dental work gone wrong - advice please.

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LadyIJ
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dental work gone wrong - advice please.

Post by LadyIJ » Sat Mar 23, 2019 8:29 pm

I went to a new dentist who did work that wasn't quite right, she fixed it (tried to) and it was still not right. what to do?
Last edited by LadyIJ on Mon Mar 25, 2019 4:02 pm, edited 1 time in total.

pre
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Re: dental work gone wrong - advice please.

Post by pre » Sat Mar 23, 2019 8:47 pm

LadyIJ wrote:
Sat Mar 23, 2019 8:29 pm
he redid the next day, and it is so wrong, it broke. I'm to go in and have him fix or replace (a third time) this week.
Mind clarifying what's "wrong" or "broke"?

Might be a good idea to get some free second opinions

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jabberwockOG
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Re: dental work gone wrong - advice please.

Post by jabberwockOG » Sat Mar 23, 2019 9:26 pm

Find another dentist for a second opinion immediately - ask friends or if you know a doctor or other medical professional for recommendations.
There is a real risk that the current dentist may just continue to make things worse. You need a pro to make an objective assessment of what has been done so far and if the next steps being proposed by the current dentist make sense.

If it were me personally even if the cost was much higher, I'd find someone else with good recommendations ASAP, and not go back under any circumstances to the current person.

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LadyIJ
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Re: dental work gone wrong - advice please.

Post by LadyIJ » Sat Mar 23, 2019 9:33 pm

jabberwockOG wrote:
Sat Mar 23, 2019 9:26 pm
Find another dentist for a second opinion immediately - ask friends or if you know a doctor or other medical professional for recommendations.
There is a real risk that the current dentist may just continue to make things worse. You need a pro to make an objective assessment of what has been done so far and if the next steps being proposed by the current dentist make sense.

If it were me personally even if the cost was much higher, I'd find someone else with good recommendations ASAP, and not go back under any circumstances to the current person.
Last edited by LadyIJ on Mon Mar 25, 2019 4:02 pm, edited 1 time in total.

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Re: dental work gone wrong - advice please.

Post by Sandtrap » Sat Mar 23, 2019 9:37 pm

Have it looked at by a reputable dentist in your area "before" going any further.
Do not have any more work until you do this.
It is not worth risking your health.
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Re: dental work gone wrong - advice please.

Post by jabberwockOG » Sat Mar 23, 2019 10:29 pm

LadyIJ wrote:
Sat Mar 23, 2019 9:33 pm
jabberwockOG wrote:
Sat Mar 23, 2019 9:26 pm
Find another dentist for a second opinion immediately - ask friends or if you know a doctor or other medical professional for recommendations.
There is a real risk that the current dentist may just continue to make things worse. You need a pro to make an objective assessment of what has been done so far and if the next steps being proposed by the current dentist make sense.

If it were me personally even if the cost was much higher, I'd find someone else with good recommendations ASAP, and not go back under any circumstances to the current person.
It's a crown - ill fitting still (the second one) shaved to "fit" and now so thin on top - weak and chipped. So do I go back for a THIRD try? I'm out the money . . .

Chalk it up to education/experience. Having lived in 4 different cities over the years I learned the hard way to use extreme caution when changing dentists. Your health and dental comfort/bite are more important that the money.

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Re: dental work gone wrong - advice please.

Post by Vanguard Fan 1367 » Sat Mar 23, 2019 10:38 pm

In some states if you contact the Dental Association and the dentist is a member of that association there is something called peer review where the work can be looked at by a group of dentists and some sort of solution such as refund of the fees may happen if the work doesn't measure up to what should be acceptable.

Perhaps Googling the dental association in your State and calling them and seeing if Peer Review is possible might be one plan.
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Re: dental work gone wrong - advice please.

Post by carolinaman » Sun Mar 24, 2019 6:59 am

My long time dentist put in a crown for me just before retiring. About a year later, I went to the dentist who replaced him for some dental work. In the process of doing the work, he accidentally cracked the crown. He told me that he did and that he would replace it at no charge. When removed the crown, he found decay in the base of the tooth. Had he not cracked the crown, this would likely have become a much bigger problem. I am saying this to point out other things that can go wrong with this procedure. It does not sound like the dentist you went to it very competent and a second opinion is warranted. Who knows what other problems may be lurking from this. Perhaps you could visit former dentist for a 2nd opinion. He/she may be able to recommend a dentist in your area too.

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Re: dental work gone wrong - advice please.

Post by TexasPE » Sun Mar 24, 2019 7:32 am

Perhaps you could visit former dentist for a 2nd opinion. He/she may be able to recommend a dentist in your area too.
+1. My dentist retired. On my next checkup at the office, the young dentist who assumed his practice found a raft of high-dollar, mostly cosmetic things he recommended. I contacted the retired dentist and asked him who he went to. Tried this dentist: None of the young dentist's recommendations were required. Problem solved!
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Re: dental work gone wrong - advice please.

Post by midareff » Sun Mar 24, 2019 7:37 am

My longtime dentist was across town after I moved and it was about 65 miles round trip. My perio recommended a dentist in my area... walking distance away I have been using for about three years so far and a couple of crowns. Excellent results.

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LadyIJ
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Re: dental work gone wrong - advice please.

Post by LadyIJ » Sun Mar 24, 2019 7:40 am

Vanguard Fan 1367 wrote:
Sat Mar 23, 2019 10:38 pm
In some states if you contact the Dental Association and the dentist is a member of that association there is something called peer review where the work can be looked at by a group of dentists and some sort of solution such as refund of the fees may happen if the work doesn't measure up to what should be acceptable.

Perhaps Googling the dental association in your State and calling them and seeing if Peer Review is possible might be one plan.
Last edited by LadyIJ on Mon Mar 25, 2019 4:02 pm, edited 1 time in total.

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Re: dental work gone wrong - advice please.

Post by bsteiner » Sun Mar 24, 2019 8:05 am

You could ask your old dentist to recommend a prosthodontist.

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Re: dental work gone wrong - advice please.

