[1beautifuldaughter]

I am having pretty extensive tooth restoration, porcelain bridge crown work. The process is killing me due to the guys lab having trouble with matching colors , Its really waring me down. And now I have some teeth temporarily glued while I decide to accept having a different shade of white on the bottom from the top. I actually stepped a little out of character the other night and spoke very openly to my dentist about how unhappy I am with whats going on. I don't think he appreciated it much. He tells me the color is close, then asked me to sign a disclaimer if he glued them in permanently.
I don't think I was unreasonable under the circumstances that he tried to pass off even a worse, very bad color match the time before and put me through hell putting them in when all he had to do is look at them before the needles and tell me they where no good.
I told him I thought he should be far more inclined to make his lab do the right thing rather than try to pass off bad jobs to his patients, Told him I should be able to trust that he has my back. Screwed up conversation that never should have happened.Then he said " no big deal, we can send them back "

The reason its a big deal is that I have spent 10 weeks with some kind of acrylic temporaries in my mouth being renewed over and over, It burns like a chemical taste and causes me a sore throat, headache, can't sleep through a night without getting up and rinsing.I explained this and I asked him if he could take a new impression and leave the bad color in my mouth while they get it right so I would not have to suffer anymore. He said no, The lab will want them back and I will have to give you a new temporaries.

The thought alone has me considering the wrong color.

My question,,, 1) Why would the lab have to have my current teeth back as opposed to a new impression? Does that sound right? Is he trying to make me suffer to accept the bad color?
2) What the hell is this god awful temporary acrylic caulk that looks like a Home Depot caulk gun, Does it come with a warning label? Can you have too much for too long? How about shooting 6 novocain needles in your mouth over and over and over. After the conversation I had with the dentist I am sure he would not be honest with me.
Sorry for rambling , trying to paint a picture for advice. So far a $16000 dollar disaster and not finished, The lab he uses seems to be a crap shoot. If I spend another 2 weeks with new temporary taste in my mouth and they send bad results again I will go nuts if I survive it. Thanks

[zephyrracer]

Look for another dentist, I just changed mine he was a great business man but had no talent on tooth care, call an oral specialist for a recommendation.

Gregg

[1beautifuldaughter]

Thanks I appreciate that advice, I plan on it . Just that I am in the middle of an expensive paid for in full procedure, and I have to figure out how to handle it without coming out loosing . If I walk now it it will be at my expense,

[Txbobcat]

Call a lawyer.

[John V.]

Not a dentist and have generally had no trouble with my teeth.

But can offer this from someone that struggles with teeth problems.

Don't know what a bridge is vs. just crowns, but know after struggling with multiple teeth problems for years, I encouraged my friend to go for all crowns on the uppers for cosmetic reasons.

Dentist suggested a particular "color" for best match to the lowers but I suggested going with one shade whiter.

I think it turned out to be the right call, a person that hated to smile started getting compliments about the new teeth.

That was 3-4 years ago. Unfortunately, one of the crowns recently came loose and now the solution is an implant (if the bone will hold it). Only about 2 months into a process that will take several months as I understand it, requiring the wearing of a removable temporary "partial" that was described to me as something like a retainer used after orthodontics. This to be worn apparently very uncomfortably until the bone is healed and ready for the implant.

Big disappointment that the crown failed after spending a lot of money (I think it was about $10k). But it was not a problem of the crown, just a continuation of the underlying tooth continuing to crumble (at least as I understand the idea of a crown).

Only reason I'm posting is because of your color question.

From what I remember, there is a limited color selection. Generally what people see is your uppers. For the friend I helped, the dentist "suggested" color choice wasn't an exact match to the lowers. I suggested one shade whiter because I thought that would look best.

I think it was the right call as the finished result looked very nice.

If you also are only getting crowns on the uppers, I'm thinking you are being unduly concerned about the match to your natural lowers.

Only difference, sounds like your dentist made the color choice without offering you the choice upfront.

