Your leading source for cosmetic dentistry
information and referrals.

Stuck with pre-paid dentistry from a dentist who lost his license

Posted on by .

Dr. Hall,
I was required to pre-pay for all my dental work. This was full mouth implants (with 2 Zygomatic implants) the implants have all been placed. I’ve been wearing temps for months now. While waiting for my doctor to complete all the work (including permanent upper and lower teeth) he has lost his license. I don’t know the reason, but I do know everything has been paid for, yet I have no permanent teeth. I cannot afford a lawyer. What are my options for refund?
Thank you
Lindsay in Wisconsin

(See Dr. Hall’s answer below.)


We thank our advertisers who help fund this site.




Lindsay,
This could be a sticky situation, but there may be a solution.
The dentist probably sold his dental practice to someone, and the sales contract would include an obligation to complete any dental work started by the previous dentist. So I would investigate that.

If you don’t get a good answer there, I would contact the state dental board and ask if they have any ideas for you. They have to have had other situations where this has come up.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

My crown has fallen off three times!

Posted on by .

Dr. Hall,
My crown has fallen off 3 times. I have returned to him again and he says I need a gingivectomy to keep the crown secure by giving the crown more tooth area to bond the crown. This sounds extreme to me. Also the base of my tooth is blackened where I recall it was not when he placed the crown the last round. I’m holding the loose crown now and need to decide soon!

Please advise!

– Nancy from San Francisco

(See Dr. Hall’s answer below.)


We thank our advertisers who help fund this site.




Dear Nancy,

The procedure is called crown lengthening—trimming the gum and maybe some of the bone to expose more of the tooth so that it can retain a crown. Sometimes that is necessary, and I had occasion to do that in my practice.

My problem with your situation is that your dentist should have known up front that crown lengthening would have been required to retain the crown. Coming to you after the crown has fallen off three times makes me not trust him. Did he not realize when he first prepared your tooth that crown lengthening would be required? Or is it that crown lengthening isn’t actually required in your situation and this is just an excuse he is giving you?

It is possible to do a crown on a short tooth and have it stay on without doing crown lengthening and without having any problem. But the tooth has to be carefully prepared with only a very slight taper and possibly cutting some grooves into the sides of the tooth. I have a blog post about crown retention form that you can read here. It cuts into the excuses that many dentists use to explain why their crown fell off. In over twenty years of practice, I never had one of my crowns fall off, because I always prepared them with a tight draw. Many dentists don’t like to prepare a crown with a tight draw because it is more demanding and even a slight error can mean that the crown won’t fit at all.

It is when a tooth is “bombed out” with most of the crown either broken off or eaten away by decay that crown lengthening is required.

Bottom line—I wouldn’t trust this dentist to try again and would get a second opinion. He’s clearly planning to do a new crown for you, so I’d have another more expert dentist do it. I don’t know what the blackening of your tooth is, but something doesn’t sound right about that either.

Oh, and I think your dentist should refund you AND the insurance company, if insurance was involved. If he doesn’t, I’d complain to the dental board and to the insurance company. A crown isn’t serviceable if it won’t stay on, so there should be no fee for it.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Does my dentist owe me a refund for not finishing my denture on time?

Posted on by .

Hello Dr. Hall,
In August 2020 I went to a dentist for a consult for a new overdenture over my 4 existing mini implants. I explained I would be leaving the state around the first part of October 2020, therefore wanted to know what time period it would take for him to complete the new denture. His answer was 3 weeks. On week 9 (Oct. 7th) I went for the final denture. It did not fit properly on the implants, so he forced it. I went home with it and tried to eat bowl of noodles, which was very difficult.
I was able to take it out with extreme difficulty, but when I tried to reinsert, it would not go in.
So I called his office the next day (Oct 8th). He was out of office so another dentist saw me. He agreed it needed work done on it as the holes were not drilled out properly around the attachments. One side of the denture is lower and the teeth are slanted slightly backward.
On Oct. 14th his office called said he is ordering new “gaskets” for the attachments and that should fix everything!
At this point I am very dissatisfied with the denture and have no time left before I have to leave town.
In your opinion do I have the right to ask for a refund, as I cannot wait for a remake?
Thank you!

