Dear Dr. Hall,
I just got 8 top veneers placed on. As I was leaving the office, I was told they may come off every couple of months. I know I can’t eat apples or crunchy things with them but are they going to fall off that often??
If they do come off, I will tell you what to do. Go back to their office and demand a refund or you will call a lawyer, because if they do, they weren’t done right. Take a copy of this email with you and show them – I’ll stand behind that statement 100%.
There is a principle in the dental profession called “the standard of care.” Now, unfortunately, since cosmetic dentistry isn’t a recognized specialty, the standard of care for cosmetic dentistry is pretty low. Your new veneers don’t have to be beautiful. They may even look dingy and still meet the standard of care. But they do have to stay on. That much is pretty basic. So if your veneers begin falling off within the first couple of years, that is a breach of the standard of care, and the dentist is legally liable for that. It’s hard to put a number on it, because they should never just fall off. But if I had to use a number, I would say they should last ten years, at least.
And about your dietary restrictions. I placed many veneers over a period of maybe 15 years, and I never told my patients not to eat apples or crunchy foods. I told them to eat whatever they wanted, except for pins and bottle caps and stuff like that.
In fact, I will go this far. I would encourage you to test the veneers by eating some apples. If these veneers aren’t going to stay on, it is better if you find out now rather than later. Put them through a stress test and see if they’re bonded properly. A properly bonded porcelain veneer will not come off. I had a couple of cases where I had to re-do some porcelain veneers, and you have to grind them off, just as if they were part of the enamel, they are bonded so tightly.
There are only a couple of legitimate restrictions to your activities after you have a set of porcelain veneers, and I list those on this website on a page dedicated to the postoperative care of porcelain veneers. That is to avoid biting metal objects, and to wear a mouth protector when playing contact sports. But even those activities would potentially cause the veneers to chip or crack, not to come off.
If someone tends to grind their teeth at night, I also would wear a nightguard over the teeth to protect the veneers from chipping or breaking.
But apples and crunchy foods? You should be fine with those. Go enjoy yourself, that’s what I would say.
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November 4, 2015
July 28, 2011
In November 2009 I had a crown put on my number 8 front tooth. My tooth was slanted from sucking my thumb when I was little, and this was to fix that.
About 3 weeks after my crown was put on my tooth was really sensitive to hot and cold. I was told that was normal for the first few weeks. About 4 months later my tooth was hurting so bad that I had to go to the ER! The next day my face swelled up and I was out of work for 5 days. When I went to another dentist, they told me that my tooth was infected and that I would need a root canal and a new crown. I was like WHAT??? how could this happen? She told me that I had an open margin and it was from the crown not being placed properly.
I called the first dentist, who did the crown, and I told the secretary the situation. I told her that i deserved my money back because for his mistake i have to pay for another crown and a root canal!! she said that once the crown was in my mouth it was my responsibility!! I said even if it was a failed job???
Is he liable for this? Shouldnt he pay?? I have seen the xray and the open margin is huge! ! If he we re to have taken xrays at the end of the job he would have seen the open margin and knew it had to be redone.
At the time I was making payments on the crown and paid a little more than half. After I found out about his mistake i told the office i was not paying the balance . About three months later I got a notice saying he was suing me for the balance! I couldnt believe it ! I of course filled a countersuit and when I went to the small claims court his lawyer told me if i drop the counter claim then the dentist would “forgive my debit”. I said NO I want the money that I paid him and his lawyer said “Well he is not willing to do that.” The case now has to be handled by the superior court because civil court can’t deal with things like this.
My question is should this guy have fixed his mistake? Because of him I was in the most extreme pain I was ever in, I had to miss days of work, I had almost a dozen appointments ( emergency room, doctors and dentist visits), my face swelled up so bad that I could barely see and I had to get a new crown and a root canal . Please let me know what you think!
– Sarah from Massachusetts
You have quite the story!
I have to qualify this because I can’t judge this without seeing. But just going from what you’re telling me, yes, your former dentist is liable for violating the standard of care. The most important thing to check when a new crown is being seated on a tooth is to run the explorer around the margins and make sure there is a good fit to the crown. Usually a dentist won’t take an x-ray before seating a crown, but they always need to run that explorer completely around the margins of the crown and check for any open margins. But having the x-ray you have is good documentation showing his negligence.
The problem, though, in many cases like this is that the dollar amounts involved make it impractical to involve lawyers and to go to trial. But here are a couple of things you can do to increase the pressure on this dentist to refund your money:
1. Threaten to complain to the dental board. Not as serious as a malpractice suit, this is still something that the dentist is strongly motivated to avoid.
2. Have the new dentist help you. A call from one dentist to another, verifying that there was indeed a problem with the work, can be very persuasive. In a trial, you HAVE to have an expert opinion of a dentist to back up any claim of negligence. Your word isn’t good enough.
