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A failed dental implant

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Dr. Hall,
Last July I bit into a sandwich and cracked #12 tooth (upper left first premolar). My dentist of three years said it could not be saved, so he pulled it. He gave me many novocaine shots & one felt like it went to my brain. I left feeling a burning/tingling on my tongue and palate in my mouth. He proceeded with a tooth implant process and every time I was in his chair I complained about the burning in my mouth. He said I had thrush and prescribed medicated mouth rinse & said burning would go away. Three months later (October), he said I was ready for implant crown. It hurt so bad when he was trying to install/screw the crown onto the implant, so he stopped and gave me more novocaine shots.

Then on December 3rd, while I was in Arizona for the winter, the crown fell off. I still had burning mouth syndrome. I went to a dentist there and he said that the implant was infected and needed to come out. That required surgery with incision from bottom to top/front. He did more bone grafting but I said no more tooth implants. I got home from Arizona in April and in June my husband’s dentist put in a 3-tooth bridge. This dentist said it should never hurt for the final install of a tooth crown. I tried contacting three attorney’s offices but they say a dental lawsuit is hard to win. I’d like my original dentist to refund what I paid for the implant, plus the surgery to take out the infected implant and then get the bridge. Pain and suffering would be a nice bonus. I’ve been in a dentist chair 22 times since last July. I still have burning mouth syndrome. Is there any way I can make the original dentist pay for all of this damage to my mouth?
– Gladys from Colorado

I Googled How to ask for a refund from your dentist for a failed tooth implant.
(See Dr. Hall’s answer below.)


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Gladys,
You have quite the story!
The reason you were hard to get numb is because of the high level of anxiety you had during this appointment. That could also explains the burning you felt. Burning mouth syndrome, while the cause is officially unknown, does seem to have an association with traumatic dental experiences. Your dentist blaming that on thrush makes me chuckle a little. Since this never went away, you must have figured out that diagnosis was wrong.

While not every dental implant failure is caused by improper procedure, a lot of them are. Placing an implant is a very demanding procedure, and many dentists don’t have adequate training for that. And what you have told me about your dental care leads me to be very suspicious of the dentist who placed the implant. He was probably at fault. We have the thrush misdiagnosis, and we have the crown coming off the implant besides the implant then failing. It doesn’t look good for him. But to prove that he was at fault, we would need another dentist who examined you to say that he was at fault.

The problem with bringing a lawsuit, besides needing an expert witness, is that dental malpractice cases don’t pay well. So that could be part of your problem in getting a lawyer. You could go to small claims court without a lawyer, but your would still need a dentist to testify that your first dentist was at fault.

And I do have a question about the dentist in Arizona. You didn’t say anything about the implant being loose. If it was infected it would be at least a little loose. I hope that was the case. From your description of how the first dentist put the crown on the implant, with the pain that caused, makes me guess that he put too much force on the implant. If he did, that could have damaged the bond between the implant and the surrounding bone, leading to later implant failure.

What can you do besides that? You can threaten reporting him to the dental board. If there was any dental insurance involved, you could threaten reporting him to the insurer. But I would scale back your demands to a partial refund, because it would be very easy for the dentist to claim that there was some other reason the implant failed. The crown coming off the implant and the thrush misdiagnosis are more easily provable errors.

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 can I get a refund? The partial broke, and insurance didn’t pay.

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Dr. Hall,
My husband broke #9 (left upper front tooth) off at the gum line. Our dentist is Cigna provider. He said he would extract the tooth and do a 4-unit bridge covering teeth #s 7-10. We paid him $1966 as our portion after insurance.

When we went in for the extraction he changed to doing a root canal over the tooth and sewed gums over the root. We asked him to get a pre-authorization from the insurance. He balked but finally did it. Six months later we find out that the insurance won’t cover any bridge because his upper arch has three teeth already missing (two molars on the rights side, plus the front tooth) and the left first molar needs to be extracted. So the dentist will now be charging another $1000. After much discussion, he will give us a refund, but only if we sign a release saying we won’t hold him responsible for any problems with #9. The temporary “flipper partial” he provided has broken twice and he wants $450 for it unless we sign the release. Should we sign it or not?

– Marion from California

(I searched the term “dental release.”)

(See Dr. Hall’s answer below.)


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Marion,
I hope you have figured out by now that you need to change dentists, regardless of what you do.

I would be threatening to sue this dentist and certainly wouldn’t be signing any releases. He clearly is worried that he has done something wrong and could be sued. Here is what I would do, exactly. I would change the terms of the bargain to this extent. I would tell him that I don’t feel inclined to sue you and probably won’t, provided you give me the refund, but I’m not going to sign any release. But if you don’t give us the refund, I will be going tomorrow to talk to a lawyer. I hope your malpractice insurance is up-to-date.

There is no way he is going to be able to collect the $450 for the dental flipper that has broken twice, so there is no need to even talk about that.

Other leverage you have is to report him to Cigna. They can’t be too happy with how he is acting. And you could report him to the dental board. You could let him know that you won’t do either of those if he gives you your refund.

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?