– BJ from Pennsylvania

I found your website searching for How to ask a dentist for a refund.

(See Dr. Hall’s answer below.)


We thank our advertisers who help fund this site.




BJ,
Thanks for a very interesting question, which is partly dental and partly legal.

Let’s address the legal question first. You made an agreement (it would qualify legally as a contract) with this dentist that he would make this overdenture for you in three weeks, and he wasn’t able to deliver, so he broke the agreement. So yes, he should refund your money. And it’s not like he just barely missed it—he was off by a lot. It was promised in three weeks and delivered in nine, and when delivered it didn’t meet any standard of acceptability.

And I will tell you what I tell others who are trying to position themselves to ask for a refund from a dentist who will be reluctant to give it. You have points of leverage. You can leave him a bad online review. We have data at Infinity Dental Web that show that 60 to 65% of prospective new patients will check online reviews before asking for an appointment, so these reviews can have a strong impact. If you want to sweeten the deal for him, you can offer to write a very nice review about his integrity if he makes this good for you.

The second point of leverage is complaining to the dental board. Dentists do not want to deal with the dental board, so this can be very effective.

The third is a malpractice lawsuit. Though your case doesn’t rise to that level and the monetary amount isn’t enough in my opinion to justify a lawsuit.

If there is dental insurance involved in paying for this, you have a fourth point of leverage in complaining to the insurance company.

Now to the dental part of your case. The dental problem is that this probably should have taken him about three weeks. The fact that it took nine reflects poorly on this dentist. And then that it doesn’t fit over the implants is a problem. Their offer of ordering new gaskets that is going to fix this problem is hollow because the other two big promises they made to you (an overdenture in three weeks and one that would actually fit) missed by a long shot.

One thing that comes to my mind is that implant dentistry is a very unregulated branch of dentistry. In dental school there is very little training for it, and dentists need to pursue some post-graduate training in order to really know what they are doing. So I suspect that this dentist was in over his head but didn’t want to share that with you. Mini implants aren’t very common, and I would be tempted to ask this dentist if he has ever worked with mini implants before.

So here’s what I would advise doing. I would start by being very nice in asking for a refund, telling him that you understand that he is in a difficult spot and offering to write a nice review about his integrity and everything you liked about their office. If you liked how the denture looked, you can write about that. Then, if he resists, I would start to get tough. I would start by asking if he has ever worked with mini implants before. I’d want specific information about how much experience he has with that. And then I would tell him that if he doesn’t help you, you’re going to file a complaint with the dental board.

I wish you luck, and would love to hear back from you on how this turns out.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

My dental implants came out the third day!

Posted on by .

Dr. Hall,
I recently decided to have dental implants to support my dentures. I paid $1700 apiece for 6 dental implants and I am supposed to pay another $5000 for two more after these heal. Problem is 3 of these came out on the third day. My question is two-fold. One, should I be charged for the three that came out? And two, what should I expect from this dentist moving forward?
– Tom from Illinois

(See Dr. Hall’s answer below.)


We thank our advertisers who help fund this site.




Tom,
A basic requirement of dental implants is that they will stay in. So no, you shouldn’t have to pay for an implant that doesn’t stay in. But I will go further than that—you need a good explanation for why they came out. That’s a 60% failure rate. Authority Dental estimates the failure rate for dental implants is 5%. And most of those failures are from poor surgical technique. Also, failures tend to occur after a period of time—months or years rather than days.

