Crowns, Onlays and Inlays Patient Information

This information serves to help you come to an informed decision in regards to your dental treatment.

Please note side effects and complications are uncommon to rare and we at Smile Cliniq would hope our rate is even less than the norm, due to the techniques and materials we use.  Also bear in mind the complications are no different to any crowns, onlays and inlays you may have had previously, it’s just you are now aware of them.

Please also note crowns, onlays, inlays and restorations (fillings) are covered by our 5 years guarantee (unless otherwise stated).

Crowns, onlays, inlays or restorations may be recommended for a variety of reasons:

• Undergone root canal treatment
• Decay
• Severe tooth surface loss
• Poor aesthetic appearance
• Replace existing crowns with poor appearance
• To protect heavily restored teeth from breaking
• To restore broken down teeth and prevent further breakage

What are my options?

1. Do nothing! Leave and monitor the problem

Advantages:

• No treatment or cost

Disadvantages:

• • Underlying problem such as decay may get worse leading to the tooth needing a root canal treatment or extraction or the tooth may break further and may not be restorable in the future again needing an extraction or root canal treatment, post and core crown.

2. A Restoration such as a composite filling

Advantages:

• • • Treating underlying problem such as decay
    • Treatment often finished in one sitting
    • Cheaper than a laboratory made indirect restoration (i.e crown, onlay, inlay)

Disadvantages:

• • • Not as strong and durable as a laboratory made indirect restoration (i.e crown, onlay, inlay)
    • May not offer teeth any cuspal protection
    • If large and placed within a tooth, increases flexing forces on the enamel walls, causing them to flex and weaken and possibly fracture.
    • Do not generally last as long as indirect restorations
    • If deep and/or lager may need a root canal treatment on the tooth at some stage

3. A laboratory made indirect restoration such as a crown, onlay or inlay

Advantages:

• • • Treating underlying problem such as decay, fracture
    • Stronger, more durable, longer lasting outcome than that of a filling
    • Offers cuspal protection (not inlays) thus preventing tooth fracture in teeth with undermined enamel walls.
    • Often a more aesthetic outcome

Disadvantages:

• • • Cost, more expensive than a direct restoration (filling)
    • 2 sittings required
    • Risk of needing a root canal treatment on that tooth, as with large fillings (if it has not already been root treated)

Please note side effects and complications are uncommon to rare and we at Smile Cliniq would hope our rate is even less than the norm, due to the techniques and materials we use.

I UNDERSTAND that treatment of dental conditions requiring a crown, onlay or inlay includes certain risks and possible unsuccessful results. Even though every care and diligence is exercised in the treatment of conditions requiring crowns, onlays and inlays and fabrication of same, there are no promises or guarantees of success.  Nevertheless, I agree to assume the risks, possible unsuccessful results and/or failure associated with, but not limited to the following:

Reduction of tooth structure: In order to replace decayed or otherwise traumatized teeth it is necessary to modify the existing tooth or teeth so that crowns (caps) and/or bridges may be placed upon them. Tooth preparation will be completed as conservatively as possible (to preserve as much tooth structure as possible), but involves irreversible tooth structure loss.

De-bonding of crown: With newer adhesive materials, we are able to bond crowns to teeth.  This means we do not have to reduce as much tooth structure from the tooth, which conserves tooth structure and decreases the risk of any future complications and treatment on these teeth, but also means the crown may de-bond or fall off.  If this happens, we merely re-bond it!  In the first year this is free of charge treatment, if this happens afterwards, further fees are applicable.

Local Anaesthesia: In order to reduce tooth structure without causing undue pain during the procedure, it may be necessary to administer local anaesthetic. Very occasionally, such administration may cause reactions or side effects which include, but are not limited to, bruising, hematoma, increased heartbeat, temporary or, rarely permanent numbness of the tongue, lips, teeth, jaws and/or facial tissues, and muscle soreness.

Sensitivity of teeth: Often, after the preparation of teeth for the reception of either crowns or bridges, the teeth may exhibit sensitivity, which can range from mild to severe. This sensitivity may last only for a short period of time or occasionally last for much longer periods. If sensitivity is persistent, you should notify us so that the cause of the sensitivity may be diagnosed.

Teeth which have received a Crown, onlay or inlay may require root canal treatment subsequently: Teeth after being crowned occasionally may develop a condition known as pulpitis or pulpal degeneration. Usually, this cannot be predetermined (unless the decay or fracture was noted as being close to the nerve). The nerve tissues may have been traumatized from an accident, deep decay, tooth preparation, or other causes. It may be necessary to perform root canal treatments on these teeth, particularly if the tooth remains appreciably sensitive for a long period of time following crowning. Research has shown that approximately 1 in 5 teeth that have deep fillings or crowns need root canal treatments at some stage of their life.

Breakage: Crowns, onlays and inlays may possibly chip or break. Many factors can contribute to this situation such as chewing excessively hard materials, opening bottles, changes in biting forces exerted, traumatic blows to the mouth, etc. Unobservable cracks may develop in crowns from these causes, but crowns/bridges may not actually break until chewing soft foods, or for no apparent reason. Breakage or chipping seldom occurs due to defective materials or construction unless it occurs soon after placement.  Please note crowns, onlays, bridges and inlays are covered by our 5 year guarantee unless otherwise stated.  Please note this guarantee does not cover any breakage of the actual tooth or crown from undue force, i.e. trauma or inappropriate use i.e. opening bottles.

Uncomfortable or strange feeling: This may occur because of the differences between natural teeth and the artificial replacements. Most patients usually become accustomed to this feeling in time. Rarely, muscle soreness or tenderness of the jaw joints (TMJ) may persist for indeterminable periods of time following placement of the crown or bridgework.

Longevity of crowns and bridges: There are many variables that determine “how long” crowns and bridges can be expected to last. Among these are some of the factors mentioned in preceding paragraphs. In addition, general health, oral hygiene, regular dental checkups, diet (excessive sugar or acids), etc., can affect longevity. Because of this, no guarantees can be made or assumed to be made concerning how long crowns will last.

It is the patient’s responsibility to seek attention from the dentist should any undue or unexpected problems occur. The patient must diligently follow any and all instructions, including the scheduling and attending of all appointments. Failure to maintain good oral hygiene can ultimately result in failure of the crown, onlay, inlay and it is advised that you attend the dentist regularly.

INFORMED CONSENT: I have been given the opportunity to ask any questions regarding the nature and purpose of crowns, onlays, inlays and fillings and have received answers to my satisfaction. I do voluntarily assume any and all possible risks, including the risk of substantial harm, if any, which may be associated with any phase of this treatment in hopes of obtaining the desired and/or any results from the treatment to be rendered to me. The fee(s) for these services have been explained to me and I accept them as satisfactory. By signing this form, I am freely giving my consent to the dentist and/or all associates involved in rendering any services he/she deems necessary or advisable to treatment of my dental conditions, including the administration and/or prescribing of any anaesthetic agents and/or medications.

I understand that it is my responsibility to notify the dentist should any undue or unexpected problems occur or if I experience any problems relating to the treatment rendered or the services performed.

5 Year Guarantee includes any fracture of crown, onlay, large fillings and  bridge work, but does not include, failure due to underlying tooth fracture, secondary decay, trauma or accidental damage or fracture caused by inappropriate use (opening bottles) or de bonding (loosening) or subsequent need for root canal treatment.  Also it is only valid for patients who attend bi-annually for examination appointments, to ensure there are no aggravating factors, gum disease, excessive force or plaque and food trapping.