I could be all wrong about this since I wasn't there. But my recollection is that there was a range of color choices to make, I'll call them 1 to 10, 10 being the whitest. The dentist suggested no. 5. I recommended going one shade whiter to no. 6. The crowns were definitely whiter than the natural lowers, but nobody notices that. They looked great and my friend stopped avoiding baring teeth, had the confidence to smile in front of people.

I don't envy your situation. But hope this helps.

[Wisco12]

Hello. I am a dentist and not a troll. I was directed to this thread from a different board that uses both messaging boards. Why did I spend the time to comment? You sounded like you had a lot of questions and I am passionate about teeth.


I am sorry to hear about your struggles with your front teeth.


My question,,, 1) Why would the lab have to have my current teeth back as opposed to a new impression? Does that sound right? Is he trying to make me suffer to accept the bad color?

If I was your dentist and I had a tooth(crown) that didn't match the others I would take pictures with the bad color crown in your mouth. Then I would send the bad color crown and the pictures to the lab. The lab could then customize the crown with stains to get the color to match better.


2) What the hell is this god awful temporary acrylic caulk that looks like a Home Depot caulk gun, Does it come with a warning label? Can you have too much for too long?
Unfortunately all dental materials taste terrible, even when they are labeled watermelon, strawberry, etc. Acrylic temporaries are safe for longer periods of wear. Some complex cases need temporaries to be worn for a few months.


How about shooting 6 novocain needles in your mouth over and over and over.
The anesthetic used to numb is pretty safe. It's lidocaine and septocaine most commonly.


Not all dentists are equally skilled. And price doesn't always correlate to skill.

Let me know if you have any other questions and I'll be here for a few days.

[cuz68]

Wisco12, That is very nice of you, Welcome to PY.

[1beautifuldaughter]

Yes Wisco12 indeed very nice of you to comment on my thread,
Its important and valuable to have a person in the same profession help me through.
Thank you for the inside info on the dental materials.
Do I have any other questions?
Well without having to write too much for you to read I think if I put it this way it will likely paint a picture for you of where I am, What I have to deal with. I would greatly appreciate it if you could elaborate as a dentist who is passionate about what you do.

After asking the dentist if my new bridgework would fit up on my gums without anything exposed and look natural ,and him saying yes I can give you a beautiful smile, should I not find it a problem that there is a black line across the top of a front tooth that can be felt like a shelf that you can hook your fingernail on? I told him I felt it was an avenue for decay and the tooth should have gone higher, He said he could put some kind of Flow stuff on it but that might cause the gum to recede.
Should the dentist who advertises cosmetic specialties have known that porcelain teeth are transparent and so one front tooth is slightly yellow and the other is a shade darker gray due to the discolored teeth under them?
Should it be common practice for a dentist to leave the new bridgework on the other side of the room and not look at it, and give you 6 needles and cut and crack your temps out and place the new ones and even adjust the bite only to hand you a mirror and let you see that they are yellow and your top teeth are white? And then try to tell you that you really don't see your bottoms when you talk? (Twice)
Should a dentist talk you into accepting a bad color match and then walk into the room with a legal disclaimer to sign?

When I kindly question his work, He just says things like, "you do have a beautiful smile" and "there really close" and my favor at one " remember what you looked like when you came in"

I currently have the bottom incorrect color in with temporary cement and he told me they fit the gum line fine, One of the teeth in the back has a shelf under it that my fingernail fits deep and easily into and feels like a live wire if I floss it. Is that OK?
Thats another reason I want to get a new impression but I am sure he will say "Its Fine"
I am actually afraid to go back because I can't trust him for what he says. But the job is paid for and I have to get it resolved.
Of course trust and character can't be bought so I know I need a new dentist for the rest of my work. I was thinking of having someone else look at the work in progress and see if I'm wrong, But I certainly can't pay someone else to do over what he has done.

Sorry, writing to much. I'll stop. Thanks again for reading

[Wisco12]

After asking the dentist if my new bridgework would fit up on my gums without anything exposed and look natural ,and him saying yes I can give you a beautiful smile, should I not find it a problem that there is a black line across the top of a front tooth that can be felt like a shelf that you can hook your fingernail on?