Typical reasons for dental implant failure include:

  • Development of infection, often because of poorly fitting fixtures
  • Diagnostic shortcuts, resulting in the failure to properly assess whether or not there is adequate bone support for the implant
  • The use of substandard implant fixtures
  • Incorrect placement of the implant
  • Premature loading—putting stress on the implant before it has fully fused with the bone
  • And less common, medical issues on the part of the patient

A question I have, also, is if three of the five implants failed on the third day, how long will the rest of them last? You could be at risk of them coming out also. When dental implants fail, it is usually after they are placed under some stress. If three of yours fell out with no stress placed on them, I can’t imagine the odds are very favorable for the remaining two once they are used to support your overdenture.

Here’s what I would do. I would go to another dentist for a second opinion and ask why these implants fell out. I see that you are in the St. Louis metropolitan area on the Illinois side. I would find a dentist with expertise in dental implants somewhere else in the metropolitan area, at a large distance from your current dentist, to help insure that they don’t know each other. The new dentist may need to ask for copies of records, and your current dentist is ethically obligated to provide those. Look for a dentist with fellowship status in a professional dental implant organization, or a dentist who is a specialist in either oral surgery or periodontics. Ask them why these implants failed.

And then, what should you do going forward? I would find another dentist. And depending on what your second opinion tells you, I would be demanding a complete refund of everything you paid—not just the for the three that came out. You’re on pretty solid ground for getting a refund, since you have quite a bit of leverage. The state dental board I think would be interested to know if you get any difficulty from your dentist over this. This is truly a dental implant horror story.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

They didn’t tell me I might need a root canal after this crown

Posted on by .

I had a molar that was cracked with a filling in it. The dentist put a crown on it a few months ago and never mentioned the possibility of needing a root canal (otherwise, I would have had it pulled). The procedure was very uncomfortable since I had trouble getting numb and it felt like I was getting electrocuted when he drilled. I knew the crown was not right from the start and told the dentist that I couldn’t bite on it or chew on that side, and it was painful to floss around it. They told me the sensitivity was normal after a new crown and it would eventually settle down. That was in September. Then in January I went back for a second crown and told them my priority was fixing the first crown. They adjusted that crown, but then brushed me off and were more concerned about putting in the second crown. I had to push the dentist to look at my first crown and all he did was put some numbing solution on it. I had to ask him to adjust it which he eventually did, but the pain remained. The dentist’s office kept saying the crown was probably not perfectly aligned and simply needed to be readjusted so scheduled me for a follow up visit, which was canceled twice due to the pandemic. The tooth became very painful and now has a periapical abscess. I will be losing the tooth later this week. The dentist has not taken any responsibility or offered a refund and is charging me to extract the tooth. I plan on requesting a refund for the crown but would like some guidance on how to go about asking for one and reasons to support my request. Thank you for your guidance, Dr. Hall, and this useful website!

– Meg

Thank you again, Dr. Hall!
(See Dr. Hall’s answer below.)


We thank our advertisers who help fund this site.




Meg,
Here’s what I see in your case.
It sounds to me like your dentist was a little sloppy. The tooth was cracked already, which puts it at risk of needing a root canal. And while some sensitivity can be normal after putting on a crown, that sensitivity would be a little extra sensitivity to temperature changes. The pain you had was not normal. Not being able to bite on it is certainly not normal. A properly done crown should blend into your bite so that you don’t even notice it. And yes, they should have mentioned the possibility that you could end up needing a root canal.

But what gets me the most is that when you went back in January, still complaining about this crown, and they brush you off and do the second crown. This is going after the fee and not serving the patient. It seems to me that they didn’t want to deal with the crown that wasn’t working because there’s no money in trying to get that right—they want to collect the fee on the second crown.

But getting a refund, I think, is going to be tricky in your situation. To do that, you would need leverage. Let me explain.

Using Leverage to Get a Refund

There are several ways to put leverage on a dentist. The strongest is a lawsuit. If a dentist departs from the standard of care, which is what an average dentist would do in similar circumstances, then they can be held legally liable. I don’t think what your dentist did rises to that level. While I believe your dentist was careless in putting a crown on a sensitive tooth before being sure that it was settled down, I don’t know that for sure. And every dentist who has done crowns has had a tooth flare up after a crown has been put on.

