Replacing Previous Dental Work

Most restorations work well for years, but none is trouble-free for ever. A 2026 review looked at single crowns on natural teeth made of one-piece lithium disilicate, zirconia (one-piece or layered with porcelain) or metal-ceramic. After five years, about 97 to 99 in every 100 were still in place¹. Staying in place is not the same as staying free of problems.

Common reasons for a fresh look:

• New decay at the edge. A crown or veneer does not protect the tooth from decay, which can start at or under the edge. In a review of bridges on natural teeth, decay and the death of the nerve in the supporting teeth were the main problems².
• The nerve of the tooth. This is the pulp, the soft tissue inside the tooth. In some teeth that were alive before a crown, a partial crown or a bridge was fitted, the nerve dies later. A review of 37 studies of these restorations put this at about 5 in every 100 teeth³. In studies with more than ten years of follow-up, it was about 7 in 100. The certainty of this evidence is low: better studies could change these figures. If the nerve dies, the tooth may need root canal treatment, sometimes years after the crown.
• The gums. Gum disease or receding gum can expose the edge of a crown, or leave a gap where food collects.
• Fracture and coming off. For ceramic veneers, fracture and debonding were the main reasons for failure in a review of 25 studies. They happened mostly in the early years⁴.
• Around implants. A review of 57 studies looked at inflammation with bone loss around an implant (peri-implantitis). It found this in about 20 of every 100 patients and 12 of every 100 implants⁵. The rates vary widely with how each study defined the disease.
• Appearance and comfort. A colour, shape or size you are unhappy with, a bite that feels wrong, or teeth that were reduced more than you expected.

None of these reasons on its own says who is at fault. A new plan starts from what is in your mouth now.

The figures on this page come from published studies, not from our own records. They are averages for groups of people, not a forecast for one tooth.

See a dentist if you notice any of the signs below. They apply to crowns, veneers, bridges and implants.

• Pain when you bite, or a feeling that the restoration is high
• Pain with hot food or drink that lasts after the heat has gone, or sensitivity that keeps getting worse
• A crack, a chip or movement in the restoration
• A crown or veneer that has come off: keep it, and do not glue it back yourself
• Bleeding, swelling, a dark line or receding gum at the edge
• Food trapping, a bad taste or bad breath from one area
• Around an implant: bleeding or pus when you brush, a crown that moves or clicks, or gum that has shrunk back

Some problems cause no symptoms and are found at a check-up or on an X-ray. Examples are decay under the edge of a crown, bone loss around an implant or an infection at the tip of a root. A finding on an X-ray is a reason to investigate. It is not always a reason to replace the work.

When it is urgent. A dental abscess needs urgent treatment by a dentist and will not go away on its own⁶. Antibiotics do not replace this treatment. If you think you have one, ask your dentist for an urgent appointment, or see a dentist where you are.

The following need urgent medical help⁶. Go to the nearest emergency department or call the emergency number where you are. Do not wait for a reply from any clinic abroad.

• It is hard to breathe, speak or swallow
• Your eye is swollen or painful, or you have sudden problems with your sight
• There is a lot of swelling in your mouth
• It is hard to open your mouth

Before anything is removed, the dentist needs to know what is there and how it was done. Bring or send what you have:

• Earlier X-rays and 3D scans, with their dates
• The treatment notes or plan from the clinic that did the work
• Which teeth have crowns, veneers, posts or root canal fillings, and the materials used
• For implants: the system, the size and the parts used, and any implant card or record you were given
• The X-ray taken when an implant crown was fitted, if you have it

If your treatment was 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 imaging⁷. Turkey's patient rights regulation also lets a patient examine their file and obtain a copy⁸. For work done elsewhere, ask the practice that treated you for copies.

