Manage royally high expectations of dental crowns

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  Posted by: Dental Design      6th September 2018









When appropriately planned for and fitted well, a dental crown can provide predictable function, aesthetics and value for money. While every dentist wants to ensure that patients receive high-quality care, it is just as important to make sure patients’ expectations are properly managed. This involves effectively communicating with patients throughout treatment – practitioners’ failure to do so has been blamed as the underlying factor in the vast majority of complaints made to the Dental Defence Union (DDU).[i]

As science and technology within dentistry has advanced, patients have become better informed, with greater access to clinical information. Consequently, they are now more aware of the treatment options available to them and this is, in many ways, particularly encouraging for dental professionals – patients are more engaged with regard to dental care and therefore more likely to be compliant with proposed treatment plans.

However, a well-informed patient base also comes with challenges. Some patients have a preconceived idea of what to expect from treatment, but these expectations might not live up to the reality. Practitioners must balance a patient’s view of possible outcomes with the techniques and materials available to achieve the very best result. Furthermore, it is essential to avoid miscommunicating to patients that a new crown will last a lifetime, regardless of how it is treated – some patients may not be aware that every dental crown requires ongoing maintenance and that, eventually, it will need to be replaced.

Practitioners can help patients form realistic expectations by educating them on the processes involved with treatment, thereby debunking any misconceptions. Many patients assume that once a crown is placed, that tooth will be unable to develop dental caries in the future. As practitioners know, however, this is not true and it has been proven that caries is one of the most common complications associated with conventional single crowns.[ii]

Patients must be informed that plaque can build up at the margin where the tooth and crown meet. While the crown itself will not decay, the tooth underneath can and if plaque is not removed, the patient may develop dental caries. Bacterial infection as a result of plaque accumulation could also cause gingivitis, eventually progressing to periodontal disease and loss of the tooth, if left untreated.[iii]It is vital that patients understand their responsibility to brush and floss regularly in order to maintain the health of both their natural teeth and any dental crowns placed. Practitioners must also make sure that patients appreciate the importance of attending the practice for professional examinations and cleanings. Education is key to ensuring that patients to do not develop unrealistic expectations of treatment.

There are a number of tools at a practitioner’s disposal that can be used to demonstrate what is achievable to patients. Various software programmes can provide a visual representation of the final crown, helping to provide a more accurate idea of what to expect. Provisional crowns go one step further by allowing patients to trial a prototype so that any further modifications can be made to the final restoration, before it is presented for fitting.

Of course, it is important to consider how best to fabricate a crown that offers supreme fit and optimal results. Many practitioners work closely with dental technicians to ensure that the most appropriate treatment is implemented – although the practitioner makes the final decision and they are ultimately responsible for the crown they fit. It is still beneficial to utilise the skill, knowledge and expertise of an experienced technician. They may be far more abreast of modern innovations and can often advise or assist in achieving technically difficult results in complex clinical cases.

Rather than refer to a laboratory for milling, practitioners may decide to mill crowns in-practice, taking advantage of the benefits offered by the latest technology. Some systems have been specifically engineered to help streamline the delivery of dental restorations. MyCrown, for example, is a fully integrated CAD/CAM system that offers the facility to create superior dental crowns – among other restorations – in just one appointment. Complete with an acquisition unit of both 2D and 3D capabilities, as well as advanced software and a state-of-the-art milling unit, MyCrown provides practitioners the freedom to choose restoration blocks they require, without limiting them to a single manufacturer or material.

Patients’ enthusiasm for treatment can be both rewarding and motivational, but a failure to manage expectations can quickly lead to a breakdown in the patient-practitioner relationship. In worst case scenarios, this could prompt the pursuit of a negligence claim. Open communication and honesty from the very beginning is essential to promoting confidence and trust, thereby increasing the chances of attaining a happy, healthy patient on completion of treatment.


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[i]DDU. (2013) Most complaints arise from failure to meet patient expectations, says DDU. Link: [Last accessed: 06.03.18].

[ii]Goodacre, C. J., Bernal, G., Rungcharassaeng, K. and Kan, J. Y. K. (2003) Clinical complications in fixed prosthodontics. J Prosthet Dent;90:31-41. Link: [Last accessed: 06.03.18].  

[iii]Workman, J. (2012) Dental Crowns: Risks and Problems. Link: [Last accessed 06.03.18].

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