A Crown For Every Tooth

If you watched the recently finished series 4 of Love/Hate on RTE recently, you will be familiar with Andrew, the dentist who is a little, shall we say, “crown happy”.  Basically every problem needed to be treated by crowning the tooth, thus leaving our friend Andrew making a “tidy profit”.

You really should have that crowned.

Dr. Andrew from Love/Hate – Crowns for Everyone!

There were even stories about the Irish Dental Association allegedly being upset with the character, which wasn’t actually true:


However, it did remind me of a rather memorable case that I saw from a few years back.  This patient came to me seeking a second (third?) opinion. She had originally presented in pain to her own dentist, who then referred her to a root canal specialist for treatment.

However before she attended the specialist, a friend encouraged her to get another assessment carried out in Dublin, with a view to attending a clinic based overseas. This is the treatment plan she was given. Don’t panic, I only want to look at one part of the plan below:

Dental Quote

Here is the treatment plan and quotation given to the patient – 10 crowns are being planned here.

This plan says that crowns should be placed on the SIX upper front teeth and the FOUR lower front teeth. The patient was not seeking cosmetic work or anything like that;  remember, her original complaint was a “back tooth causing pain”. Nonetheless she was advised that the teeth should be crowned.

So here’s the actual teeth in question. Every tooth with a dot on it is to be crowned.

Teeth for crowns

Here is a picture of the teeth with the dots indicating what work is planned

The tooth with the red dot has a filling on the end and a small fracture along one edge. The one with a yellow dot also has a small filling on the end. All the black dotted ones, while needing a clean, are fully intact, healthy teeth.

So how many crowns do I think we need here? Well I would repair the fractured central tooth (the red dot) but if I use a crown I will probably take away about 5 times more (healthy) tooth structure than is missing already. A little excessive, no? I would be looking at providing a nice bonded tooth-coloured filling here.

As for all the other teeth marked? I simply can’t see any justification for treating these teeth at all. It just isn’t there. Most of the rest of the treatment plan was debatable too.

The final treatment I recommended was the molar (back tooth) root canal her own dentist had originally advised her to get done.

If you’ve any concerns about treatment you’re being offered, don’t be shy about asking questions. Remember, they are YOUR teeth so you’re entitled to know what’s being done, and why. I always prefer patients who take an active interest in their treatment. It’s usually more successful!

Karl Cassidy - Dublin DentistWritten by .
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