Which X-rays, and why

UK guidance on dental X-rays says they should be chosen for each person after a history and a clinical examination⁹, not taken routinely for everyone. Small X-rays of single teeth can show the root canal, the bone level and decay at some crown edges. They do not show everything under a crown (see "What can only be seen later" below). The same guidance shows that a 3D scan (cone beam CT) usually gives a higher radiation dose than small X-rays⁹. European guidelines say it should be used only when lower-dose X-rays cannot answer the question¹⁰. Planning an implant is one use where it can be justified¹¹.

Why implant records matter

There are many implant systems, and the parts made for one do not necessarily fit another. A 2017 international consensus report on diseases around implants recommends recording an X-ray and gum measurements once the implant crown is completed¹². Without that starting point, bone change around an implant is harder to judge.

What can only be seen later

Some things cannot be judged until the old crown or veneer is off: decay underneath, a crack, or how much sound tooth remains. A good plan says so in advance and explains what would change.

Replacing work is not automatically better than repairing it. The decision depends on the cause of the problem and how much sound tooth remains. The gums, the bite and what you want from the result matter too.

• Leave it and monitor. A small stain at an edge, a minor chip with no sharp edge or a slight colour difference may not need treatment. It is checked again at the next visit.
• Adjust or repair. A high spot can be adjusted. A small chip can sometimes be polished or repaired with composite (tooth-coloured filling material). A crown that has come off can be cemented back if the crown and the tooth are both sound and it still fits. A loose implant screw can often be tightened or replaced.
• Treat the problem underneath first. Decay, gum disease or an infected root canal is treated before any new crown or veneer is made. A new restoration does not treat the disease beneath it.
• Replace the restoration. This is considered for decay under the edge, an edge that does not fit, a fracture, or an appearance that cannot be corrected another way.
• Replace the tooth. A crack that runs down the root, or too little tooth left, can mean that a tooth cannot be kept; the examination decides. A tooth that cannot be kept may be removed, and an implant, a bridge or a denture can then replace it.

How strong is the evidence for repairing rather than replacing? For fillings, a review found no clear difference in failure between repaired and replaced restorations¹³. It rested on three studies, and the certainty of the evidence was very low. Our sources contain no comparable evidence for crowns or veneers.

Keeping your own tooth is worth weighing seriously. A review of 143 studies found that root-treated teeth and single implant crowns had similar long-term survival rates¹⁴. Direct comparisons between the two were very rare.

Crowns

A crown covers the whole visible part of the tooth, so the tooth under it has already been reduced on every surface. Shaping a tooth in this way is called preparing it. In a laboratory study on model back teeth, a full crown preparation removed about two-thirds to three-quarters of the tooth above the gum, by weight¹⁵. An old crown often has to be cut off, and it cannot then be reused. The tooth is cleaned and shaped again, which usually removes more tooth. How much depends on any decay or damage found. Each replacement may leave less tooth to hold the next one. If the nerve has died, the tooth may need root canal treatment first. If little tooth is left, the missing part may be built up with filling material; under a crown, this build-up is called a core. In a root-treated tooth with too little tissue left to hold the core, a post may be placed in the root canal. More on our dental crowns page.

Bridges

A bridge is one piece that fills a gap and is fixed to one or more teeth or implants beside it. If one supporting tooth develops decay or a fracture, the bridge often has to come off to treat it. The plan then covers that tooth, any other support and the gap together. The answer may be a new bridge, or an implant or another way of filling the gap.

Veneers

Veneers are bonded to the front of the tooth, usually after a thin layer of enamel is removed. That enamel does not grow back¹⁶; from then on, the tooth needs a veneer or another restoration. Old veneers are usually removed by grinding them away, and some enamel may go with them. How much enamel remains matters for a new veneer. Under the enamel is a softer layer, the dentine. In a study of 580 veneers followed for up to 12 years, 99 in every 100 survived where the preparation stayed in enamel¹⁷. In the same study, veneers bonded to dentine were about 10 times as likely to fail¹⁷. Where little enamel is left, other options such as composite or crowns are discussed, each with its own trade-offs. More on our dental veneers page.