And while I believe he or she was unethical in not taking care of the first tooth before doing the second, there’s some fuzziness there, too. Maybe they had a reason the second tooth was going to fracture if you didn’t get a crown on it soon enough. Even if that wasn’t their thinking, they could easily say that at this point, making it difficult for you to get anywhere with your complaint.

Another way to put leverage on a dentist is to complain to the dental board. But again, in my opinion, what your dentist did didn’t depart enough from what a lot of dentists would do for you to get much sympathy from the dental board. It’s just too easy for them to paint this as a routine dental procedure that went bad as some of them unfortunately do.

The final way is with online reviews. You could try that. Check and see what the current status of their online reviews is. If they don’t have any serious complaints, that might be enough to make them want you to be happy. But if there already are other unanswered complaints, adding yours won’t make much difference to them.

Why Not Get the Root Canal?

You said that the tooth now has a periapical abscess. That means that the tissue inside the tooth is dead. Do you realize that the dentist could now drill into the tooth with no novocain and you wouldn’t feel it? However, with the abscess, if this is an upper tooth, it becomes considerably more difficult to get the tooth numb. An extraction could be a very traumatic experience. Especially in the hands of an endodontist (root canal specialist), a root canal would be much, much easier than an extraction. And once this molar is gone, what are you going to do to replace it? If you leave the space without putting in a false tooth, the teeth on either side will tip into the space, as well as the opposing tooth, which would disrupt your bite and you could end up with TMJ disorder down the road.

My Recommendation

From what you’re telling me, I’m not feeling that this dental office is looking after your best interests, and I would find a different dentist—one who is willing to sit down with you and discuss what to expect, the pros and cons of various treatments, and who cares about your comfort. And one clue that you have such a dentist would be their willingness to explain what will happen if they just extract a molar without replacing it.

I wish you luck, and feel free to come back with the rest of the story when this is all over.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Bad experience at a chain dental practice

Posted on by .

I went to a large dental chain that has several locations in the Houston area. I went to two of the locations and had a large amount of dental work done. I went to a new third location that was closer to my job last week for an annual cleaning and exam. Upon reviewing my x-rays the doctor asked me where I had gotten some of my work done previously and I told her the same company, just a different location. This left me feeling uneasy because she wanted to put a crown on a tooth that had received fillings just three months ago. By the end of the visit I was upset and wanted to go somewhere else.

I found an office with only one location and had another set of x-rays and exam done. The new dentist informed me that almost all my fillings would need to be redone and my crowns on two of my root canals were ill-fitted and needed to be redone.

Am I subject to a refund for all the work that needs to be redone? This is a large corporation and I have not yet requested the refund. I am seeking advice first.

– Anna Kay from Houston

(See Dr. Hall’s answer below.)


We thank our advertisers who help fund this site.





Anna Kay,

It could be tricky to get a refund from this dentist, but I’ll see if I can help you. I think you’re going to have to put some pressure on this dental practice.

I would start by getting another second opinion. This is a large discrepancy between the two dental practices, and you want to be sure you’re on solid ground. If I were you, I would tell this new dentist something like this, “I’m really upset over this, and I believe you, and I want to get this work done, but I’d like to ask for two favors. First, I’d like you to help me get a refund from this other dental practice. And second, just to be sure, I want to get one more opinion.” You’re entitled to get a copy of the x-rays for that. Then I would find another dentist in a private, solo practice who has good online reviews some distance away. I wouldn’t tell them anything about any of the dentists you have been to or what they said but to just look at the x-rays, look you over, and tell you what they think needs to be done. We want this to be a “blind” second opinion.

If this new second opinion agrees with what you’ve been told, then I would ask your new dentist to call the dentist that did the original work, tell them you have two independent opinions that all this work needs to be re-done, and that you want a refund. Here’s the reason for that. To make a complaint about the quality of dental work, legally you need the opinion of another dentist that this needs to be re-done. And your just going in and saying that another dentist told you that isn’t good enough—you need to have the first-hand report of the dentist.

