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AUSTRALIAN FINANCIAL REVIEW ARTICLE

Read Jacquie Hayes, of the AFR, interview Dr Kia Pajouhesh on dental costs "The Crowning Glory - 8 September 2012"

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Dental Costs - Porcelain Veneers and Ceramic Crowns

When considering crowns or veneers, remember:

  1. A tooth should only be crowned or veneered once all other options have been carefully contemplated
  2. There are two major contributors to every finished crown or veneer: A treating clinician and a laboratory ceramist
  3. General dentists and registered specialist dentists called prosthodontists offer dental crowns and veneers

Cost issues in relation to point 1
To crown or veneer a tooth: What are your options?

Porcelain Veneers and Ceramic CrownsOnce your tooth is clinically prepared (or commonly termed as shaved down) for a crown or veneer, there is no going back. If you prefer to minimise expense or retain as much of your natural tooth structure as possible, enquire about all the alternatives. If you wish to get a second opinion from a specialist as to what options you have, ask your dentist to refer you to, or search online for, a prosthodontist (veneer, crown and bridge specialist).

What options are there?

In many cases, veneers can be avoided with one or a combination of conservative treatment methods:

Problem Solution
Colour of teeth Various home or in-chair whitening systems
Shape of teeth Cosmetic recontouring or reshaping of natural teeth
Gummy smile or short teeth Gum lift surgery, gum recontouring with laser and/or composite resin additions
Crooked positioning of teeth Various cosmetic orthodontic options including internal lingual braces and Invisalign
Stained and cracking fillings Composite resin replacement of the fillings

In many cases, crowns can be avoided with one or a combination of conservative treatment methods:

Problem Solution
Broken front tooth

Composite resin build up

Broken back tooth Porcelain onlay filing conserving as much of the natural tooth as possible by two-step laboratory made ceramic onlay or one-step Cerec ceramic onlay

 


Cost issues in relation to point 2
Two major contributors to every finished crown or veneer

When considering crowns or veneers, remember:


Dental Crown and Tooth A crown or veneer usually requires two service providers – in the first instance the tooth is prepared by the treating clinician to take the new ceramic restoration, and in the second instance the ceramic crown or veneer is fabricated by a laboratory ceramist ready for insertion onto the tooth by the clinician.


Considerations for porcelain veneers and crowns costs, so as to "compare apples with apples":

 

The treating clinician


The specialist training of the treating clinician – whether they're a specialist prosthodontist or not.

It is not considered rude to ask your treading clinician what level of experience they have, particularly with crowns and veneers. It is also highly recommended to ask them to show you large before and after images of work "they have done themselves" specifically relevant to your presenting case and personal expectations.

The laboratory ceramist


The choice of laboratory is made by the treating clinician.

Thousands of dental laboratories are available, with varying levels of standards and quality both locally and internationally. The net cost to the clinician can range from $60 to $240 for the same veneer or crown made overseas in say China or Thailand, depending on the quality of the laboratory engaged; and can range from $200 to $650 for the same veneer or crown made in Australia, depending on the quality of laboratory engaged.

Crown Tooth

Beware claims that the work is being manufactured by a local laboratory. The critical question to ask is: Does the local laboratory then subcontract the task to workers in mass production centres in developing countries? It is estimated that some 10,000 units of crowns, veneers and implant crowns are fabricated overseas for Australian dentists each month. It is very reasonable to ask to meet the laboratory ceramist engaged to make your veneers or crowns in person.

One benefit of using local Australian laboratories is the close working relationship between clinician and ceramist that is developed over many years. Work subcontracted offshore to laboratories where the focus is on minimising costs to the dentist means there may never be direct communication between the prescribing dentist and the workers making the crowns.


Cost issues in relation to point 3
General dentists and dental board registered specialists

If you're wanting to see a specialist prosthodontist for veneers or crowns, never assume that a practitioner is such a specialist. It's not uncommon for junior associate dentists, dental assistants and reception staff to imply that their senior clinicians are "specialists", or even to refer to them as such, usually understanding neither the official industry definition of the title nor the implications of such an error. Always ask to be given a business card or title attached to an email that includes the word "prosthodontist" to confirm the registration status of the practitioner. Or simply check for yourself on the AHPRA website.


The thoughts and opinions expressed on this website are those of Dr Kia Pajouhesh, BSc, BDSc (Melb)