Teeth that were reduced more than you expected

If your teeth were cut down further than you expected, the tissue that was removed cannot be replaced. A new plan cannot return the teeth to how they were. It aims to protect what remains and to keep the nerves healthy where possible. Within what the remaining teeth allow, it also aims for restorations that fit well and come close to the look you want. Ask for the state of each tooth in writing before anything more is removed.

An implant restoration has several parts: the implant in the bone, a connecting part (the abutment), a screw, and the crown or bridge on top. A problem in one part does not always mean replacing the others.

• A loose or moving crown. Screw loosening is a common technical problem. A review of 46 studies of single implant crowns estimated screw loosening in 8.8 per cent over five years¹⁸. Its published summary does not say whether this is counted per implant or per crown. A loose screw can often be tightened or replaced. Have any movement checked soon: the dentist checks whether the crown, its screw or the implant itself is loose.
• Screw-retained or cemented. A crown held by a screw can be taken off through a small access hole. A cemented crown may have to be cut off. A review of 59 studies found that screw-retained restorations are more easily retrievable, so complications can be treated more easily¹⁹. Screw-retained restorations had more technical problems, and cemented ones more serious biological complications, such as implant loss or bone loss of more than 2 mm¹⁹. Neither method was clearly better overall, although the authors judged screw-retained restorations to seem preferable, partly because they are more easily retrievable.
• Inflammation around the implant. Bleeding or pus around an implant is treated before a new crown is made. Sometimes the crown has to come off first so that the area can be reached. If bone loss has got worse since earlier X-rays, its cause is treated first too. Treatment may need surgery. If the inflammation cannot be controlled, the implant may be lost, and a new implant cannot always be placed in the same spot.
• Parts and records. Ask which implant system is in your mouth, and whether original parts from that system can still be obtained. If the system is unknown, finding matching parts may be difficult.

Implants need regular care for as long as they are in place. A European clinical guideline calls for a supportive care programme, with periodic checks of the tissue around the implants²⁰, once they are in use. A history of periodontitis, the advanced form of gum disease, matters too. In a review of 14 studies, people previously treated for it lost implants at about 1.75 times the rate of people without that history²¹. More on our dental implants page.

The material for a new crown or veneer is chosen tooth by tooth. It depends on the tooth's position, your bite, the opposing teeth, any grinding habit and how you want it to look. For single crowns on natural teeth, the differences in five-year survival between one-piece lithium disilicate, zirconia and metal-ceramic crowns are small¹. A different material is therefore not, on its own, a reason to replace work that is sound.

Points to settle before anything is removed:

• Colour. Whitening does not work on crowns or veneers²², so the colour of new ceramic cannot be lightened later. If your other teeth are to be whitened, that is done first.
• Shape and size. Very white, large or uniform teeth are a choice, not a standard. Ask whether a trial of the new shape (a mock-up) can be shown in your mouth before any tooth is prepared.
• The gum line. Healthy, stable gums come first. Inflamed or receding gum changes how the edges look and fit. If your gums bleed, have them checked by a dentist before any new work. More on our gum disease treatment page.
• Grinding. Veneers may not be suitable if you grind or clench your teeth²³, so this is checked before new veneers are chosen. A night guard may be advised to protect new work.
• What cannot change. A replacement cannot add back tooth that has been removed. A single new front crown cannot always match its neighbours exactly.

Replacing earlier work follows an order. Each step can change the next. A plan that goes straight to new crowns or veneers should explain why the earlier steps are not needed. Gum disease is treated before new work, in steps. A European guideline on treating periodontitis describes cleaning above and then below the gum line, then surgery where needed for areas that do not respond²⁴. It sets supportive care afterwards at intervals of 3 to 12 months according to each person's risk²⁴. If the plan changes along the way, ask to be told straight away and to get the updated plan in writing.