If the dentist who did the original work doesn’t cooperate, to give “teeth” to your request for a refund, you have three levels of things you can do. The first is relatively mild, and that is to threaten to tell your story in an online review. Stronger than that is to make a formal complaint to the state dental board. And your ultimate tool is a malpractice case. Though in your case, where there is no pain and suffering involved, the dollar value of your case wouldn’t be enough to interest most lawyers. If there is dental insurance involved, the insurance company could also help in providing leverage against the dentist.

So this isn’t a sure thing that you’ll be able to get a refund, but it’s worth a try. These corporate practices are profit-driven and I doubt that they are going to want to refund your money out of the goodness of their heart. You’re going to have to threaten some pain to get your money back. The threat of some kind of sanction from the dental board plus publishing an online review about the incident—that is what I think will be required to get some action.

The Problem I Have with Corporate and Chain Dental Practices

Dentistry, on the whole, is one of the most ethical professions there is. People tend to want to become dentists for the satisfaction of helping people in one-on-one situations. When I was in practice I got to know my patients well. I would keep notes on personal details that I wanted to remember and got great satisfaction out of seeing them year after year. I enjoyed it when parents would bring in their children and we’d get to know the whole family. I especially enjoyed doing smile makeovers, transforming an ugly smile into a beautiful one and how that changed my patient’s life. I also enjoyed it very much when I had a patient come in suffering from dental neglect because of fear of the dentist and I could help them overcome that fear and see them begin to come in now year after year with healthy teeth, unafraid to sit in the dental chair. These kinds of feelings are what motivate people to go into dentistry. Of course, they want to then make money and live a comfortable lifestyle, but generally, that isn’t the primary motivation.

Expansion into a group practice can be motivated by financial considerations, but in a group practice there is the added enjoyment and professional stimulation of associating with other dentists plus the convenience of having colleagues to back you up when you want to go on vacation or be out of the office for other reasons.

A corporately owned dental chain, on the other hand, comes about by the drive to make a lot of money. In addition, the dentists they hire can tend to not have a long-term commitment to the practice. Especially where they have patients rotating through different dentists, you’re taking away from the joy that attracts many dentists to the profession. Plus, management tends to be very profit-oriented and they can put pressure on the dentist to produce and to cut the amount of time they spend on procedures.

I want to be careful about making sweeping generalizations here because there are some very caring, capable dentists who work in a corporate setting. I know some of them. But generally, you’re going to see a higher level of ethics, caring, and professional skill in smaller practices.

Bottom Line

Anna Kay, I hope in this new dentist in the single-location practice is one you are comfortable with and you can develop a long-term relationship. If so, that will help provide you with quality care for years to come.

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

How do I get a refund from my dentist?

Posted on by .

Dear Dr. Hall,
I found you searching for “refund protocol from a dentist.” I hope you can help me.
I paid for a service through Care Credit about 4 years ago. I’ve already paid Care Credit off. The initial work was never done but other work was. I no longer wish to go to this Office, and asked for a refund of the remaining balance. They seem to be dragging their feet. Is the check written in office or is that something that comes from somewhere else?
-Josie from Houston


We thank our advertisers who help fund this site.

Josie,
Care Credit pays the dentist up front for the work done, after you have signed the contract. They deduct certain fees from what they pay him. If you didn’t get the work done then absolutely the dentist needs to refund the balance to you. It needs to come out of his pocket.

The first and most effective place to complain if they don’t do this would be to the dental board. The dental board has power over the dentist’s livelihood. So I would call your dentist and tell them you will do that if they don’t pay you promptly. Another weapon you have is online reviews, and you could threaten that, too. You could go to Yelp, Google, or Facebook. About 2/3 of prospective new patients will check online reviews before selecting a new dentist, and most dentists are particularly sensitive about bad reviews.
– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

A full-mouth reconstruction horror story

Posted on by .

Hi Dr. Hall,
I found you by searching on crowns and dry mouth.

