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