Risks

• More tooth is lost. Removing an old crown or veneer and preparing the tooth again takes away more tissue, and it does not grow back.
• The nerve. Preparing a tooth can affect its nerve. The figure of about 5 in every 100 teeth whose nerve died³ comes from teeth that were alive at the start. The review gives no separate figure for teeth prepared a second time, so it cannot say whether the risk is higher. If the nerve dies, the tooth may need root canal treatment.
• Root canal retreatment. If a root-treated tooth under a crown becomes infected again, the crown, and sometimes a post, may have to come out to reach the canal. Removing a post carries a risk of damaging the root.
• Damage during removal. Cutting off a crown or grinding away a veneer can chip the tooth or the core beneath. A tooth may turn out to be unrestorable once the old work is off.
• The gums. New edges, temporary crowns and repeated treatment can irritate the gum. Damage from periodontitis, the advanced form of gum disease, cannot be reversed, but the disease can be stabilised²⁵. It is treated before new work.
• Implants. Removing an implant crown, treating inflammation and removing an implant are separate procedures, each with its own risks.
• Time and visits. Replacing work can take several appointments, with temporary restorations in between.
• The result. New work can solve the problem it is aimed at. It cannot be promised to meet every expectation. It needs ongoing care, and it may in time need repair or replacement.

Benefits

• Treating the cause, such as decay under an edge or inflammation around an implant, can protect the tooth or the implant.
• Restorations that fit well are easier to keep clean.
• A new plan can correct a colour, shape or bite you are unhappy with, within what the remaining teeth allow.

A plan to replace several crowns or veneers is a big decision, and it is reasonable to have it checked. You can take a written plan to another dentist and ask whether they agree, tooth by tooth. In Turkey, the patient rights regulation gives patients the right to ask for another doctor's opinion⁸.

Informed consent means that, before you agree, you know:

• What is wrong, and what is proposed for each tooth
• The other options, including doing nothing, with their benefits and risks
• What could go wrong, and what happens if it does
• Who will carry out the treatment, where, and over how long
• The cost, and what is and is not included

Apart from the cost, these points match the information Turkey's patient rights regulation says a patient is owed before an intervention⁸. Ask for a written treatment plan before your treatment starts. It should set out the proposed treatment for each tooth and a realistic indication of the cost.

If the treatment is abroad, ask too what to do if a problem appears after you go home, and whom to contact.

These are the questions we suggest you ask before dental treatment abroad. They apply just as well to a clinic that is redoing earlier work. Below, each question comes with what this page can tell you about our clinic in Antalya, Turkey, today. Where it cannot answer yet, it says so and tells you what to ask. A longer list is on our page about dental treatment abroad.

Who will treat me, and what are their qualifications and registration?

Treatment is provided by our clinic in Antalya, Turkey, and carried out there by the clinic's dentists, who practise in Turkey. A dentist in private practice in Turkey must register with the provincial or regional dental chamber²⁶ within a month of starting. Ask for the name of the dentist who will treat you, their qualifications and their registration details in Turkey, and how you can check them. Ask too which legal entity your agreement is with, and which country's law applies to it.

Will the dentist speak English?

Ask whether the dentist speaks English, or whether a translator will be there. Ask which language your consultations and your written plan will be in.

What are the clinic's own results?

Ask how many times the treatment has been carried out, and its success and complication rates. The figures on this page come from published studies, not from our own records. Ask any clinic for its own figures and how it records them.

Is the clinic itself authorised?

In Turkey, a health facility needs an authorisation certificate⁷ from the Ministry of Health to treat international patients. The Ministry publishes a register of authorised facilities²⁷ that you can check yourself. The authorisation belongs to the facility, not to the dentist. It is a condition for operating and says nothing about the result of your treatment. Dental regulation differs between countries; check the rules in your own country as well.

Will I get a plan and a cost estimate in writing?

You should be assessed by a qualified dentist before you are given a treatment plan and a cost estimate. A plan made from photographs is only a preliminary view. Ask for the plan in writing before treatment begins. It should say what it covers, what it does not cover, and what could change once the old work is off.