A couple of months ago my dentist removed my 18-year-old veneers and restoration of my upper teeth 7 veneers and bridge was to begin. I complained every day about my temporaries and requested that he take them down on 2 separate occasions. My bridge fell out 3 times before permanents arrived. A little over 3 weeks ago he delivered them. The appointment was over in 40 minutes.

I’m suffering with my lip sticking, air stuck in my front teeth blowing bubbles, and my mouth is so dry that I’m eating popsicles all day and night for relief from dryness and the sucking I’m doing of my tongue and lip. I suck on my tongue and back of teeth so hard it burns! I can’t seem to stop sucking. What is wrong with me?!?! The porcelain is tough and rigid. He said he had to open my bite so I can show my teeth but I’m not showing teeth at all actually, it’s really really odd and the dentist claims I’m going to have to adapt because his “checkpoints” are perfect and textbook case. All I wanted was B1 shade and the hand press style porcelain that I’ve known my adult life! Please help me if you can.

I’m 42 and my second time in veneers and I’m miserable. I gained 3 extra crowns and a substantial gap in my bridge. With almost a month in, this can’t be healing tissue, is it?

Sofie from Michigan


We thank our advertisers who help fund this site.

Dear Sofie,
No, this isn’t a healing issue. This is a “dentist screwed up issue.” You need to get this fixed and I’ll be blunt as is my style—you need this new work taken out and started over again. And I wouldn’t have this guy doing it.

Opening the bite requires crown work on at least every tooth in one arch—most typically it is done with a full-mouth reconstruction meaning every tooth is restored. And it needs to be done with great care. It needs to be done with temporaries first. At least it looks like your dentist did that, but it sounds like he didn’t respond to your discomfort. You wear the temporaries at the proposed new opening to make sure you are comfortable with it and function properly. You’re telling me that you “complained every day” about your temporaries, but it looks like your dentist plunged ahead anyway.

Your body has a certain amount of jaw opening that it is comfortable with. This amount of opening is tied to the muscle tension in your jaw muscles, as well as reflexes that are part of speaking. Opening the bite is indicated when there is bite collapse—you have worn down your teeth to where your mouth is over-closed. In that case, we open the bite to restore your normal vertical dimension.

A big part of the problem in your case is that your dentist opened your bite when I’m guessing that you already had a comfortable bite. He was doing it to get more of the upper teeth to show. That puts him into risky territory from the start. If this is correct, that your bite was already comfortable, opening would put you beyond your normal opening, and that’s when you get into these issues that you are having: lip incompetence (the lips when relaxed don’t close all the way) leading to dry mouth, speaking problems, and other issues. He claims that your “’checkpoints’ are perfect and textbook case.” No, I’m sorry, that’s not the case. The main checkpoint is does your mouth when relaxed close naturally, and it doesn’t.

A Warning

A side note and warning for you. DO NOT EAT POPSICLES to keep your mouth wet. That is one of the worst things you can do, unless the popsicles are sugar-free. Your dry mouth doesn’t have the proper amount of saliva, and it’s your saliva that has your defenses against decay. You are risking rampant tooth decay getting in under your crowns and ruining your teeth. Get something sugar-free to suck on.

What to Do Now

I’m sorry to have to break this to you, but you need your whole case re-done. And I would not have this guy do it. I’m sorry again, but I wouldn’t trust him. What has happened in your case causes me to question his ethics. This is a serious breach of professional care and admittedly I don’t know all the facts in your case, but from what I know he is liable for malpractice. Maybe he is a really good guy and was just trying to do the right thing. But the stakes are high here and there is a small minority of dentists who know how to do this right.

I’ll tell you what I’ll do. I’ll email you privately with a recommendation for a very good dentist with strong ethics and well trained in cases like yours. I don’t want to give a name like this publicly lest the dentists I don’t recommend get offended. And then I would ask this new dentist to contact your current dentist and ask him nicely to refund your money to keep you from complaining to the dental board, putting his license in jeopardy; or from going to a lawyer.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

My new crown feels funny

Posted on by .