Post by fru-gal » Sun Mar 24, 2019 8:33 am

I would not let the current dentist touch your teeth again. My former dentist did bad work making a bridge just before he retired, and after trying to find a dentist to fix it (none of them would touch it for liability reasons), I wound up at a faculty practice associated with a dental school. The problem was solved by their prosthodontist, and yes, I had to fork out a tidy sum.

Dental work has been a shocking expense for me as a retired person.

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Re: dental work gone wrong - advice please.

Post by LadyGeek » Sun Mar 24, 2019 8:36 am

As a reminder, medical advice (details of treatment, etc.) are off-topic. See: Medical Issues
Questions on medical issues are beyond the scope of the forum. If you are looking for medical information online, I suggest you start with the Medical Library Association's User's Guide to Finding and Evaluating Health Information on the Web which, in addition to providing guidance on evaluating health information, includes a list of their top recommended sites.
Please stay focused on the financial and consumer aspects.
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LadyIJ
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Re: dental work gone wrong - advice please.

Post by LadyIJ » Sun Mar 24, 2019 12:43 pm

LadyGeek wrote:
Sun Mar 24, 2019 8:36 am
As a reminder, medical advice (details of treatment, etc.) are off-topic. See: Medical Issues
Questions on medical issues are beyond the scope of the forum. If you are looking for medical information online, I suggest you start with the Medical Library Association's User's Guide to Finding and Evaluating Health Information on the Web which, in addition to providing guidance on evaluating health information, includes a list of their top recommended sites.
Please stay focused on the financial and consumer aspects.
I was more concerned about how to present this to the dentist. I feel bad for her - losing money on me, a new client, but on the other hand, I would like it redone.
Last edited by LadyIJ on Mon Mar 25, 2019 4:03 pm, edited 2 times in total.

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Re: dental work gone wrong - advice please.

Post by toofache32 » Sun Mar 24, 2019 9:43 pm

Perception is fascinating.
All crowns fit. But some better than others.
The dentist could have just ground down the occlusion to make it fit your bite, while leaving you with a severely compromised crown and you would not know the difference. But he was not satisfied with the quality and sent it back to the lab for a remake. Twice. He has to pay the lab for every new crown. This dentist has already lost money and is upside down on your case, but is still working to get the best crown. And you want your money back on this? Pretty jerk move.

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Re: dental work gone wrong - advice please.

Post by LadyIJ » Sun Mar 24, 2019 9:53 pm

toofache32 wrote:
Sun Mar 24, 2019 9:43 pm
Perception is fascinating.
All crowns fit. But some better than others.
The dentist could have just ground down the occlusion to make it fit your bite, while leaving you with a severely compromised crown and you would not know the difference. But he was not satisfied with the quality and sent it back to the lab for a remake. Twice. He has to pay the lab for every new crown. This dentist has already lost money and is upside down on your case, but is still working to get the best crown. And you want your money back on this? Pretty jerk move.
Thanks for your perspective.
Last edited by LadyIJ on Mon Mar 25, 2019 7:16 am, edited 1 time in total.

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Re: dental work gone wrong - advice please.

Post by toofache32 » Sun Mar 24, 2019 10:01 pm

No you should not have a cracked crown after 3 weeks. And your dentist agrees with you which is why he's trying to get it right. The crown broke and the dentist wants to make a new one. What else do you want???
Has he asked you for more money? Because when my dad had a 2nd heart attack only 2 months after his cardiac stent, the cardiologist charged him again for the new stents.
Last edited by toofache32 on Sun Mar 24, 2019 10:20 pm, edited 2 times in total.

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Re: dental work gone wrong - advice please.

Post by LadyIJ » Sun Mar 24, 2019 10:13 pm

toofache32 wrote:
Sun Mar 24, 2019 10:01 pm
No you should not have a cracked crown after 3 weeks. And your dentist agrees with you which is why he's trying to get it right. The crown broke and the dentist wants to make a new one. What else do you want???
Has he asked you for more money? Because when my dad had a 2nd heart attack only 2 months after his cardiac stent, the cardiologist charged him again for the new stents.
I can see you're irrate about this. I guess I should feel sorry for the dentist. Thanks for your perspective.

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Re: dental work gone wrong - advice please.

Post by toofache32 » Sun Mar 24, 2019 10:16 pm

duplicate, sorry
Last edited by toofache32 on Sun Mar 24, 2019 10:21 pm, edited 2 times in total.

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Re: dental work gone wrong - advice please.

Post by toofache32 » Sun Mar 24, 2019 10:19 pm

I cannot tell if you are being sarcastic, but NO you should NOT feel sorry for the dentist. I'm not irate, but I have seen this mindset over and over. The general public really does think they are buying a crown just like they are buying a flat screen TV. They think everything should be perfect every time.

Yes I am a dentist which means I know exactly how this scenario works. This patient thinks they are buying a muffler for their car and gets mad when it doesn't fit their car. This patient sees a crown as a commodity like a muffler and refuses to understand how this is a custom job which means every crown starts from scratch. Nothing in life is 100% successful and nothing is 100% accurate, including a polyvinyl siloxane impression and including type III gypsum stone. This patient thinks it's so simple so why shouldn't it work every time? Why did it fail in MY case? Why me?
There isn't a dentist on this planet that hasn't had a crown fail way too soon. But the good ones will do everything they can to make it right. He is not trying to rip you off. If you want to be ripped off, then go to a corporate dental office.

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Re: dental work gone wrong - advice please.

