Metal-Ceramic (PFM) Crowns

Where it may be suitable

• A tooth that has lost much of its structure, or is at risk of breaking, and that a filling cannot repair
• Bridges of several units, in selected cases where the supporting teeth and the surrounding tissues are sound. The longer the bridge, the more carefully its load and the risk of complications need to be assessed.

Where it is not suitable, or another option should be considered first

• Healthy, well-shaped teeth. A crown should not be made on a healthy tooth only for its appearance. Options that remove less tissue are considered first, such as teeth whitening, shaping with composite (bonding) or porcelain veneers. See "Crown or veneer" below.
• Teeth that a filling or a partial restoration can repair. An inlay fills a cavity inside the tooth; an onlay also covers weakened cusps (the raised chewing points) where needed. If enough of the tooth remains, these can take the place of a full crown.
• A known metal allergy. If you are allergic to metals used in dental alloys, tell your dentist; metal-free options are then considered.
• Untreated decay or gum disease. These are treated first.

Where extra care is needed

• Heavy chewing forces, clenching and grinding. The porcelain on top can chip. A 2026 review reported fewer fractures and chips¹ on single-piece zirconia and lithium disilicate crowns than on designs with a porcelain layer on top.
• Limited space. The tooth needs enough room for both the metal and the porcelain. Where space is limited, the material and the design are chosen with this in mind.
• Expectations about appearance on front teeth. The metal framework does not let light through. The crown can look more opaque than an all-ceramic one, and a dark line may show at its edge if the gum recedes.

The right option is decided at an examination, with X-rays assessed. Recent X-rays you already have can be used.

• Doing nothing, or monitoring. For a tooth that causes no symptoms and has kept its structure, waiting is an option; your dentist will explain the risk to you.
• A filling or a partial restoration (inlay, onlay). Both keep more of the healthy tooth than a full crown.
• For a missing tooth, options other than a bridge. In suitable patients, an implant, a resin-bonded bridge (glued to the neighbouring teeth) or a removable denture is also considered. Leaving the gap and monitoring it is another option. A conventional bridge also needs the neighbouring supporting teeth to be reduced.
• Zirconia. Has no metal alloy or metal framework; depending on the type, it is used on front and back teeth and in bridges.
• Lithium disilicate (e.max). Has no metal framework and lets more light through; used for single crowns, veneers and partial restorations.

How the result looks depends on more than the material: the colour of the tooth underneath, the laboratory's work and the clinical conditions matter too. Whitening does not lighten crowns², so if you plan to whiten your natural teeth, tell your dentist before the shade is chosen.

In Turkey you may hear the word kaplama for both crowns and veneers. In English, the name "PFM veneers" is sometimes used for what are full metal-ceramic crowns. So ask which one is proposed for each tooth. The two remove very different amounts of tooth, and neither can be undone.

• A porcelain veneer is a thin layer of ceramic bonded to the front of a tooth. Usually only a thin layer of enamel is taken from the front. Even so, the treatment is not reversible, because enamel is removed to place a veneer³.
• A crown covers the whole tooth. The tooth is reduced on every surface, and this often goes through the enamel into the dentine beneath it. A laboratory study used plastic model back teeth. There, full crown preparations removed about two thirds to three quarters⁴ of the visible part of the tooth. The design for a crown with a metal framework was at the top of that range. These are laboratory values and give only a sense of scale. That study did not measure front teeth or veneers.

What a crown can mean for the tooth's nerve is set out under risks, below.

What "Turkey teeth" refers to

In British media, "Turkey teeth" is a loose label for extensive cosmetic dental work, such as a full row of very white crowns or veneers. One concern raised with it is that healthy front teeth were cut down for full crowns when the patient expected veneers. The criticism is not of ceramics. It is of a plan that gave healthy teeth more treatment than they needed, without the patient understanding which treatment it was.

A crown on a healthy, straight front tooth, made only for colour or a small fault in shape, reduces the tooth for no clinical reason. This is why whitening, bonding and veneers come first on this page when the only concern is appearance.

What UK dentists report. The British Dental Association surveyed its members about patients treated abroad. Most of the dentists who answered named crowns as the treatment most likely to need follow-up work⁵. That is what responding dentists reported. It does not show how often treatment abroad goes wrong.