Hello Dr. Hall,
I moved, & went to a new dentist for a recommended crown. The dentist allowed the hygienist to attach the permanent crown, & did not check it, much to my surprise. It feels like there is “play” in it, & it is not fitted properly. Can this be corrected, & what should I do?

Kathy from Missouri
 


We thank our advertisers who help fund this site.

Kathy,
I checked the dental regulations for Missouri and was able to verify that this is legal for a dentist to allow a dental assistant to cement a crown. And I’m suspecting that this auxiliary who cemented the crown was an expanded function dental assistant and not a dental hygienist. Dental hygienists specialize in cleaning teeth and screening examinations, and usually don’t perform other functions in a dental office. In Missouri, a dental assistant who has completed education in expanded functions can be certified to be able to place fillings once the tooth has been prepared by the dentist. They can perform adjustments on permanent crowns as long as they do it outside the mouth, and they can perform the final cementation of that crown.
It would seem to me, though, that the dentist would need to check the crown to make sure it fits properly. I can’t tell, by reading the regulations if that is specifically addressed by the dental board, but I suspect that some type of direct supervision of the dental assistant is required meaning that the dentist at some point needs to check the crown and make sure it meets certain clinical standards. And even if that isn’t spelled out clearly in the regulations, in my opinion a good dentist dedicated to providing quality work would want to check the crown before it is cemented. If I were the dentist in that situation, I can’t imagine doing anything less than that.
About your feeling that there is “play” in the crown—I don’t know how to evaluate that. If the crown is loose on the tooth in any way, it will fall off, so I’m sure that isn’t the case. But a new crown should not be noticeable to you. There shouldn’t be any type of strange feeling with a crown, a feeling that it isn’t quite right. It should feel so perfectly natural that you don’t notice it.
What to do at this point? I would start by making an appointment with the dentist to check the crown. There should be no charge for that. Then, if you don’t get a satisfactory answer, I would ask for a second opinion from another dentist. If you are interested, let me know and I could find you a quality dentist for that second opinion.
– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

I went directly to the dental lab to make my partial

Posted on by .


We thank our advertisers who help fund this site.

Dr. Hall,
I had an upper partial made by a dental lab. I did not go through a dentist.

The last partial I got, nine years ago, my dentist used this lab. They did such a good job that I decided to go directly to them this time. But this time it’s not working out so well. I have a front tooth missing that was supposed to be replaced using this partial, however, the tooth won’t stay fastened to the metal. There was so much plastic backing that all the pressure was on my one bottom front tooth. He ground down a lot to make my bite touch but now there is not way of holding this tooth in place. Also the plate is too short and is sitting in the cavity where my old tooth was and it creates a rocking motion when I chew.

I have been back at least nine times and the last time he told me to go away and stop bothering him. I asked for my money back but he refused. What can I do to get my money back?
– Bill

Bill,
A very interesting question, and there are some interesting points to make in answering you.

I must say that I’m not following you as far as understanding the problems you are having with the bite and the one tooth in this removable partial denture. The rocking I understand, and that is a fundamental problem that in most cases is due to a distorted framework—a problem that could have originated with a distorted impression. Fixing this would require starting over again. The impression is supposed to be taken by the dentist, who is trained and experienced in creating an accurate model of your teeth that will enable the technician to fabricate an accurate metal framework. Technicians aren’t trained to do this step, which is one of the reasons it is illegal for them to do that.

So the answer to how to get your money back is fairly simple—just threaten to report the technician to the authorities. This seems mean because, while it was illegal for him to make this removable partial without involving a dentist, you were the one who asked him to do it, so you should share in that responsibility. But he is the one who knows the law better and so bears the bulk of the responsibility. So just go to him and tell him that if he doesn’t refund your money you’ll tattle to the state dental board and agree to be a witness in his prosecution. My guess is that this will work magic. And hopefully that may save some other patient from making the same mistake you did.
– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.

Categories

Follow this blog

Get every new post delivered right to your inbox.