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Q: My friend needs a cap and her dentist told her it would be xxxx she decided to have a second opinion and that dentist told her yyyy. Why is there such a large difference in price?

A: This is a great question. There can be many different reasons why there is such a difference in the fee charged for a crown. Most people are unaware of the numerous choices they have available to them when it comes to having their teeth fixed. It can be thought of in terms of cars. The options can range from anywhere from a Bentley to a Nova and anything in between.

So, let’s make sure the comparison is between apples and apples. The cost of a crown involves the preparation of the tooth by the dentist, the materials used in the preparation of the tooth, staff and other related costs as well as the charge billed by the laboratory that will fabricate the crown. More than ever patients are concerned about their health and their appearance. That is why it is so important to understand the variances between the different fees.

First of all your friend should ascertain that each dentist has treatment planned the exact same type of crown. There are many types of crowns available with some being only suited to a particular situation. In the past, the choice of materials was very limited which severely narrowed the options available to the doctor, the patient and the laboratory. The materials available today are much broader allowing for a wide range of choices.

The most common type of crown has a metal substructure with a porcelain covering that is shade matched to the adjacent teeth. The metal substructure can be made from a variety of different metals and or combinations of those metals. The metals can be precious or base and any combination in between. Crowns can also cover the whole tooth or part of the tooth. They can also be made entirely out of ceramic or entirely out of gold. However, selecting the type of material is really just the beginning of the process. Your friend and her dentist would need to consider a few things first. Are esthetics a concern? Is the crown visible when smiling? Is she interested in whitening her teeth? Does she have any allergies? Is this a new crown or a replacement? These are all factors that should be considered by both the patient and doctor.

The fee charged for the crown can be determined by analyzing these factors combined with the selection of an appropriate laboratory to fabricate the crown. The right lab is an integral part of the process. Finding the right lab goes back to the questions above. Is your friend a beauty queen? Well, then ask the doctor to use the same lab that the television show “Extreme Makeovers” uses. Of course, the fee will go up because of their expertise, precision and high quality materials they use. Suppose your friend is on a fixed income and just wants the cheapest crown available. Well, there are labs that mass produce crowns using low cost materials with less “quality assurance.” For these the fee will be less because it was mass produced, generally without regard to esthetics, and utilizing lower quality materials.

By now you should be beginning to understand there are vast differences and everything is not apples to apples. The old adage still rings true and that is “you get what you pay for.”

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Dr. Eck can be contacted at marcodentalcare@aol.com or at (239)389-9400.