Post by bampf » Sun Mar 24, 2019 10:42 pm

LadyIJ wrote:
Sun Mar 24, 2019 10:13 pm
toofache32 wrote:
Sun Mar 24, 2019 10:01 pm
No you should not have a cracked crown after 3 weeks. And your dentist agrees with you which is why he's trying to get it right. The crown broke and the dentist wants to make a new one. What else do you want???
Has he asked you for more money? Because when my dad had a 2nd heart attack only 2 months after his cardiac stent, the cardiologist charged him again for the new stents.
I can see you're irrate about this. I guess I should feel sorry for the dentist. Thanks for your perspective.
On the flip side, if you go to 10 dentist you will likely get 10 different diagnostic results. You could get anything stemming from you need 30 new crowns to "nice job, nothing needs doing." In one sense I am sympathetic that there is a certain artistery to getting a tooth made from scratch. In the other sense I have been told I need crowns three or four times. I even got two crowns. I went to a number of different dentists each time and explained that a previous dentist had suggested a crown. However, not where I was told to get the crown. I didn't feel any pain and oddly sometimes I was told, yes I did need a crown (just on a different tooth). The results almost always are different, substantially so. This seems like a baffling area of care to me.
More importantly, I don't generally trust a dentist to look out for me. I have no doubt that my childhood dentist used me to put his kids through university. I also have a fantastic dentist right now that I very much trust. However, even he suggested a crown when I cracked a filling. We discussed the options. I told him my preference was to go as slowly as possible, and be as cautious as he could be. I know he would have preferred to put me in a crown. I was pleased that he repaired the filling. It may fail, I am aware of that. And then we can put the crown on. But, in the meantime I avoid the root canal, the crown, the pain and the expense.

Its a bit like taking your car to the dealer. You may get all kinds of things done you don't need. You may also find a really great dentist that is looking out for you. I don't trust a priori that they have my best interest at heart. You only have one mouth. Take care if it the way you want it taken care of.

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Re: dental work gone wrong - advice please.

Post by toofache32 » Sun Mar 24, 2019 11:10 pm

It's not an exact science and you prove my point. There is rarely a "textbook" answer of how to manage a given situation. There is no crystal ball to know if a filling will prove to be adequate or if a crown is definitely needed. The dentist has to choose between a patient being upset because they got a filling and it broke within a year, or a patient who got a crown that later complains it was not needed.

Do you want to be undertreated or overtreated? Neither is ideal and both can lead to more expensive and invasive procedures later. Which brings us full circle right back where we started.

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Re: dental work gone wrong - advice please.

Post by bampf » Sun Mar 24, 2019 11:19 pm

toofache32 wrote:
Sun Mar 24, 2019 11:10 pm
It's not an exact science and you prove my point. There is rarely a "textbook" answer of how to manage a given situation. There is no crystal ball to know if a filling will prove to be adequate or if a crown is definitely needed. The dentist has to choose between a patient being upset because they got a filling and it broke within a year, or a patient who got a crown that later complains it was not needed.

Do you want to be undertreated or overtreated?
False dichotomy. I want to be treated correctly. Your question presumes that there is no right answer, which reduces the profession to guess work and shenanigans. I doubt that is true. The dentist can treat me correctly and be aggressive or conservative. It depends on the needs of the patient.

Whether you have a hole in your tooth should not be ambiguous. My treatment options may be more on a case by case basis. And the dentist doesn't have to choose between the patient being upset or a crown. The dentist has to provide me options and choices (if there are ones) and make sure I am aware of the ramifications of my choices. Frequently they don't. Maybe they are lazy. Maybe they presume us mere mortals don't know or can understand. Maybe they don't have the time or the skills to explain it. And there are lots of other reasons why. That being said, the choice isn't "undertreat or overtreat". The choice is treat correctly. I will never again listen to, work with, pay or put up with a dentist that doesn't understand that.

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Re: dental work gone wrong - advice please.

Post by Christine_NM » Mon Mar 25, 2019 12:03 am

LadyIJ -

I'm a veteran of the dental wars. As I understand it, you now have a crown that is shaved thin to "fit" and yet doesn't fit. The new dentist thinks it is done and good enough. If possible, try going back to your old dentist (in the city?) and tell him/her the story. See if the old dentist thinks it needs redoing. (I'd guess it does, but of course can't know for sure.)

A trusted and capable dentist is one of your best friends in retirement. And they do not grow on trees, sigh.
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LadyIJ
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Re: dental work gone wrong - advice please.

Post by LadyIJ » Mon Mar 25, 2019 8:11 am

LadyIJ wrote:
Sun Mar 24, 2019 10:13 pm
toofache32 wrote:
Sun Mar 24, 2019 10:01 pm
No you should not have a cracked crown after 3 weeks. And your dentist agrees with you which is why he's trying to get it right. The crown broke and the dentist wants to make a new one. What else do you want???
Has he asked you for more money? Because when my dad had a 2nd heart attack only 2 months after his cardiac stent, the cardiologist charged him again for the new stents.
thanks for your perspective.

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Re: dental work gone wrong - advice please.

Post by samsoes » Mon Mar 25, 2019 8:47 am

LadyIJ wrote:
Sun Mar 24, 2019 10:13 pm
toofache32 wrote:
Sun Mar 24, 2019 10:01 pm
No you should not have a cracked crown after 3 weeks. And your dentist agrees with you which is why he's trying to get it right. The crown broke and the dentist wants to make a new one. What else do you want???
Has he asked you for more money? Because when my dad had a 2nd heart attack only 2 months after his cardiac stent, the cardiologist charged him again for the new stents.
I can see you're irrate about this. I guess I should feel sorry for the dentist. Thanks for your perspective.
Don't go back to this dentist again. Nobody should be subjected to a hack-job you describe. If the dentist doesn't refund your money, consider legal intervention.
"Happiness Is Not My Companion" - Gen. Gouverneur K. Warren. | (Avatar is the statue of Gen. Warren atop Little Round Top @ Gettysburg National Military Park.)

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Re: dental work gone wrong - advice please.

Post by samsoes » Mon Mar 25, 2019 8:51 am

toofache32 wrote:
Sun Mar 24, 2019 11:10 pm
Do you want to be undertreated or overtreated?
How about correctly treated, the first time?
"Happiness Is Not My Companion" - Gen. Gouverneur K. Warren. | (Avatar is the statue of Gen. Warren atop Little Round Top @ Gettysburg National Military Park.)

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Re: dental work gone wrong - advice please.

