Dental crowns in Islington, with onlays and inlays where possible

Most of the dental crowns Islington patients ask us about begin the same way: a back tooth has cracked, or a large filling has failed, and someone has said the word "crown". Our first question is whether a full crown is really necessary. Very often a smaller onlay or inlay will protect the tooth just as well while keeping more of it. This page explains how we decide, what each restoration involves, what it costs at our N1 clinic and how to look after it.

What are crowns, onlays and inlays?

All three are custom restorations made in a dental laboratory from a digital scan of your tooth, then bonded or cemented into place. The difference is how much of the tooth they cover.

• Inlay: fits inside the tooth, within the cusps, replacing a cavity or old filling. It is the most conservative of the three.
• Onlay: replaces part of the biting surface, including one or more cusps, and is sometimes called a partial crown. It reinforces a tooth that is weakened but still has healthy walls.
• Crown: covers the entire visible part of the tooth down to the gum line. It is used where so much tooth has been lost, or the tooth is so compromised, that only full coverage will protect it.

A laboratory-made ceramic restoration is stronger and more durable than a large direct filling. Where a cavity is small, a white filling remains the simpler answer. Where it is large, a filling can act as a wedge and split the tooth, and that is when an inlay, onlay or crown earns its place.

Who needs a crown, and who doesn't

Crowns, onlays and inlays tend to suit patients with:

• A large filling that has failed, leaked or fractured, and is beyond what composite can reliably restore.
• A cracked or fractured tooth, often a molar, that is sore on biting or sensitive to cold.
• A back tooth that has had root canal treatment and now needs protecting from fracture.
• Worn teeth, often from grinding or clenching, where the bite needs rebuilding.
• Heavily restored teeth whose appearance you would like to improve with natural-looking ceramic.

A crown is usually not the right choice when the cavity is small enough for a filling, when an onlay would protect the tooth equally well, or when the tooth cannot be saved. If the root is fractured or there is too little tooth left, we will discuss replacing it instead, for example with a dental implant or a bridge.

Dental crowns Islington: comparing your options

Choosing between restorations is really a question of how much healthy tooth remains and what forces it must withstand.

Ceramic inlays

An inlay replaces a moderate cavity between the cusps. Because the cusps stay intact, very little additional tooth is removed. It is a strong, precise alternative to a large filling and is often our choice for replacing old amalgam fillings in otherwise sound teeth.

Ceramic onlays

An onlay caps one or more cusps while preserving the healthy sides of the tooth. Because it is bonded rather than relying on a tight mechanical fit, it can reinforce a weakened tooth with far less preparation than a crown. For many cracked molars and post-root-canal teeth with sound walls, an onlay is the conservative first choice.

Porcelain-bonded crowns

A porcelain-bonded crown has a metal substructure with porcelain layered over it. It is a long-established, strong option, particularly for back teeth under heavy load, although a thin grey line can sometimes show at the gum margin over time.

Full-ceramic (Emax) crowns

Emax is a lithium disilicate ceramic that combines strength with natural translucency and contains no metal. We use it widely for front and back teeth where appearance and strength both matter. It can be bonded to the tooth, which helps retention where the tooth is short.

Crown or onlay: how we decide

We assess the remaining walls, any cracks, the bite, whether the tooth has been root treated and how the gum sits around it. The aim throughout is the least intervention that will reliably protect the tooth over the long term.

The process, step by step

1. Assessment. A dental examination or problem assessment, with X-rays where needed, to confirm the tooth is healthy enough to restore and that the nerve is not compromised. We discuss whether an inlay, onlay or crown is appropriate and give you a written, costed plan.
2. Preparation. Under local anaesthetic, old filling material and decay are removed and the tooth is shaped. We take a digital scan rather than traditional putty impressions, and match the shade to your neighbouring teeth.
3. Temporary restoration. A temporary is fitted the same day to protect the tooth while the laboratory makes the final restoration, usually over two to three weeks.
4. Fitting. The temporary is removed, the final restoration is tried in, checked for fit, contact and colour, adjusted to your bite, then bonded or cemented and polished.
5. Review. We check the bite and the gum around the new restoration at your next routine examination.

Results, longevity and aftercare

A well-made ceramic crown, onlay or inlay commonly lasts ten to fifteen years, and many last considerably longer. Longevity depends on the tooth underneath, your bite, grinding habits, diet and home care. Results vary, and no restoration is permanent.

