Is your dentist ripping you off?

By Independent Reporter

Cost and choice of material inject the pain into getting a crown

I had a root-canal done recently. As you possibly know already, it can cost quite a bit but fortunately my health insurance covers that. The unfortunate bit, and what they rarely tell you, is that every root-canaled tooth requires a crown to protect it.

The reason they never tell you is that either your insurance does not cover the crown, considering it an aesthetic health item, or you dentist figures if they gave you the root-canal bill together with the crown; you would finch and make a decision unfavourable to them.

As a result, as happened to me, you get news of the need for a crown after you have had the root-canal. Not that it helps. You still have to shop around for a good deal and, believe me, one dentist in our dusty Kampala actually asked for US$1200 (Approx. Shs3 million). If you are in my seat, you need to read below to make a choice. The material is from an Internet search.

Common types of crowns:

Porcelain-fused-to-metal (PFM) Crowns

Porcelain-fused-to-metal (PFM) crowns can be colour matched to your other teeth and are the most common type of crown used.  PFM crowns are very strong, have a good appearance, and are very reasonably priced.

They are most commonly recommended for rear teeth, as they have a good aesthetic appearance and the metal base provides a strong core that can withstand the pressure exerted on these teeth during chewing.

However, in full natural light, the metal base can show through as a shadow in the tooth, especially for front teeth.  Also, over time, if the gums recede from the crown, the metal base can be seen as a dark line that will show where the crown meets the gum.

All types of alloys are used.  Porcelain can be fused to a standard alloy base which can be comprised of metals such as nickel or chromium, or they can be fused to precious metals such as platinum, silver, or gold.  The precious metals cost more than standard alloys.

Full Porcelain/Ceramic Crowns

Full porcelain or full ceramic crowns provide the best natural appearance and are also an excellent choice for patients who have metal allergies.   They are most commonly used for front teeth, as they have an excellent natural appearance.

However, they are not as strong as PFM crowns, are more expensive, and can be prone to chipping or cracking.  As such, they are not typically used for rear teeth.

Zirconia Crowns

Zirconia crowns are the strongest crown available and also have an excellent natural appearance that is comparable to full porcelain or full ceramic crowns.  They are also the most expensive.  Zirconia crowns are virtually indestructible and can be used for front or rear teeth, but since they are so hard, they can wear on the other teeth.

They can either be milled out of solid blocks of zirconia, or used as a strong, natural looking base fused to a porcelain veneer.  Since zirconia crowns are so durable, they can me made much thinner than other crowns and require less removal of the tooth for placement.

Temporary Crowns

Temporary crowns are usually an acrylic material that can be temporarily cemented onto the tooth while the permanent crowns are being prepared by the dental laboratory.  The can be fitted immediately after preparation is done on the tooth for a permanent crown.

How long do crowns last?

Typically, crowns last for about 10-15 years, though many patients will have their crowns for a lifetime.  Zirconia crowns or full gold/metal crown are the longest lasting.  Crowns need to be replaced when they have chipped or broken, though most crown failures are caused by other issues such as decay of the tooth under the crown or by gum disease.  Proper oral hygiene is important in maintaining crowns.