Post by Sandtrap » Mon Mar 25, 2019 8:54 am

Christine_NM wrote:
Mon Mar 25, 2019 12:03 am
LadyIJ -

I'm a veteran of the dental wars. As I understand it, you now have a crown that is shaved thin to "fit" and yet doesn't fit. The new dentist thinks it is done and good enough. If possible, try going back to your old dentist (in the city?) and tell him/her the story. See if the old dentist thinks it needs redoing. (I'd guess it does, but of course can't know for sure.)

A trusted and capable dentist is one of your best friends in retirement. And they do not grow on trees, sigh.
Great Term.

"Tooth War Veteran"

I stuck with my aging dentist. . . with aging techniques. . for many years.
After retiring and moving to another state 8 years ago, I found a young "modern" dentist with a wonderful family practice.
(They even had kitten pictures on all the digital screen monitors)
Extensive diagnositics were worth it and we came up with a 3 year plan to correct and redo 30-40 years of bad dentistry.
It was arduous (and very pricey) but in the long run, I'm glad with the results.
IMHO, dental work is like "spine surgery", you pay for poor work forever.

Fellow "Tooth War Veteran".
j :shock:
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Re: dental work gone wrong - advice please.

Post by TylerS7 » Mon Mar 25, 2019 9:05 am

It sounds to me like the new guy is honest and also cares about his work enough to spend money on redo lab bills, extra chair time, extra materials, etc. to make sure the crown you paid for is done correctly. Ideally things are always done correctly the first time but unfortunately it's an imperfect world. If you're uncomfortable proceeding with this dentist and you feel like you should be reimbursed then it is within your right to ask for your money back. Without having first hand knowledge of the actual circumstances I can't begin to speculate whether or not the dentist should feel obligated to honor your request.

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Re: dental work gone wrong - advice please.

Post by soitgoes2 » Mon Mar 25, 2019 9:36 am

What about going to a dental school for a second opinion? You will get examined by a student with input from faculty who know what they are doing even if you do not want to be treated their it may be a good way to inexpensively get a second opinion that is not focused their bottom line.

To the extent this is an ill fitting crown that the dentist tried to make work and is now having remade a the lab for you it may not have much to do with his or her skill and rather be a lab issue that was just not able to be corrected without the new crown to the extent they have been working on correcting this issue that is a good sign may still be worth while to get a second opinion.

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Re: dental work gone wrong - advice please.

Post by rh00p » Mon Mar 25, 2019 10:01 am

When vetting people for their services I often use the ratings in Google Maps as a starting point. My network's dentist is 4.0/5.0 and my oral surgeon is 4.9/5.0

It sounds like the OP's crown is fubar and should seek the services of a second dentist who'll have to start over from scratch. Since he gave the first one a second chance seek restitution in a small claims court.
Preparing for the worst. Hoping for the best.

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Re: dental work gone wrong - advice please.

Post by Turbo29 » Mon Mar 25, 2019 10:16 am

bampf wrote:
Sun Mar 24, 2019 10:42 pm

On the flip side, if you go to 10 dentist you will likely get 10 different diagnostic results. You could get anything stemming from you need 30 new crowns to "nice job, nothing needs doing."
When I was 19 I was told I had eight cavities. Due to financial reasons, I didn't have these "cavities" filled. A year later I went to a different dentist and he found one cavity, which he filled. (Did a good job too; I still have that filling.) Now at the age of 63 I have a grand total of four cavities that have been filled. I guess the other four that the first dentist saw magically healed themselves.
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Re: dental work gone wrong - advice please.

Post by terpdds » Mon Mar 25, 2019 10:22 am

LadyIJ wrote:
Sat Mar 23, 2019 9:33 pm
jabberwockOG wrote:
Sat Mar 23, 2019 9:26 pm
Find another dentist for a second opinion immediately - ask friends or if you know a doctor or other medical professional for recommendations.
There is a real risk that the current dentist may just continue to make things worse. You need a pro to make an objective assessment of what has been done so far and if the next steps being proposed by the current dentist make sense.

If it were me personally even if the cost was much higher, I'd find someone else with good recommendations ASAP, and not go back under any circumstances to the current person.
It's a crown - ill fitting still (the second one) shaved to "fit" and now so thin on top - weak and chipped. So do I go back for a THIRD try? I'm out the money . . .
Was it a "same day crown" or is it the temporary that broke? What material?

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Re: dental work gone wrong - advice please.

Post by samsoes » Mon Mar 25, 2019 10:27 am

Turbo29 wrote:
Mon Mar 25, 2019 10:16 am
bampf wrote:
Sun Mar 24, 2019 10:42 pm

On the flip side, if you go to 10 dentist you will likely get 10 different diagnostic results. You could get anything stemming from you need 30 new crowns to "nice job, nothing needs doing."
When I was 19 I was told I had eight cavities. Due to financial reasons, I didn't have these "cavities" filled. A year later I went to a different dentist and he found one cavity, which he filled. (Did a good job too; I still have that filling.) Now at the age of 63 I have a grand total of four cavities that have been filled. I guess the other four that the first dentist saw magically healed themselves.
That's absolutely inexcusable and should be criminal, if it isn't already. It's nothing less than intentional medical mutilation.
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Re: dental work gone wrong - advice please.

Post by bampf » Mon Mar 25, 2019 10:32 am

Sandtrap wrote:
Mon Mar 25, 2019 8:54 am

IMHO, dental work is like "spine surgery", you pay for poor work forever.

Fellow "Tooth War Veteran".
j :shock:
Astonishingly enough, your analogy is apt.

"But men with aging spines should be wary of fusion and its false promises, says Dr. Steven Atlas, an associate professor of medicine at Harvard Medical School. "Based on the evidence, the indications for fusion are few and far between, but that doesn't stop surgeons from doing them or patients from getting them."

Unnecessary dental work is prevalent throughout the industry. A quick online search is able to validate my statement, although hard to substantiate. Again, probably like a car dealer. Yes, you got underbody coating. But did you need it?

