Consumers

Questions to ask your dentist about your dental restorations and why you should ask them.

Question to ask: Are my restorations made in the UK?

Why ask?

There can be significant differences between custom made dental appliances manufactured in the UK and in countries like China and India. The UK dental technology profession manufactures millions of crowns, bridges and dentures every year for both NHS and private dental patients, all of which are subject to standards that are set by the Medical Devices Directive and policed by the Medicines and Healthcare products Regulatory Agency. In China and India, there are no mandatory regulations regarding the manufacturing of dentures, crowns and bridges. It is impossible to know what materials are used in an unregulated environment.

U.K. dental labs must comply with regulations disclosing the materials used and also are required to hire registered dental technicians. The regulations are designed to protect patients; however, imported appliances are not made by registered personnel or inspected labs. The system does require, however, that a UK registered technician must approve (and sign off) an imported appliance before it is used by the dentist.

Question to ask: What materials are in the restorations you are prescribing for my treatment plan?

Why ask?

Many materials ranging from impression materials, waxes, investments and luting cements to fabricating materials are needed when directly or indirectly making dental prostheses. In general, they comprise metal alloys, ceramics, and polymers. Although rare, people can experience an allergic reaction to metals and other materials. Instances have been reported of the presence of toxic substances in imported restorations.

“In these turbulent economic times it is understandable that dental practices are looking to cut costs; however, by sourcing crowns, bridges, dentures and veneers from dental laboratories in the Far East just to save money isn’t acceptable without making the patient aware,” said Richard Daniels, chief executive of the DLA.

All patients who are prescribed a dental appliance i.e. crown and bridge, partial and full denture, implant, orthodontic appliance or anti-snoring device are entitled to a ‘statement of conformity’. This statement includes information on materials, location of manufacture and registration of the professional that manufactured their appliance.

Question to ask: Is the laboratory you use accredited by the Dental Appliance Manufacturers Audit Scheme (DAMAS)?

Why ask?

DAMAS is a quality management system designed specifically for the manufacturers of custom made medical devices. DAMAS accreditation ensures that the laboratory complies with the Medical Devices Directive (MDD) and the Medical Devices Regulations (MDR); are registered with the MHRA; use tried and tested materials which help protect the health of patients; are geared up to meet the needs of both the NHS and the private dental market; value the skills of their employees and care about the service that they provide.

Terec laboratories are either accredited by DAMAS or in the process of gaining it.

Question to ask: What is the difference between types of crowns?

Why ask?

Asking your dentist about the choice of crowns available for your treatment, will enable both you and the dentist to consider options that may have initially been excluded.

There are four main types of dental crowns, including metal, porcelain fused to metal, all porcelain or all ceramic, and composite resin.

Metal

Crowns made of metal (ie metal alloys such as palladium alloy, gold alloy, or a base-metal alloy like chromium or nickel), are among the strongest, although their major disadvantage is their aesthetic look. They are used in less visible areas such as back molars.

Porcelain Fused To Metal

These crowns combine the strength provided by their metal base with the aesthetic appeal of their porcelain exterior surface, and they can match your other teeth. Porcelain is not quite as durable as metal only, but is still long lasting and durable. Sometimes the metal shows through the porcelain as a dark shadow or a dark line at the gumline, making them less aesthetic than all porcelain or all ceramic crowns.

Porcelain or All Ceramic

These crowns look like real teeth and can naturally match your tooth colour. They are normally indicated for front teeth and metal allergic patients and may be slightly more expensive than other types of crowns. Not as resilient as metal crowns but more aesthetic.

Composite Resin

These are used for partial tooth replacement and inlays as an alternative to a crown. They wear like natural teeth but they can discolour. They are usually a less expensive option.


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