It seems like you are describing a type of bridge that has white porcelain/ceramic on top of a metal frame. This type of crown/bridge has a long successful track record. The downfall is the possible presence of a black line near the gums. Depending on the size or how many teeth this bridge is replacing AND how your bite it is, it may be possible to get an all ceramic one to get rid of the black line.

I told him I felt it was an avenue for decay and the tooth should have gone higher, He said he could put some kind of Flow stuff on it but that might cause the gum to recede.

The junction between your tooth and bridge that you can feel with your fingernail is almost impossible to avoid. It could be an avenue for decay if it is not cleansible. There is a wide variety of these shelves.....as in some are okay with no long term downfalls and others are an almost certain disaster......it really depends on the severity and location. Basically is the crown acceptable with this or not....which can only be judge by viewing it your tooth.


Should the dentist who advertises cosmetic specialties have known that porcelain teeth are transparent and so one front tooth is slightly yellow and the other is a shade darker gray due to the discolored teeth under them?

Yes and he probably did. Sometimes when doing work like this, you have it planned well, it goes to the lab and you get it back and the one tooth that was slightly yellow is still the mismatched tooth....which means you need to send it back to the lab to customized and stained.


Should it be common practice for a dentist to leave the new bridgework on the other side of the room and not look at it, and give you 6 needles and cut and crack your temps out and place the new ones and even adjust the bite only to hand you a mirror and let you see that they are yellow and your top teeth are white?

Sometimes it is difficult to tell that the color is off unless placed on the teeth and compared to the other teeth. Sometimes people are very sensitive unless numbed. No one likes getting numb. Dentists don't like giving "shots" or needles either but I know sometimes the patient will be sensitive for 10-15 minutes while trying in, adjusting, etc new crowns so I numb them before we get started...

And then try to tell you that you really don't see your bottoms when you talk? (Twice)

Sounds like they lost sight that they are YOUR teeth so YOU should be satisfied with how they appear. With that being said you don't really see your bottom teeth when you talk unless you are kevin spacey

Should a dentist talk you into accepting a bad color match and then walk into the room with a legal disclaimer to sign?

No.



When I kindly question his work, He just says things like, "you do have a beautiful smile" and "there really close" and my favor at one " remember what you looked like when you came in"

I would prefer to have a patient be as specific as possible. Example. I don't like how long the tooth is at this corner.

I currently have the bottom incorrect color in with temporary cement and he told me they fit the gum line fine, One of the teeth in the back has a shelf under it that my fingernail fits deep and easily into and feels like a live wire if I floss it. Is that OK?

Why is your fingernail in your mouth?? . Maybe the temporary doesn't fit as precise as ideal.....maybe there was a really big cavity on the tooth before you started with work and it will be sensitive for a awhile as it heals. Is it okay? Probably....goes back to the "is it clinically acceptable?" From earlier.

Thats another reason I want to get a new impression but I am sure he will say "Its Fine"
I am actually afraid to go back because I can't trust him for what he says. But the job is paid for and I have to get it resolved.
Of course trust and character can't be bought so I know I need a new dentist for the rest of my work. I was thinking of having someone else look at the work in progress and see if I'm wrong, But I certainly can't pay someone else to do over what he has done.

If you are going to have someone else look at it try a member of the academy of general dentists, look for a fellow or master....it means they have gone to numberous educational courses after dental school to stay up to date and learn advance techniques

You could also look for an American academy of cosmetic dentistry...accredited members are the most exclusive in this group there are also regular members.

Full disclosure I belong to both the groups I recommended and am just a regular member for both

[1beautifuldaughter]

Thanks again for taking the time,
The teeth are all porcelain, He told me he did that to avoid a black line across the top.
The dark line is my old tooth showing across the top.
My fingernail is in my mouth because I don't trust my dentist,

The bottom tooth with the shelf was a healthy tooth with no cavity.used to anchor.
It is an all porcelain tooth that is discolored because you can see the old tooth inside of it.