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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.)


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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 new crown fell off three times! And my dentist was dishonest with me.

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Hi Dr. Hall,

I had large amalgam filling, and my dentist took it out and put a crown on the tooth. While I was waiting for the crown, my temporary crown came off once. Then, after I got the permanent crown, that has come off three times in about six weeks. Three times!

The crown was also very much the wrong shade. It was like super white and my teeth a bit off white. I told him I wasn’t happy about that and he said he would change it for just under $400, so I said I’d live with it as I wanted to save money. I didn’t think that was fair but didn’t want to argue.

The last time the crown came off, I asked him what he planned to do, and he said he was going to get me a new crown. The scheduling person said he would deem it defective to the lab and replace it. I told her I didn’t feel like I should pay for it. I wasn’t going to return to him but since she said he would replace it I thought to just do it.

When I arrived for the appointment, he ended up drilling some more. He said he was shaping and putting posts in and making new molds. As I was leaving the scheduler told me that I actually owed money from going over my insurance—which I do not think is accurate at all—and that I owed $385. I think they tricked me into paying for the tooth.

The more I think about it the more upset I get. I cannot possibly imagine going back to him and having him work in my mouth after this. What should I do?!!!

– Susan from Philadelphia

(See Dr. Hall’s answer below.)


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Susan,
Your story really takes the cake!
So it sounds to me like your dentist’s crown policy is this: You pay a certain amount for a crown for your tooth. Then, to get it the right color is an additional $400. Then, to get it to actually stay on will cost you another $385.

I don’t think so.

Part of the service a dentist delivers when they do a crown on a tooth is that they will match the color with your existing teeth, and they will actually get it to stay on. To bring this to more familiar ground for consumers, let’s make an analogy with a common consumer product, let’s say a refrigerator. Let’s say the appliance store sells you a refrigerator, and when you take it home you discover there are two problems with it. One is that it gives off a nasty odor inside that stinks up all the food inside. The other is that it isn’t actually cold inside the refrigerator. So you complain to the appliance store and they tell you that they can fix the stink for an additional $400, And they can make it actually be cold inside for another $385. There’s no way they could get away with that. Just like it’s essential for a refrigerator to keep your food cold and to not make it stinky, it’s essential for a dental crown to stay on your tooth and to be at least somewhat close in color to your other teeth.

So what do you do? You have several options for dealing with this dishonest dentist.

First step is that I wouldn’t pay the $385. If you have already paid that and it has been with a credit card, I would contact your credit card company and see if you can get that charge reversed. There’s no way they could enforce this surprise billing on you.

Next, for sure I wouldn’t set foot in that office again.

And then I would find another dentist to help you get a refund from your dentist and get this tooth fixed right. I’d be happy to help you with that. You haven’t told me what tooth this is, but unless it’s one of your front teeth, you wouldn’t necessarily need an expert cosmetic dentist. Email me back, or use the comment form at the bottom of this page and I’d be happy to help you find a competent, honest dentist to fix this. If you need a dentist who accepts your insurance, we can deal with that, too.

This other dentist may be able to talk to your dentist and get this resolved. If not, it sounds to me like you have plenty of leverage. What your dentist has done is below the recognized standard of care, and if he refuses to correct it, he could face dental board discipline. So tell him that if he doesn’t give you your money back you’ll report him to the board. You also have leverage with your insurance company. Since he didn’t deliver a professionally acceptable service for you, the insurance company doesn’t owe him anything, and they have several ways they can get that money back.

And then, of course, I think you have a duty to let others know the problem you had with this dentist. Leave a well-written review on Google, or Yelp, or any online review platform that you have used before. If you’re new to writing reviews, do it on Google.

And don’t hesitate to get back with me if you have any difficulty with any of these steps.

– Dr. Hall

You may be interested to read my other post “Why Your Crown Fell Off.”

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!

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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.)


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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.

Bad experience at a chain dental practice

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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.)


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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?

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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


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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.

I went directly to the dental lab to make my partial

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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.

A situation where Invisalign didn’t work

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Hello Dr. Hall,

The reason I want to speak with you is because I started with Invisalign October 25th 2016 with a Dentist. We agreed upon me paying $4,675.00.

My goal we spoke about for my smile was to fix my midline and also make room to put veneers on my lateral teeth.

His expert recommendation was Invisalign over a period of 9 months. I finished my first set of trays during the 9-month period (August 2017). Since my midline was not straight after the 9 months, my dentist ordered a new set of trays.

I was supposed to be done in March 2018. I’ve sacrificed double the time to work with him to correct the midline as we had initially discussed in Oct 2016.

So at this point, I’m at my wits’ end. I’m frustrated from sacrificing so much time and money. I took it upon myself to speak with doctors about my current situation. These are doctors who work with both Invisalign and traditional metal braces. Their professional recommendation was Invisalign would not give me the results I need and traditional braces is the only option.

How do I go about getting a refund to be able to fund my new braces?