Before you agree to crowns on healthy teeth

The British Dental Association advises that patients should be aware of the risks and alternatives to the treatment they want⁶. Dentists in the UK must give patients a written treatment plan before their treatment starts⁷, and an updated one in writing if it changes. That is the GDC's standard for dentists on its UK register, not a rule for a clinic in Turkey; ask for the same. Before any tooth is prepared, ask:

1. Which teeth will have a crown, which a veneer, and which nothing?
2. For each crown, why is a filling, an onlay, a veneer, bonding or whitening not enough for that tooth?
3. If a metal-ceramic crown is proposed, why that material rather than a metal-free one for that tooth?
4. How much will be removed from each tooth, and can I have that in writing?
5. Can I take the plan and my X-rays to a dentist in the UK for a second opinion before I decide?

The answers should rest on the state of each tooth, not on a package or a material. A plan that gives every tooth the same treatment needs a reason, tooth by tooth.

Crowns are also made by dentists in the UK, so having them abroad is a choice, not the only route. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone.

The steps below are for crowns on natural teeth and are usually completed in two or three appointments. Bridges and work on several teeth can take longer. How the appointments fit a trip is covered in "Treatment in Antalya when you live in the UK".

The risks below apply to crowns on natural teeth. The figures come from published studies, not from the clinic's own results.

Risks and disadvantages

• It cannot be undone. Tissue is removed from every surface of the tooth for a crown; from then on, the tooth needs a restoration to protect it.
• Effect on the tooth's nerve. The pooled results of 37 studies cover teeth that were alive at the start. These teeth then received a crown or a partial restoration, or supported a bridge. In about 5 in every 100 of these teeth, the nerve died⁸. In studies with more than ten years of follow-up, the figure was about 7 in 100. The certainty of this evidence is low. If it happens, root canal treatment is needed to keep the tooth.
• New decay. A crown does not protect the tooth beneath it from decay. New decay can develop at its edge or underneath it.
• Chipping of the porcelain. Fractures can occur in the porcelain layer on top. Small chips can sometimes be smoothed or repaired; more extensive damage may mean the crown has to be replaced.
• A visible metal edge. If the gum recedes, a dark line may show at the edge of the crown.
• Gum inflammation. Plaque at the edge of the crown, or an edge that does not fit or is poorly shaped, can inflame the gum. If the gum bleeds or swells around the crown, see your dentist.
• Wear of the opposing tooth. A porcelain surface, especially a rough one, can add to wear of the tooth it bites against. After the bite is adjusted, the porcelain should be polished smooth.
• Sensitivity. Sensitivity to hot and cold may follow the procedure. Tell a dentist if it does not settle or keeps getting worse.
• Coming loose, and replacement. If the cement bond weakens, the crown can come off. The dentist checks why it came off and examines the crown and the tooth. It can be cemented back only if both are sound and the crown still fits. No crown stays in place for ever, and in time it may need replacing.

Benefits

• It is one of the crown options whose long-term clinical results are well documented⁹.
• In selected cases it can be used for bridges of several units.

After the procedure, wait until the anaesthetic has worn off before eating or drinking. While the temporary crown is in place, avoid hard and sticky foods. Mild sensitivity and tender gums are common in the first days.

Daily care

• Brush twice a day with a fluoride toothpaste.
• Clean every day where the crown meets the gum, and under bridges; use interdental brushes or bridge floss.
• If you clench or grind your teeth, wear the night guard your dentist recommends.
• Keep up regular check-ups with your own dentist in the UK.

Studies do not give a lifespan in years. They report how many crowns are still in place after a period of time. The figures below come from published studies, not from the clinic's own results. They describe crowns staying in the mouth; they do not mean that no problem or repair was needed during that time.

A 2026 review combined the results of earlier studies of single crowns on natural teeth. It estimated how many of every 100 would still be in place after five years. For metal-ceramic, monolithic zirconia and layered zirconia alike, it was about 97¹. For monolithic lithium disilicate it was 98 to 99.

