have gaps, remaining teeth may tip or move into the space, affecting the way you bite. Food can also get trapped in spaces, increasing your risk of tooth decay.

Private veneers offer the ability for a greater aesthetic result. A veneer is a thin, custom-made tooth facing made most often from porcelain, but can also be composite or Emax, which is bonded to the front surface of a tooth.

Veneers can provide an effective solution for stained, chipped, misshapen or crooked teeth.

They can also be used to cover gaps in teeth and create a more uniform smile. where orthodontic treatment may not be suitable.

Private veneers are a cosmetic treatment. They cover only the front surface of the tooth and will mimic the size, shape and colour of your teeth, creating a very natural look.

A precise shade of the veneer can be chosen to give the best colour to improve a single discoloured tooth or to lighten your front teeth.

What are the advantages of a veneer over a composite bonding?

Porcelain veneers are more stain resistant and durable than composite bonding. Veneers can provide a long-lasting, cosmetic solution. They can last for over 10 years, if taken care of appropriately. However, whilst veneers are very tough and durable, they can break if exposed to strong impact, for example., biting on hard foods, biting your nails or grinding your teeth.

Sometimes, we recommend that you wear an overnight bite guard which can protect your veneers once they are fitted, if you do grind at night.

NHS – A dental onlay may provide another option for a worn tooth or a tooth with a fractured cusp to be rebuilt, provided there is sufficient space and can provide a longer term solution than a filling.

A dental crown completely covers the surface of a tooth, but an onlay (or partial crown) covers only part of a tooth.

On the NHS they are a band 3 charge and may be silver coloured or tooth coloured depending on the clinical need for that tooth.

These can also be provided privately, again with an increased selection of materials and aesthetic results. Speak to your dentist if this is something that you might be interested in.