Undoing 40 years of poor dental work presumes you needed the dental work in the first place. Maybe you did, maybe you didn't. Darn tooting the dentists got paid both times.

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Re: dental work gone wrong - advice please.

Post by DrGoogle2017 » Mon Mar 25, 2019 10:37 am

LadyIJ wrote:
Sat Mar 23, 2019 8:29 pm
I went to a new dentist after I stopped working in the city (retired). I had dental work done that was just wrong, he redid the next day, and it is so wrong, it broke. I'm to go in and have him fix or replace (a third time) this week. I had no insurance and paid out of my pocket. I don't know how to proceed. If you have some advice, I can go into more detail via message, but I've never had a problem like this with my old dentist - I almost wish I had gone into the city (an ordeal, now that I'm not working).
This is what happened to my daughter with the new dentist. He had to fix the filling 3 times. But she paid cash also. Just make him fix it. After this you can find a new dentist.

terpdds

Re: dental work gone wrong - advice please.

Post by terpdds » Mon Mar 25, 2019 10:37 am

bampf wrote:
Sun Mar 24, 2019 11:19 pm
toofache32 wrote:
Sun Mar 24, 2019 11:10 pm
It's not an exact science and you prove my point. There is rarely a "textbook" answer of how to manage a given situation. There is no crystal ball to know if a filling will prove to be adequate or if a crown is definitely needed. The dentist has to choose between a patient being upset because they got a filling and it broke within a year, or a patient who got a crown that later complains it was not needed.

Do you want to be undertreated or overtreated?
False dichotomy. I want to be treated correctly. Your question presumes that there is no right answer, which reduces the profession to guess work and shenanigans. I doubt that is true. The dentist can treat me correctly and be aggressive or conservative. It depends on the needs of the patient.

Whether you have a hole in your tooth should not be ambiguous. My treatment options may be more on a case by case basis. And the dentist doesn't have to choose between the patient being upset or a crown. The dentist has to provide me options and choices (if there are ones) and make sure I am aware of the ramifications of my choices. Frequently they don't. Maybe they are lazy. Maybe they presume us mere mortals don't know or can understand. Maybe they don't have the time or the skills to explain it. And there are lots of other reasons why. That being said, the choice isn't "undertreat or overtreat". The choice is treat correctly. I will never again listen to, work with, pay or put up with a dentist that doesn't understand that.
It should not be ambiguous, yet often it is. Whether you believe that or not really does not matter. It is the simple truth that no two situations are the same. Recommendations are often based on experience and experience is subjective. There are many ways to treat correctly. If I think a filling is going to fail then I do not recommend it. I recommend a crown. Why? Because most people "forget" that you told them that the filling most likely won't work. They either think you are incompetent or they want their money back for something you told them wouldn't work. I don't mess with that anymore. Patient directed treatments fail much more often than dentist directed ones.

bampf
Posts: 523
Joined: Thu Aug 04, 2016 6:19 pm

Re: dental work gone wrong - advice please.

Post by bampf » Mon Mar 25, 2019 10:54 am

terpdds wrote:
Mon Mar 25, 2019 10:37 am
bampf wrote:
Sun Mar 24, 2019 11:19 pm
toofache32 wrote:
Sun Mar 24, 2019 11:10 pm
It's not an exact science and you prove my point. There is rarely a "textbook" answer of how to manage a given situation. There is no crystal ball to know if a filling will prove to be adequate or if a crown is definitely needed. The dentist has to choose between a patient being upset because they got a filling and it broke within a year, or a patient who got a crown that later complains it was not needed.

Do you want to be undertreated or overtreated?
False dichotomy. I want to be treated correctly. Your question presumes that there is no right answer, which reduces the profession to guess work and shenanigans. I doubt that is true. The dentist can treat me correctly and be aggressive or conservative. It depends on the needs of the patient.

Whether you have a hole in your tooth should not be ambiguous. My treatment options may be more on a case by case basis. And the dentist doesn't have to choose between the patient being upset or a crown. The dentist has to provide me options and choices (if there are ones) and make sure I am aware of the ramifications of my choices. Frequently they don't. Maybe they are lazy. Maybe they presume us mere mortals don't know or can understand. Maybe they don't have the time or the skills to explain it. And there are lots of other reasons why. That being said, the choice isn't "undertreat or overtreat". The choice is treat correctly. I will never again listen to, work with, pay or put up with a dentist that doesn't understand that.
It should not be ambiguous, yet often it is. Whether you believe that or not really does not matter. It is the simple truth that no two situations are the same. Recommendations are often based on experience and experience is subjective. There are many ways to treat correctly. If I think a filling is going to fail then I do not recommend it. I recommend a crown. Why? Because most people "forget" that you told them that the filling most likely won't work. They either think you are incompetent or they want their money back for something you told them wouldn't work. I don't mess with that anymore. Patient directed treatments fail much more often than dentist directed ones.
A hole is a hole. The great thing about science is my belief doesn't matter and your hand waving about my ignorance in dentistry is part of the problem.

How you treat that hole is subjective and based on experience... and the needs of the patient. Their whole health.

Putting unnecessary holes in my head, or taking my tooth because its easier for you to crown me instead of filling my tooth is criminal. My tooth is never coming back once you take it. Having two dentist in the room and not being able to agree on whether there is a hole or not is ludicris.

Must be rough for a dentist not to have his or her word treated as gospel. Clearly we have no reason to suspect their motives.

To your problem. Simply present your patient with the "I think you need a crown, you selected a filling. I think it will fail. If it does, you get to lump it" in writing. Make them sign. Or refuse to treat them. Up to you.

You don't mess with presenting your patients with choices about the aggressiveness of treatment? How does that jive with your oath?

I understand and accept that my primary
responsibility is to my patients, and I shall
dedicate myself to render, to the best of my
ability, the highest standard of oral health care
and to maintain a relationship of respect and
confidence. Therefore, let all come to me safe
in the knowledge that their total health and
well-being are my first considerations


** Edit: I had another thought. Patients don't direct your treatment. You do. A patient can refuse. A patient can ask. Ultimately you are the Dr and you direct what you do to the patient. If you think it is going to fail, don't do the treatment. Walk away. Leave the money on the table. Your oath demands it.
Last edited by bampf on Mon Mar 25, 2019 11:14 am, edited 1 time in total.