• Brush twice daily and clean between the teeth every day; the junction between restoration and tooth is where new decay can start.
• Keep regular examinations and 30-minute hygiene appointments so we can check the margins.
• Avoid using your teeth to open packaging or bite very hard objects.
• If you grind, wear a protective night splint. We may recommend a Davies splint (£495) to protect new ceramic work.

After the anaesthetic wears off, a little sensitivity to temperature for a few days is normal. If the bite feels high, contact us so we can adjust it.

Risks, and how we reduce them

• Loss of tooth structure. A crown removes more tooth than an onlay or inlay. We reduce this by choosing partial coverage wherever it will protect the tooth reliably.
• Nerve inflammation. Occasionally a heavily restored tooth becomes inflamed after preparation and may later need root canal treatment. Careful preparation, cooling and a well-sealed temporary lower the risk.
• Fracture or chipping of ceramic. More likely with heavy grinding. We assess your bite, choose the appropriate material and protect it with a splint where indicated.
• Decay at the margin. Precise fit, careful bonding and good hygiene keep the margin sealed.
• Gum irritation. We place margins carefully and check the gum at review.

Crown costs in Islington and London

Our fees for crowns, onlays and inlays at our Islington clinic are:

• Ceramic inlay: £750.
• Ceramic onlay: £850.
• Porcelain-bonded crown: £950.
• Full-ceramic (Emax) crown: up to £1,200.

The fee includes the temporary restoration between visits. If the tooth needs root canal treatment first, that is £550–£950 depending on the tooth. A dental examination is £65 (30 minutes), or a problem assessment for a specific tooth is £75. Everything is set out in writing before treatment begins, and 0% APR finance over 12 months via Tabeo, subject to status, is available. For a broader view of the options across London, see our main crowns, onlays and inlays page.

Why choose Dr Vishal Patel for your crown

Your restoration is planned and fitted by Dr Vishal Patel, BDS (Liverpool) and MSc in Aesthetic & Restorative Dentistry (Manchester), GDC 103127, and a member of the American Academy of Cosmetic Dentistry. He has around 20 years in dentistry and over 15,000 cases behind him. His restorative training shapes the conservative approach on this page: protect the tooth, keep as much of it as possible, and make the result look like a natural tooth.

The practice has been on Essex Road since 2009 and is rated 4.7 stars from over 300 Google reviews. Patients who might otherwise travel to central London or Harley Street for onlays and ceramic crowns can have the same standard of laboratory work close to home, with a dentist they will see again at every check-up.

Questions patients ask about crowns

How much does a dental crown cost in Islington?

At Dental & Wellness London a porcelain-bonded crown is £950 and a full-ceramic Emax crown is up to £1,200. A ceramic onlay is £850 and an inlay £750. The temporary between visits is included. You receive a written plan before treatment, and 0% APR finance over 12 months via Tabeo is available, subject to status.

Is an onlay better than a crown?

When a tooth still has healthy walls, an onlay is often the better choice because it removes less tooth and is bonded for strength. A crown is better when too little tooth remains, or when the tooth is badly cracked around its circumference. We examine the tooth and explain which will protect it more reliably.

Do I need a crown after root canal treatment?

Back teeth usually need cusp coverage after root canal treatment, because they become more brittle and can fracture under chewing forces. That coverage may be an onlay or a crown, depending on how much tooth remains. Front teeth with little damage can sometimes be restored with a filling alone.

Does getting a crown hurt?

Preparation is done under local anaesthetic, so most patients feel pressure rather than pain. Some sensitivity to hot and cold for a few days afterwards is common. If discomfort persists, or the bite feels high, we ask you to contact us so we can check and adjust it.

How long does it take to get a crown?

Usually two appointments about two to three weeks apart. The first prepares the tooth, takes a digital scan and fits a temporary; the second fits the final crown, onlay or inlay. Teeth that need root canal treatment or gum treatment first will take longer, and we explain the timeline in your plan.

This page is part of our wider guide to emergency dentist in Islington, which sets out every option we offer side by side.

Getting here

Dental & Wellness London is at 222 Essex Road, Islington, London N1 3AP. Essex Road station is two minutes' walk, and Highbury & Islington is one stop by train. Buses 38, 56, 73, 341 and 476 stop on Essex Road. From Angel it is a 15–20 minute walk, and Canonbury is close by. Many patients cycle or use Lime or Forest e-bikes; from Dalston it is about ten minutes by bike. We are open Monday to Friday, 8am to 7pm, by appointment; please contact us or call 020 8127 4567 to book.