For a longer period, there is a series of 2,340 single crowns from one practice, made on a high-gold alloy framework. In this series, 2,211 crowns were judged to be in a favourable condition when they were cemented. Of every 100 of them, about 97 were still in the mouth after 10 years and 85 after 25 years⁹. This result belongs to one practice, to selected crowns and to one type of alloy. It cannot be applied to other alloys or to everyone.

These estimates are for single crowns on natural teeth and cannot be applied directly to bridges or implant crowns. The material, the state of the tooth, the bite and oral hygiene together affect how long a crown stays in place.

Contact your dentist if any of the following happens:

• The crown feels loose or comes off (keep it, and do not glue it back yourself)
• The porcelain cracks, chips or feels rough
• Sensitivity that does not settle, or keeps getting worse
• Pain that starts on its own, wakes you at night or gets worse when you bite
• Swelling, bleeding or discharge from the gum around the crown
• The crown feels high when you bite, or your jaw feels tired

If pain is increasing, or you have facial swelling or a fever, see a dentist where you are without waiting for the clinic's reply. A dental abscess does not go away on its own and needs urgent treatment by a dentist¹⁰. In England, the NHS advises asking for an urgent dentist appointment or getting help from NHS 111¹⁰ if you think you have a dental abscess. If you do not have a dentist or cannot get an emergency appointment, it says to call 111 or use 111 online. Elsewhere in the UK, check the urgent dental care route where you live.

Emergencies. The NHS lists the following as needing urgent medical help¹⁰. Do not wait for a dental appointment or for the clinic's reply. In the UK, call 999 or go to A&E. In Turkey, the emergency number is 112.

• Difficulty breathing, speaking or swallowing
• A lot of swelling inside your mouth
• Swelling around your eye or in your neck¹¹
• Pain in the eye, or sudden problems with your sight
• Difficulty opening your mouth

Before you fly home

Make sure your bite has been checked and that you have written care instructions and a written record of your treatment.

Once you are back in the UK

If a problem comes up that is not urgent, write to the clinic and send photographs. See your own dentist in the UK for problems that need someone to look in your mouth. If you do not have a dentist, use NHS 111 as described above. In the emergencies above, do not wait for a reply.

A crown on a natural tooth usually needs two or three appointments. The crown is made in a laboratory between preparing the tooth and fitting it, and you wear a temporary crown in between. The number of days in Antalya depends on how many teeth are treated and whether a bridge is involved. It also depends on whether decay, root canal or gum problems need treating first.

Before you book, you receive a written preliminary plan with the appointments and how many days they need. It is based on your photographs, so the examination confirms or changes it, and with it the days and the cost. If it changes, ask for the revised plan in writing before any tooth is prepared.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment¹², and longer after surgical procedures. The authors note that the research is limited and comes mainly from military aviation. Treat it as a starting point for your dentist's advice, not as a rule.

Your own dentist

The UK General Dental Council suggests talking to your own dentist¹³ before you go. They need to know the plan in case problems come up later. If you do not have a dentist in the UK, it helps to find one before you travel. The NHS lists exchanging medical records and arranging aftercare back home¹⁴ among the things to consider before treatment abroad.

Ask for a written record of the treatment to take back to your dentist. It should show which teeth were crowned and the materials used, including the metal alloy, and any root canal treatment. In Turkey, the health tourism regulation entitles international patients to an itemised bill. On request, they also get free copies of the records of the materials used, the tests and the imaging¹⁵.

A crown needs regular check-ups for as long as it is in the mouth. These are usually with your own dentist in the UK. National guidance in England (NICE) says the interval between check-ups should be set for each person according to their risk¹⁶ and discussed with them.

If a problem appears after you are home

Problems that appear after you return are usually first seen by your own dentist in the UK. For a problem that is not urgent, you can also write to the clinic and send photographs. Before you start, ask what the clinic's written terms say about a crown that comes loose, chips or fails after you are home. Ask whether a repair would be done in the UK or on another trip, and who pays for the repair and the travel.