TylerS7
Posts: 82
Joined: Wed Dec 14, 2016 8:46 am

Re: dental work gone wrong - advice please.

Post by TylerS7 » Mon Mar 25, 2019 11:00 am

samsoes wrote:
Mon Mar 25, 2019 10:27 am
Turbo29 wrote:
Mon Mar 25, 2019 10:16 am
bampf wrote:
Sun Mar 24, 2019 10:42 pm

On the flip side, if you go to 10 dentist you will likely get 10 different diagnostic results. You could get anything stemming from you need 30 new crowns to "nice job, nothing needs doing."
When I was 19 I was told I had eight cavities. Due to financial reasons, I didn't have these "cavities" filled. A year later I went to a different dentist and he found one cavity, which he filled. (Did a good job too; I still have that filling.) Now at the age of 63 I have a grand total of four cavities that have been filled. I guess the other four that the first dentist saw magically healed themselves.
That's absolutely inexcusable and should be criminal, if it isn't already. It's nothing less than intentional medical mutilation.
Maybe. Maybe not. You're speaking pretty confidently about something you are under informed about.

Sometimes, with proper oral hygiene, cavities that are only partially into the enamel can remineralize- there is nothing magical about it. Depending on each patient's unique situation there are some different possible treatment options. Do we prescribe a high fluoride tooth paste and monitor? Do we make custom trays and have the patient use pastes/gels that encourage remineralization? Do we restore with traditional fillings? Is the patient high risk for cavities? How is their home care? Are they going out of the country for a few years without access to dental care (such as the peace corps)? Is this patient going to be diligent with annual follow up appointments? Does the dentist have poor ethics and a lot of debt? Most importantly, has the patient been educated about all of these possible solutions, how aggressive/conservative do they want to be, and how can we help them make the best educated decision for themselves and their oral health?

This is starting to get off topic but I wanted to illustrate that things are not so obviously black and white. There is a huge range of possible reasons why you have had this experience so far. If the dentist has shown willingness to correct the mistake and you are comfortable allowing him to try to help again then that is going to be the cheapest way to get this tooth fixed. If you truly believe he screwed up and you want your money back, then that is a conversation you need to have with him.

terpdds

Re: dental work gone wrong - advice please.

Post by terpdds » Mon Mar 25, 2019 11:24 am

bampf wrote:
Mon Mar 25, 2019 10:54 am
terpdds wrote:
Mon Mar 25, 2019 10:37 am
bampf wrote:
Sun Mar 24, 2019 11:19 pm
toofache32 wrote:
Sun Mar 24, 2019 11:10 pm
It's not an exact science and you prove my point. There is rarely a "textbook" answer of how to manage a given situation. There is no crystal ball to know if a filling will prove to be adequate or if a crown is definitely needed. The dentist has to choose between a patient being upset because they got a filling and it broke within a year, or a patient who got a crown that later complains it was not needed.

Do you want to be undertreated or overtreated?
False dichotomy. I want to be treated correctly. Your question presumes that there is no right answer, which reduces the profession to guess work and shenanigans. I doubt that is true. The dentist can treat me correctly and be aggressive or conservative. It depends on the needs of the patient.

Whether you have a hole in your tooth should not be ambiguous. My treatment options may be more on a case by case basis. And the dentist doesn't have to choose between the patient being upset or a crown. The dentist has to provide me options and choices (if there are ones) and make sure I am aware of the ramifications of my choices. Frequently they don't. Maybe they are lazy. Maybe they presume us mere mortals don't know or can understand. Maybe they don't have the time or the skills to explain it. And there are lots of other reasons why. That being said, the choice isn't "undertreat or overtreat". The choice is treat correctly. I will never again listen to, work with, pay or put up with a dentist that doesn't understand that.
It should not be ambiguous, yet often it is. Whether you believe that or not really does not matter. It is the simple truth that no two situations are the same. Recommendations are often based on experience and experience is subjective. There are many ways to treat correctly. If I think a filling is going to fail then I do not recommend it. I recommend a crown. Why? Because most people "forget" that you told them that the filling most likely won't work. They either think you are incompetent or they want their money back for something you told them wouldn't work. I don't mess with that anymore. Patient directed treatments fail much more often than dentist directed ones.
A hole is a hole. The great thing about science is my belief doesn't matter and your hand waving about my ignorance in dentistry is part of the problem.

How you treat that hole is subjective and based on experience... and the needs of the patient. Their whole health.

Putting unnecessary holes in my head, or taking my tooth because its easier for you to crown me instead of filling my tooth is criminal. My tooth is never coming back once you take it. Having two dentist in the room and not being able to agree on whether there is a hole or not is ludicris.

Must be rough for a dentist not to have his or her word treated as gospel. Clearly we have no reason to suspect their motives.

To your problem. Simply present your patient with the "I think you need a crown, you selected a filling. I think it will fail. If it does, you get to lump it" in writing. Make them sign. Or refuse to treat them. Up to you.

You don't mess with presenting your patients with choices about the aggressiveness of treatment? How does that jive with your oath?

I understand and accept that my primary
responsibility is to my patients, and I shall
dedicate myself to render, to the best of my
ability, the highest standard of oral health care
and to maintain a relationship of respect and
confidence. Therefore, let all come to me safe
in the knowledge that their total health and
well-being are my first considerations
In certain cases, I feel that recommending a filling is substandard care (that will ultimately fail). How would that not jive with an oath that vows to uphold the highest standard of care? No one said they extract or a crown a tooth because it is easier. We would crown or extract because it is the best thing for the tooth and will provide a predictable and lasting solution. I don't give solutions that will not work. Also, legally, a patient can not consent to substandard care. That has been tested and proven in our legal system. An informed consent in this situation will not hold up in court.

bampf
Posts: 523
Joined: Thu Aug 04, 2016 6:19 pm

Re: dental work gone wrong - advice please.