3. Have a lawyer write a threatening letter. Rather than pay for an entire malpractice case, just having a letter from an attorney can get the dentist to take your complaint more seriously.
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April 23, 2011
Just two days ago I took my daughter in to have some Lumineers put on, first four teeth on the top. Prior to this she had braces to fix her teeth, and close in as many spaces as they could. We were told that the Lumineers were the least invasive and would close the gaps and be better than using bonding to fill them in. When talking with the dentist earlier, we saw a picture of before and after from the Lumineer book and said that we wanted them to be more tapered and not square, similar to the picture. They said they would take care of it and let us know when they came in.
When I asked if we could see them first before going on they said yes, but the way they did this was not the way they said they would. She had them in her mouth with some kind of temp material and her mouth was pulled back with a rubber device that really was hard to tell what was going on, and I couldn’t get a good view of them. Earlier they said she could get up and walk around with them in different lights, but this never happened. He assured us that it would look better when they are put on permanently.
I realized right away how big they appeared compared to her other teeth and how bulky they looked. I asked if there was something they could do to taper them, but he said to live with it for a week and see how we feel. I approached this again, and said how big they looked in the front, but they kept telling us how perfect they were. I felt like we were in shock and didn’t know what to say.
So, at home we really could see that these did not fit her face or her other teeth. They were large, straight across and she seemed to be having trouble talking and closing her mouth. Bottom line is that we are very unhappy.
The next day she went to school and the poor girl got teased, horribly. The kids comments were, horse teeth, they look fake, and the nice kids would say, they are nice but too perfect and big.
I see now, after the fact, that you really do need a cosmetic dentist. He claims to do cosmetic work, but when I checked out further, he is a general dentist. I called today and they are going to tapper them more, and they should look a lot better. But now I’m afraid of what the integrity will be. We could try this, but I think we just want them off and be refunded, so we can see a cosmetic dentist. What do you think is our best approach so we can do this without legal matters? We paid by credit card and we are not going through the insurance.
Cindy – Not happy in Oregon
I think there is a decent chance you could get money back to get this fixed right, if you go about this the right way.
I don’t know this dentist you’re talking about, so I’m judging this by what you are telling me. But it certainly sounds like you are right, and you have a dentist there who simply lacks the passion for appearance-related dentistry that you need for a case like this. An excellent cosmetic dentist would have been able to predict that these teeth would end up looking bulky. That is what Lumineers do. Also, an excellent cosmetic dentist would never have rushed through the try-in process, and would not have pooh-poohed your concerns when you first expressed them. He would not have said they will look better when they are put on permanently, and would not have asked you to live with them for a week and then see how you feel. All of these are attempts to brush aside your dissatisfaction.
One of the fundamental differences between dentists who are “fixers” and not artists is that the artists are very sensitive to your opinion of the appearance of their work, and they will deal with even the slightest hint of dissatisfaction.
A problem in dealing with a patient’s dissatisfaction with the appearance of dental work is that the standard of care for dental work involves primarily the function of the work, so it is difficult to get restitution simply because you are unhappy with the appearance. But your complaint is more than just that you don’t like how it looks – you were deceived about how the process would work, and the biggest thing is that you must have told them you didn’t want them to be put on – because you told me that they tried to assuage your concerns by telling you they would look better once they were on permanently – which isn’t true. Plus the embarrassment suffered by your daughter is very real and very documentable.
You say you want to get this resolved without involving lawyers. To do this, however, you will be most effective if you tell them that is your intention, while letting them know that you understand the strength of your position if you actually were to go that route. Here’s how I would proceed.
First, I wouldn’t have them do any more work on this. Wherever you are in the process, stop right now. Not only will this help your case, but it is more fair to them. The less chair time they waste on this, the lower their costs are. Plus that way you are making the strongest statement about your dissatisfaction.
Second, I would be very clear about your dissatisfaction, that you were led on and that you were told things that weren’t true. I would also be clear about the embarrassment being suffered by your daughter. These are your bargaining chips.
Third, you need to enlist the help of another dentist who will be sympathetic and who will go to bat for you, and be the person who will get you the deal from this dentist. Dentists are very conscious of their reputations with other professionals, so the other dentist will be in a little better position than you are to get this done.
I would suggest going to a dentist from out of town, because they would be more likely to take your side on this issue. Find an excellent cosmetic dentist on our list, and go see them for an opinion, and ask what they would be willing to do to help you get a refund of this procedure,
Also, if you haven’t yet paid the credit card charge for this procedure, I would tell the dentist that you intend to lodge a complaint with the credit card company and refuse to pay that bill unless you get a refund. This gives you one more avenue of protection, because the credit card company may be persuaded to take your side in a dispute over the charge.
I wish you well. I feel for your daughter. School mates can be cruel.
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