Thank you for your advice.
– Kristen


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Kristen,
I’m going to give you a two-part answer, and in the first part I’m going to address whether or not Invisalign would work in your situation. I’m guessing that these other dentists, who sound like orthodontists since you said they work with both Invisalign and traditional braces, are probably right that this wasn’t a case for Invisalign. Having said that, in my experience, many orthodontists, educated in traditional methods, don’t give Invisalign the credit it deserves. I’ll tell a story as an illustration. When I was practicing, there was an orthodontist who was an excellent orthodontist, and he had a patient come to him who wanted Invisalign. He told the patient that traditional braces were the best way to correct his crooked teeth, and he wouldn’t do it any other way. With those options, the patient chose no treatment at all because he was dead set against wearing metal braces. Then he came to me, and I told him that yes, the orthodontist was right that traditional braces were the “best,” most predictable way to move his teeth, but that Invisalign would also work and if he was willing to accept the limitations I would take the case. I did, and the results turned out fine and he was very happy. The point is that some dentists have this strict mindset. This includes some orthodontists who stubbornly refuse to give Invisalign the credit it deserves. Part of what is going on in the backs of their minds, I am sure, is that you don’t need to be an orthodontist specialist to use Invisalign, and they feel protective of their status as specialists. Their identity and status is tied up in diminishing Invisalign as much as they can.

Anyway, moving a midline and keeping it straight is a little tricky to accomplish, and I think is best handled by a specialist—an orthodontist, so I think you’re now in good hands.

So that brings us to my second point—getting your refund. Different dentists are going to respond very differently to a situation like this. Some will be fine with giving a refund for a treatment that didn’t work, while others will be nasty about it. So you start with a simple request, and then you ratchet up the pressure until you hopefully get your way. Here are the steps for ratcheting up the pressure:

  1. Start with a straightforward, polite request to the dentist
  2. Ask another dentist to call with the request for a refund. If another dentists feels that a refund is warranted, this adds a lot to the strength of your request.
  3. Complain to a local peer review committee, if one exists. This step may not be too effective, and most people could easily skip this.
  4. Threaten, and then follow through, with a complaint to the state dental board. No dentist wants a black mark on their record with the dental board.
  5. Get a lawyer.

And through all of this, you don’t want to be emotional or nasty. Be polite, with a calm voice, but firm.

I wish you the best.
– Dr. Hall

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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.

Porcelain Veneers Gone Bad

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Dear Dr. Hall,
I recently went to a dentist to do a smile makeover, specifically because my four upper front teeth are misaligned and crowded. After he explained that cosmetic dentistry could correct the problem faster without the inconvenience of braces, I opted for that.

He said that a combination of bonding on #10 (left lateral incisor), a single veneer on #7 (right lateral incisor) and shaping would provide complete alignment, no crowding and an even smile. He also claimed he did shaping on the lower teeth – which I never discussed or mentioned about treating at a cost of 1.3k. He charged overall 9k for this work. When he declared it complete, the veneer was too small with a gap near the gum line, the teeth were still crowded and they remained uneven. When I asked him what would provide the outcome he originally described he said only 4 porcelain crowns on the upper teeth would, but at an additional cost of 7k, because he would need to do root canals in addition to placing crowns.

I went to another dentist for a second opinion and he advised me that his recommendation would have been to place 4 veneers to correct the original crowding and alignment problem. They also said that to correct the current problem I would still need the 4 veneers, no root canals necessary and no crowns necessary, just 4 veneers at a total cost of 4.5K.

My question is how do I successfully recover my 9K from the first dentist?
– Grant from New Jersey

Grant,
Well, I guess we’ll add your experience to our list of cosmetic dentistry horror stories.

Just from what you’re telling me it sounds like the first dentist took you for a ride, not delivering work that was promised and leaving you with a very poor smile makeover. In my opinion, you should be entitled to a refund of what you paid, if you go about it right. But before I get into that, I have a real concern about your second dentist. How do you know the second dentist will deliver the attractive smile you are wanting? Do you realize that smile makeovers are not taught in dental schools? You might want to check my blog post, Why you shouldn’t ask your family dentist to do porcelain veneers.

I strongly suggest getting a third opinion from a dentist you know can do smile makeovers. You’re there in the New York City metropolitan area where you have a varied selection of excellent cosmetic dentists. You can go to our list, or find an accredited cosmetic dentist.

Now back to your question of getting a refund from the first dentist.

Start, of course, by just asking for one, with some gentle pressure. I address some pointers about this in my blog post, How to ask for a refund. If that doesn’t work, you need to apply more leverage. There are a series of steps, each one applying a little more pressure.

The next step would be, after you find your expert cosmetic dentist who can do a beautiful job with this, is to see if that dentist will call on your behalf and say that a refund would be appropriate. Dentists tend to be sensitive about what other dentists say about their work.

Unfortunately, it seems to me from what you’ve told me about his conduct so far that your dentist is one who is going to require more pressure than that and you’ll need to play hardball. The next step in escalating pressure against the dentist is to complain to the dental board. The step after that is to contact an attorney. For each of these steps, it is very helpful to have the backing of another dentist to document the problems with the earlier work.

Good luck.

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.

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