Post by bampf » Mon Mar 25, 2019 11:37 am

terpdds wrote:
Mon Mar 25, 2019 11:24 am
I don't give solutions that will not work. Also, legally, a patient can not consent to substandard care. That has been tested and proven in our legal system. An informed consent in this situation will not hold up in court.
You can't really have it both ways. You said:
"Why? Because most people "forget" that you told them that the filling most likely won't work."

Then you said:
I don't give solutions that won't work.

But then you (or someone else) said there are a range of options and many different ways to treat someone correctly and there is no black and white. It is subjective and based on opinion and experience. But, if a court can decide what is substandard care, than there must be right and wrong options. Right?

See, this is why dentistry is baffling. Its a science but its not. It won't work but then it sometimes does. Holes are there but, maybe they aren't. You need 8 fillings, but, no really you don't. Its all "trust me" and you don't know what you are talking about.

At the end of the day, to the OP, find someone you trust that you feel is genuinely looking out for you. You are your only advocate and people that wear a white coat and stand to benefit from doing your work are going to be biased. They can't help it. Many can overcome it, but, many cannot or chose not to.

URSnshn
Posts: 231
Joined: Sun Mar 13, 2016 6:10 pm

Re: dental work gone wrong - advice please.

Post by URSnshn » Mon Mar 25, 2019 12:11 pm

OP wrote:
I went to a new dentist after I stopped working in the city (retired). I had dental work done that was just wrong, he redid the next day, and it is so wrong, it broke. I'm to go in and have him fix or replace (a third time) this week. I had no insurance and paid out of my pocket. I don't know how to proceed. If you have some advice, I can go into more detail via message, but I've never had a problem like this with my old dentist - I almost wish I had gone into the city (an ordeal, now that I'm not working).
I imagine this is aggravating and frustrating. There are too many scenarios that might be woven into your post to know whether this is just an unfortunate issue or if the problem is with the dentist. But taking it at face value. Here are my thoughts (and I'm not a dentist nor do I have any expertise on the subject matter):
  • You have a dentist that appears to want to fix the issue. That is a positive. When you meet with the dentist - make sure you know what the issue is, what has been tried and what could be tried. Make sure you understand the pros and cons of the issue(s) and the possible solution(s).

    You might seek a second opinion - consider vetting the dentist. Take a look at their website and verify the information that's there, etc. Seek recommendations from family, friends and/or look at a local university dental program. You might vet the dentist you are seeing now as well. There is a wealth of information out there.

    Some things take time. Youe teeth are important. I'd take the time to get the information I needed, do my homework and have a clear understanding with dentist(s) involved.
Good luck! Hopefully a month or two from now, you'll look back and be pleased with the decisions you made.

toofache32
Posts: 2051
Joined: Sun Mar 04, 2012 6:30 pm

Re: dental work gone wrong - advice please.

Post by toofache32 » Mon Mar 25, 2019 1:32 pm

samsoes wrote:
Mon Mar 25, 2019 8:51 am
toofache32 wrote:
Sun Mar 24, 2019 11:10 pm
Do you want to be undertreated or overtreated?
How about correctly treated, the first time?
That would be ideal and is often possible....when the correct treatment is easy to determine.

Turbo29
Posts: 863
Joined: Tue May 01, 2018 7:12 am

Re: dental work gone wrong - advice please.

Post by Turbo29 » Mon Mar 25, 2019 6:02 pm

Some of my coworkers are animal lovers and we all have a saying, "Dentists and veterinarians, they are either really good or the are really bad."

More similar than one might think. The animal can't talk so you have to trust the vet. You can't see in your own mouth, so you have to trust your dentist. Some take advantage of that trust, some don't. Currently I have a great veterinarian but I am not so sure about my dentist.
It is by the goodness of God that in our country we have those three unspeakably precious things: freedom of speech, freedom of conscience, and the prudence never to practice either of them. --M. Twain

bowtie
Posts: 372
Joined: Sun Jul 20, 2014 11:41 am

Re: dental work gone wrong - advice please.

Post by bowtie » Fri Mar 29, 2019 10:28 pm

Hope the OP is doing better, problem solved, or at least on the way to being solved.

sawhorse
Posts: 3560
Joined: Sun Mar 01, 2015 7:05 pm

Re: dental work gone wrong - advice please.

Post by sawhorse » Fri Mar 29, 2019 11:08 pm

Turbo29 wrote:
Mon Mar 25, 2019 10:16 am
bampf wrote:
Sun Mar 24, 2019 10:42 pm

On the flip side, if you go to 10 dentist you will likely get 10 different diagnostic results. You could get anything stemming from you need 30 new crowns to "nice job, nothing needs doing."
When I was 19 I was told I had eight cavities. Due to financial reasons, I didn't have these "cavities" filled. A year later I went to a different dentist and he found one cavity, which he filled. (Did a good job too; I still have that filling.) Now at the age of 63 I have a grand total of four cavities that have been filled. I guess the other four that the first dentist saw magically healed themselves.
My husband was told by a new dentist that he needed 7 fillings. He found that very odd. He went to a dental school for a second opinion and was told he needed none. I would recommend a second opinion from a dental school to anyone who has been told they need extensive work that doesn't pass the sniff test. They don't have an incentive to rip you off.

Funny story, my husband called the dentist and told him that he decided not to have any of the fillings she recommended. She left a voice message begging - and I mean begging - him to reconsider. "Please let me do a filling. Just one. Please, please."

capsaicinguy
Posts: 149
Joined: Thu Sep 29, 2016 9:00 am

Re: dental work gone wrong - advice please.

Post by capsaicinguy » Sat Mar 30, 2019 10:38 am

There are a lot of reasons that could have lead to OP having a problem with a crown. Some could have been from the dentist and some could have been from things outside the dentists control. People have a hard time with the variability in dental diagnosis because they think it should be like a check engine light on a car. There isn't anything like "P0420 - catalyst efficiency below threshold, replace catalytic converter" about dentistry. Dentistry is a land of shades of gray (literally in the case of radiographs) that must be interpreted in the context of the patient, their preferences, and the experience, judgement and skills of the dentist.