Is the work guaranteed, and who pays for remedial work?

Ask whether the work is guaranteed and for how long. Ask too who pays for extra flights, the hotel and remedial work if there are complications.

This page cannot answer that question yet. The clinic's written terms for remaking work and handling complications are not published here. Ask for them in writing before you agree to treatment. Read what they cover, for how long, what is excluded and what you must do to keep them. Check who pays for travel, and for treatment by a dentist near your home. Do not rely on a verbal answer from any clinic, including this one.

Am I insured if something goes wrong?

In Turkey, a facility must take out complication insurance for surgical and interventional procedures carried out in an operating theatre⁷. That does not by itself tell you that a crown or a veneer is covered, so ask which procedures in your plan are. If you take out travel insurance, ask whether it covers anything connected with planned treatment.

Who do I contact after treatment?

Ask for the name of the person to contact after treatment, how to reach them and how quickly they reply. For anything urgent once you are home, get care locally first.

How do I complain if something goes wrong?

Ask for the clinic's written complaints procedure before treatment. In Turkey, a patient can apply first to the facility's patient rights unit. After that, they can apply to the Patient Rights Board of the provincial health directorate⁸, which also covers private facilities. The Board does not assess claims of medical error. The dental chamber can also open disciplinary proceedings²⁶ against a dentist.

Will my records come home with me?

Ask for a written record you can hand to a dentist near your home. It should list the teeth treated, the materials, any root canal treatment or posts, the X-rays, and for implants the system and parts used. Ask too for your aftercare instructions in writing. They should say how to care for the new work and any temporaries, which problems to report, and when and where your check-ups are.

Warning signs, for any clinic

Think twice before booking any treatment abroad if you see any of these signs. They are a hard sell, a lack of information, pressure to make a quick decision, no discussion of possible complications, and no mention of aftercare. Use the same test on this clinic.

Wherever the work is done, your own dentist near your home is usually the first person to see a problem after you return. Tell them about the plan before you go, and bring the written record back to them. Keep regular check-ups at the interval they set for you. You can also have the assessment, and any treatment, with a dentist where you live.

A dentist near your home may not take over work done elsewhere. What a health service or an insurer covers after treatment abroad also differs from country to country. Who pays for correcting the work is therefore a question to settle with the clinic, in writing, before treatment.

Before you book anything:

• Ask the clinic for its remake and complication terms in writing. Ask whether it pays for treatment by a dentist near your home.
• Ask the health service or your insurer where you live what, if anything, they would cover if the work needs correcting. Tell your travel insurer about your plans too. Do not assume anything is covered.
• Ask your own dentist whether they will see you for check-ups and problems after treatment abroad.

If you have urgent symptoms after you return, contact your own dentist or, if you cannot, a dentist where you are. If you have any of the urgent signs listed earlier on this page, such as difficulty breathing, speaking or swallowing, you need urgent medical help⁶. Go to the nearest emergency department or call the emergency number where you are. Do not wait for a reply from the clinic.

Replacing earlier work often needs more steps than first planned, because some findings appear only once the old work is off. Before you book travel, ask for a written preliminary plan with the appointments and the days they need. It is based on your photographs and any X-rays you send. 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 treatment starts. You can take time to decide, and you can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone.

Gum treatment, root canal treatment or implant healing can mean more than one trip. A 2023 narrative review of flying after dental treatment suggests waiting about a week after most dental procedures²⁸. It gives shorter minimums of 24 hours after restorative treatment and 72 hours after implant placement²⁸. These intervals assume no pain, swelling or bleeding at the treated site²⁸. Its authors note that the research is limited and comes mainly from military flying. Treat these intervals as a starting point for your dentist's advice, not as clearance to fly.

If you go home between visits with temporary crowns or veneers, ask how long they are meant to last. Ask too what to do if one comes off, and whether a dentist near your home can re-cement it.

Ask us the questions in the section above, and ask for the answers in writing.