Choosing a Tooth Repair
The three main ways of repairing a damaged tooth, why we'd choose one over another, what each costs, and what happens at each appointment.
How Do Dentists Choose Between a Filling, an Onlay and a Crown?
The choice depends on how much healthy tooth remains and how much chewing force that tooth has to take. A small cavity is repaired with a filling. A back tooth with a large cavity but strong outer walls usually does best with an onlay, which covers the biting surface without the whole tooth being trimmed down. A tooth that's mostly old filling, cracked or root treated generally needs a full crown. At Lanark Smile Studios, white fillings start from £105, a ceramic onlay costs £750 and ceramic crowns start from £675.
The Smallest Repair That Will Last
Our rule is to use the least invasive repair that will do the job well. Any drilling removes tooth that can never grow back, so it makes no sense to crown a tooth when a filling would look after it. The opposite mistake matters too: forcing a very large filling into a tooth whose walls are already thin leaves it likely to split.
| Feature | Filling | Onlay | Crown |
|---|---|---|---|
| Suits | Chips, and small to medium cavities | Back teeth with big cavities but strong walls | Cracked teeth, root-filled molars, teeth with little remaining |
| Tooth taken away | Just the decay | The decay and a thin layer from the chewing surface | A layer from every side |
| Where it's made | Directly in your mouth, at the same visit | By a dental laboratory, from a scan | By a dental laboratory, from a scan |
| Number of visits | One | Two, usually | Two, usually |
| Starting fee | £105 | £750 | £675 |
When we examine you, we'll show you the X-ray and photographs of the tooth, so you can see exactly what we can see.
When a Filling Will Do the Job
Most cavities and minor breaks can be fixed with a white composite filling. Composite is a resin matched to your tooth colour. It's bonded directly to the tooth, added in thin layers and set with a blue light, all at one appointment. Because it's stuck to the tooth rather than simply packed in, it can even help hold the rest of the tooth together.
What a filling costs depends on which tooth it's in and how many surfaces it covers. A single-surface filling is £105 on a front tooth and £118 on a back tooth. A filling that covers three surfaces of a molar is £165. 1
There's a point where fillings stop being the right answer. Composite shrinks a tiny amount as it hardens, and in a very big cavity that can open gaps at the margins or put strain on the walls of the tooth. Once a filling would form most of a back tooth's chewing surface, we'll normally recommend a stronger repair.
A Filling That Keeps Breaking, or a Cracked Tooth?
Book an examination and we'll talk you through the X-ray and the repair that fits your tooth.
Why an Onlay Is Often Our Choice
An onlay is a piece of ceramic made to measure for your tooth. It replaces the damaged part of a back tooth, including one or more of its raised points, called cusps, and is bonded to the healthy tooth that remains. It sits somewhere between a filling and a crown. Because it covers and supports the top of the tooth, chewing forces are shared out rather than pushing the walls apart, yet the sound sides of the tooth are left as they are.
Onlays work well for:
- A premolar or molar with a big old filling that keeps breaking
- A tooth cracked through one cusp but strong everywhere else
- Lots of back teeth after root canal treatment, provided the walls are still thick enough
- Swapping out large metal fillings for something stronger that matches your teeth
A ceramic onlay costs £750, or £675 for dental plan members. 1 It takes two appointments. At the first, we prepare the tooth and scan it with our iTero scanner, and at the second we bond the finished onlay in place.
When a Crown Is the Answer
A crown fits over the whole visible part of the tooth, a bit like a thimble over a fingertip. We suggest one when too little healthy tooth remains for an onlay to hold onto, or when the tooth needs support all the way round. Typical examples are teeth that have broken in two, teeth with a crack running down one side, teeth ground flat or worn by acid, and many back teeth that have had root canal treatment.
The crowns we make are ceramic and colour-matched to the neighbouring teeth, so there's no grey line of metal at the gum. Crowns for back teeth start at £675, and for front teeth at £750. If very little tooth is left, it may first need building up with a core, which is sometimes anchored by a fibre post, £160. 1 For someone who grinds heavily on a back tooth with limited space, gold is still a sound choice, and we can give you a price on request. Our dental crowns page has more detail.
What the Appointments Involve
A filling is done in a single visit. We numb the tooth, take out the decay and any old filling, then place and polish the new composite. You can eat as soon as the numbness has gone.
An onlay or crown takes two visits, normally around two weeks apart.
- At the first visit, we numb the tooth, clear out old filling and decay, and shape it. Instead of a tray of putty, we take a digital scan. A temporary is then fitted to protect the tooth
- In between, a dental laboratory makes your onlay or crown using the scan
- At the second visit, we remove the temporary and try the new restoration in, so you can check the colour and fit. Then we bond it in and fine-tune your bite
While you have the temporary, avoid chewing gum and toffee on that side, and slide floss out sideways rather than pulling it upwards, so the temporary doesn't get lifted off. If it does come away, hold on to it and phone us.
The Full Fee List
| Treatment | Fee | Plan member |
|---|---|---|
| Examination for new patients, including X-rays | £70 | Included in your plan |
| White filling, one surface, front tooth | £105 | £95 |
| White filling, one surface, back tooth | £118 | £106 |
| White filling, three surfaces, back tooth | £165 | £149 |
| Ceramic onlay | £750 | £675 |
| Ceramic crown for a front tooth, from | £750 | £675 |
| Ceramic crown for a back tooth, from | £675 | £608 |
We confirm your fee in a written plan before any treatment, and dental plan members save 10% on fillings, onlays and crowns alike. 1 If root canal treatment is needed first, it's charged separately, as explained in our root canal guide. If you're an NHS patient with us, clinically necessary fillings and crowns are available at NHS charges, and we're accepting new NHS adult patients now.
How Long Each Repair Lasts
Looked after well, a ceramic crown will commonly last 10 to 15 years, and often a good deal longer. Onlays do about as well, and a carefully placed composite filling in a small cavity can also last for many years. Size makes a difference: larger fillings generally don't last as long.
It's rare for a restoration to fail by itself. Most often the cause is fresh decay where the edge of the restoration meets the tooth, gum disease or grinding. Brushing twice a day, cleaning between your teeth daily with floss or interdental brushes, and regular dental examinations that pick up small problems at the edges will keep them going. If you clench or grind, a night guard, £210, protects both the restoration and the tooth beneath. Our guide to teeth grinding describes the signs to watch for.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.