And to the comment about "a hole is there or it isn't": not all cavities are cavitated (a hole). Only about 50% of the time when the cavity is half way to the pulp of the tooth is the enamel surface broken leaving a hole. Xrays only tell part of the story and generally underestimate the extent of a lesion. I have opened up occlusal lesions that were barely visible on xray, were not cavitated clinically, and nearly went to the pulp. Add in the extra layers of 'surgical threshold' and the quality and angulation of the diagnostic radiographs, and that is why you get two opinions of "you need 8 fillings" and "you don't need any". One doctor might want to watch something until it is clear beyond any doubt there is a cavity there (but will be a much bigger lesion), where as one might want to treat a lesion early before it gets any bigger and keep the filling as small as possible. Neither one is necessarily wrong. The absence of a history with the practice makes this more difficult if there are no old xrays from a year or two ago to evaluate if a lesion has changed. Most new patients don't present with 10 years of old xrays for us to look over. Just adding a .02.

Full disclosure: I am a dental student.

bampf
Posts: 523
Joined: Thu Aug 04, 2016 6:19 pm

Re: dental work gone wrong - advice please.

Post by bampf » Sat Mar 30, 2019 11:12 am

capsaicinguy wrote:
Sat Mar 30, 2019 10:38 am
There are a lot of reasons that could have lead to OP having a problem with a crown. Some could have been from the dentist and some could have been from things outside the dentists control. People have a hard time with the variability in dental diagnosis because they think it should be like a check engine light on a car. There isn't anything like "P0420 - catalyst efficiency below threshold, replace catalytic converter" about dentistry. Dentistry is a land of shades of gray (literally in the case of radiographs) that must be interpreted in the context of the patient, their preferences, and the experience, judgement and skills of the dentist.

And to the comment about "a hole is there or it isn't": not all cavities are cavitated (a hole). Only about 50% of the time when the cavity is half way to the pulp of the tooth is the enamel surface broken leaving a hole. Xrays only tell part of the story and generally underestimate the extent of a lesion. I have opened up occlusal lesions that were barely visible on xray, were not cavitated clinically, and nearly went to the pulp. Add in the extra layers of 'surgical threshold' and the quality and angulation of the diagnostic radiographs, and that is why you get two opinions of "you need 8 fillings" and "you don't need any". One doctor might want to watch something until it is clear beyond any doubt there is a cavity there (but will be a much bigger lesion), where as one might want to treat a lesion early before it gets any bigger and keep the filling as small as possible. Neither one is necessarily wrong. The absence of a history with the practice makes this more difficult if there are no old xrays from a year or two ago to evaluate if a lesion has changed. Most new patients don't present with 10 years of old xrays for us to look over. Just adding a .02.
This is absolutely why dentists are universally not trusted. Lets just take for a second some issues I have with what you just said:
not all cavities are cavitated (a hole).

1. The definition of cavity is an empty space within a solid object, in particular the human body.
2. The definition of cavitated is an unfilled space within a mass especially : a hollowed-out space. 2 : an area of decay in a tooth : caries.

You literally just said not all holes are holes and you did it by authoritatively using words that mean exactly what you claim they don't mean.

To your point: Can you absolutely know if there is a hole there? If you use old x-ray equipment with poor resolution, then you can conveniently not be sure. You can get greater resolution with new equipment. Frankly I am not skilled enough or knowledgeable enough to know the combinatorial requirements for visual examination and analysis of demineralization that imagery can show. Sure, most patients don't present with 10 years. Why? Cause dentists make it hard to take your records with you.

Neither one is necessarily wrong when one dentists says no fillings and one says 8?
You gotta be drinking a very special form of kool-aid to justify that statement. I will stipulate that there are varying degrees of aggressiveness and varying degrees of treatment. I will also stipulate that it requires skill and discrimination that is predicated on the whole health of the patient.

Here is what they don't tell patients. Everytime you drill a hole in the tooth to fill it, you weaken the structure. You run the risk of cracking the tooth. The bigger the hole, the more risk. So, when you talk about aggressiveness of care, the patient endures the risk and you, the dentist, get the reward. Put another way: If you do nothing, you make no more money. If you do something, regardless of how unjustified it is, you get paid. And you can't undo it. And there is no proof that you did it out of vanity or greed after its done. You literally destroy the evidence.

Sometimes you need to fill the hole. Justifying 8 vs none is just absolute horse hockey and you should be ashamed you even said that. Filling 8 holes in teeth when 1 dentist said you need none and 30 years later the patient still needs none is immoral.

Final note:
Again, to the OP, find someone you trust. Find someone that is ethical and will treat you. Maybe this guy working on your crown is great and something just went wrong. It happens. That being said, you gotta look out for yourself.

toofache32
Posts: 2051
Joined: Sun Mar 04, 2012 6:30 pm

Re: dental work gone wrong - advice please.

Post by toofache32 » Sat Mar 30, 2019 11:56 am

Listen bampf a “cavity” is a layman’s term, which are rarely accurate. Kinda like how everyone still says their dentist gave them “novacaine” even though novacaine was taken off the market over 30 years ago. Since it sounds like you are a stickler for accuracy, you should start using the correct term “caries”. Sometimes called decay. The presence or abscence of a hole has nothing to do with if decay is present.

Can you please provide us with the definition of caries?
And while you’re at it, please list the indications and contraindications for a filling. It sounds like we dentists have been doing it all wrong and would love for you to make the decision easier. Specifically, how much decay needs to be present before it needs to be removed? And how do you measure this?

And why does my mom's physician treat her blood pressure with lisinopril while my physician chooses to just monitor my blood pressure which is similarly high? Blood pressure is either high or it's not, right?
Last edited by toofache32 on Sat Mar 30, 2019 1:45 pm, edited 3 times in total.

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