I know how hard it is to just read about a problem and get the full jest, For that I really appreciate your help. Thanks again

[Wisco12]

Originally Posted by 1beautifuldaughter

Thanks again for taking the time,

are your new teeth(crowns) on the top teeth or bottom?
The teeth are all porcelain, He told me he did that to avoid a black line across the top.
The dark line is my old tooth showing across the top.
okay I know what you are talking about! The crowns were likely finished just below the gum line at the time of the impression and then due to a variety of reasons your gums have now receded back and exposed your dis colored tooth underneath. Reasons for this recession are numerous and could be your tissue type(thin or thick), temporary crown fit, homecare, etc. If you are seeing your dis colored tooth below your new crown and above your gum and do not want it, you will need to have your tooth prep redone and impressed.
My fingernail is in my mouth because I don't trust my dentist,

The bottom tooth with the shelf was a healthy tooth with no cavity.used to anchor.
this could be a wear facet in the side of the tooth caused by grinding or aggressive brushing. Depending on the severity and cause it may or may not need tx.....judgement call depending on factors.

It is an all porcelain tooth that is discolored because you can see the old tooth inside of it.
I'm going to guess that the old tooth is pretty dis colored. The porcelain tooth/crown is transparent and that is why you can see it. This is obviously not wanted and can be overcome with different porcelain selection, special cement, prep design(the shape of the old tooth to accept the new crown)
I know how hard it is to just read about a problem and get the full jest, For that I really appreciate your help. Thanks again

no problem, it is kinda eye opening to read about things from a non tooth person perspective. Hopefully I can increase my communication with my patients. If anyone else reading this thread has some tooth questions ask away.

[1beautifuldaughter]

Yes after all this problem I have is all about communication and trust. When I told him on my last visit that I was very unhappy with the work and didn't feel he lived up to his promise, And that I thought asking me to sign a waiver was " A Very Bad Element", He walked out of the room and eliminated the usual hand shake as I left.
I just hate the fact that he won't acknowledge and/or address anything I'm not happy with or concerned about.
By the way the step in the bottom tooth is brand new, so has nothing to do with brushing or wear, and Yes I guess you would call them crowns,although they are attached making them a bridge. Thanks again

[Wisco12]

Yes after all this problem I have is all about communication and trust. When I told him on my last visit that I was very unhappy with the work and didn't feel he lived up to his promise, And that I thought asking me to sign a waiver was " A Very Bad Element", He walked out of the room and eliminated the usual hand shake as I left.
I just hate the fact that he won't acknowledge and/or address anything I'm not happy with or concerned about.
By the way the step in the bottom tooth is brand new, so has nothing to do with brushing or wear, and Yes I guess you would call them crowns,although they are attached making them a bridge. Thanks again


dentists are people too, he/she probably felt weird after your convo and was thrown off their usual game of a handshake. I wouldn't read too much into that.
Maybe you need to get a quick appoint with him to discuss your concerns. The last thing you or the dentist wants is to permanently cement something that you are not satisfied with.....assuming you are being reasonable. Are you okay with the size, shape, contour of the teeth going in? The color is being changed so hopefully will match better. Did they take photos at your last appointment?

Are you feeling the edge of the crown on the bottom with your fingernail? If so this goes back to the early statement of it being common to feel a little lip but not too much.....clinical judgement call that can only be done in person while looking at your crown.

[Chris65LeMans]

Originally Posted by Wisco12

. If anyone else reading this thread has some tooth questions ask away.

I have a quick one - I took my 4 year old daughter to a new dentist that's more convenient for me recently. This dentist claimed she had four cavities needing three fillings and one crown. I pre-paid for all of them, but she (the dentist) spread the treatment over 2 appointments.