What the NHS does and does not do

If you later need NHS dental care in England or Wales, having been treated abroad does not by itself shut you out of it. An NHS dental practice that accepts you for a course of treatment, not only an urgent appointment, provides clinically necessary treatment, with your consent¹⁷. That may not be a new crown. The free repair or replacement¹⁷ an NHS practice can give for its own work does not apply to work done by another provider. The NHS also states that it is not liable for negligence or failure of treatment¹⁴ when you have treatment abroad. On the NHS England routes that fund planned treatment abroad, you cannot get reimbursement for dental treatment¹⁸.

The NHS guidance quoted here is for England, and for England and Wales where stated. Scotland and Northern Ireland have their own NHS rules, which this page does not cover; if you live there, check the arrangements.

Travel insurance

The NHS says that most travel insurance policies will not cover you for planned treatment abroad¹⁴, so you may need specialist cover. Tell your insurer about your plans.

The General Dental Council lists questions to ask before treatment abroad¹³. Below are its questions, some of them combined, with what this page can answer today and what to ask for in writing. The last question is one of our own.

1. Who will carry out my treatment, and what are their qualifications? The treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists. Ask for the name of the dentist who will prepare your teeth and fit your crowns. Ask where they qualified and what their title is.
2. Will my dentist speak English, or will an interpreter be there? Ask before you book. You need to understand your plan, your consent form and your care instructions.
3. Are you regulated by a professional body and registered with it? The GDC notes that it cannot guarantee that other countries have an equivalent regulator¹³. In Turkey, a health facility needs an authorisation certificate¹⁵ from the Ministry of Health to treat international patients. Authorised facilities appear in a register the Ministry publishes¹⁹, so you can check it yourself. The authorisation belongs to the facility, not to the dentist, and it says nothing about the result of your treatment. Ask for the treating dentist's own registration details as well. See health tourism authorisation.
4. Will a dentist assess me before I get a plan and a cost estimate? The GDC says you should always be assessed by a qualified dentist before a treatment plan and cost estimate¹³. A plan made from photographs is preliminary. Ask for the final plan in writing, tooth by tooth, before any tooth is prepared.
5. How many times have you done this, what are your success and complication rates, and can you give references? We publish no figures of our own yet, and this page carries no patient reviews. The figures on this page come from published studies. Ask for the clinic's figures in writing, and how they were collected.
6. Is the work guaranteed, are the terms in writing, and for how long do they apply? This page makes no guarantee. Ask for the clinic's written terms for remaking a crown or bridge and for handling complications, and read them before you commit. Check what they say about a crown that fails after you are back in the UK.
7. What aftercare do you provide, and who can I contact after the treatment? Your written plan should name who to contact, how, and in which language.
8. If there are complications, or I am unhappy with the result, what happens and who pays for further treatment, extra flights and the hotel? Is further treatment included in the cost? Ask for the answers in writing before you commit. A remade crown usually needs laboratory time, so it can mean another trip.
9. Do you have a complaints system, and can I see a copy? Ask for it before treatment. The GDC says it cannot resolve complaints or help with refunds²⁰; its investigations concern the dentists on its own register. Turkey's health tourism regulation makes the facility responsible for complications and medical malpractice arising after the health service it provided¹⁵.
10. Do you have insurance to cover this treatment? In Turkey a facility treating international patients must take out complication insurance for surgical and interventional procedures carried out in an operating theatre¹⁵. That does not by itself tell you whether your treatment is covered, so ask which procedures in your plan, if any, fall under it. Ask too, in writing, whether the clinic or the treating dentist holds insurance for complications or errors, what it covers and whom it protects.
11. What happens if the examination shows that a crown is not right for me, or I decide not to go ahead? You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone. Ask before you book what you would pay in that case, and what would be refunded.

The NHS names warning signs to think about before booking any treatment abroad. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare¹⁸. Apply them to this clinic too.

This page does not show prices. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• How many teeth need crowns, or how many units a bridge has
• The metal alloy used and the laboratory work
• Treatment needed first: decay treatment, root canal treatment, gum treatment, rebuilding the tooth
• The number of trips the appointments need

Ask for the plan in writing, including what it covers and which procedures would be assessed separately. Ask too who pays for further treatment and extra travel if there is a complication.

If you are comparing with a quote from a UK practice, compare what each one includes, tooth by tooth. Check whether both propose a crown, a veneer or nothing for each tooth, and which material.