During the second appointment, she decided to do a regular filling instead of that fourth crown. When I asked the office about a partial refund, they charged me more money! (four fillings cost more than just three fillings and a crown.) They claimed that was correct, but my opinion is that they charged insurance for that crown they didn't do, charged them for the fourth filling, then got really greedy and charged me an extra co-pay.

I know you're not the billing guy but, hey, you offered. Thanks in advance for your help.

[Wisco12]

Originally Posted by Chris65LeMans

I have a quick one - I took my 4 year old daughter to a new dentist that's more convenient for me recently. This dentist claimed she had four cavities needing three fillings and one crown. I pre-paid for all of them, but she (the dentist) spread the treatment over 2 appointments.
why wouldn't you want the treatment spread over two appointments? Do you honestly think your 4 year old daughter could sit still that long to allow the dentist to do an adequate job helping your daughter? The dentist did you a favor here by not forcing to do everything at one appointment and scar your kid for life.

During the second appointment, she decided to do a regular filling instead of that fourth crown. When I asked the office about a partial refund, they charged me more money! (four fillings cost more than just three fillings and a crown.)
this could very well be true. Insurance likes to play games with the amount they cover for each procedure category. Filling is a separate category than a crown.
They claimed that was correct, but my opinion is that they charged insurance for that crown they didn't do, charged them for the fourth filling, then got really greedy and charged me an extra co-pay.this would not be possible as they would have had to charge a filling and a crown out on the same tooth. If there is some fraud going on, it would be very easy for you to check. Just call your insurance and ask what has been submitted to them for treatment and compare it to what the office gave you. If the office gave you a sheet saying that four teeth were worked on and insurance says they worked on five teeth then yes there is fraud going on. Report them.

I know you're not the billing guy but, hey, you offered. Thanks in advance for your help.

billing gets confusing. Dental offices estimate what the insurance will pay for your treatment. The insurance payment is then deducted from the procedure free and the resulting balance is your co pay. Sounds straight forward until the insurance comes back and says that patient X doesn't qualify for full insurance payment due to xyz.
For example, patient X needs some fillings. Wants whites, procedure gets done and insurance is filed. Instance now comes back and says patient X only deserves silver fillings and will only pay for such. The procedure has already been done with white fillings. Now the patient has a larger co pay then originally estimated.

I look forward to hearing about you found out about the fillings vs fillings and crown from your insurance company.

[Chris65LeMans]

I didn't take issue with her spreading it over two days - it was the money. In this case, it's not so much about the extra hundred bucks - I'm concerned that she may have done unnecessary work on my daughter in order to raise funds.

Thanks for your input.

[Wisco12]

gotcha Chris. I thought you had a problem with splitting treatment up. A lot gets lost online. I hope no unnecessary work was done. Like I said compare the two treatment printouts from office and insurance and you will have your answer.

[1beautifuldaughter]

I am a plumber, not a dentist, This is what I am talking about when I say a "shelf" on the bottom of a tooth.
You can feel the tooth at the gum line and as you come up onto the crown there is a valley

[Wisco12]

Fantastic drawing. I'm i pressed you drew it so well. What you are describing is an open margin and if you can feel it with your nail, it is large and not acceptable.

[1beautifuldaughter]

This is exactly what I have on the back of an end tooth of a lower front 7 tooth porcelain bridge.
It is the bottom that is put in with what he called temporary cement while I am left to decide if I want to correct the color.
I asked him if they fit well to the gum line when he put them in and he said yes, It was two days later that I found it while flossing. I can even feel it with my tung and it is very sensitive. They are tight down,not loose.
Hence the reason I would rather he just send them a new impression as opposed to trying to change the color, ( I was wondering if thats what they tried to do). And not have me go through the temporary acrylic taste for 2 weeks again.
I was thinking of going to a different dentist and have a look see and consult about the work in progress before I see him again, Because I know he will tell me its acceptable even if its not.
He told me I could keep it in temporary for a while, but I feel I need to get this resolved soon. Because he did temporary cement,he did not clear the cement so that I could floss under some of the teeth. At this time I am using a water pick. Thanks again