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Thursday, May 23, 2013
Crowns, Bridges, Dentures, Implants
Restoration after Dentist Issues
I have been limited in my choice of dentist due to a switch to HMO. I am not happy with this current dentist. On my first visit, I felt I was given a menu of things they could do that my insurance would cover at no cost to me. I have always been in the dental chair since the age of 5 and have nice teeth. My problem is that, since going to this dental office, I have begun to have problems that I am not sure how to fix. I had a dental instrument jammed sharply up into a space between a tooth and a filling. That very day, the tooth broke. I was told the tooth was not able to be "saved" and that it would have to be pulled (the first I have ever lost in 45 years). The Dentist slipped as my tooth was pulled and now the tooth next to it has a crack up it (on the inside where it butted against the pulled tooth). I`m convinced the tooth was broken when he slipped. I had a crown that I had several years ago. Since that time, I had moved and changed dentists 3 times and no major problems were ever noted. Yet, when I see this dentist a dental instrument was jammed under the crown (I don`t mean the usual gentle prod done to a crown at the gumline). He asked who did this crown? Acting as if I had seen some quack. Crown was fine before him and again within a day or two there was a squishing sound around it. The crown has worked loose now to where it can pop up on that side. I don`t know what to do? First of all, I will have a new dentist this year. I went in with a set of teeth that every dentist I have ever had complimented me on. Now I am missing tooth #4 (showing in my smile). The tooth next to it has a crack in it on the inside where the other tooth is missing. I have a broken tooth that has had a root canal that I hope can be crowned. And also, this molar that has a loose crown. What can I expect a new dentist to want to do? I can not afford expensive work and it looks like the HMO cost me more than it saved. My biggest concerns are the cracked tooth and the loose crown. I don`t want to lose anymore teeth.
First of all, you need to find a new dentist. Is always safe to ask for second or third opinions, if you are not in pain there is always time to have another opinion and make a decision with no rush.
For me is very difficult to tell you what to do with your broken teeth without seeing you or have radiographs or models of your teeth. Usually fractured teeth do not have a good prognosis, but it depend how big and deep the fracture is, the location, the bite, etc…
Unfortunately, HMOs do not offer the best treatment options for the patients, just the more convenient and inexpensive for them. This limits the options for patients and dentist.
To replace #4, the best option is to have it replaced with an implant (usually not covered by an HMO). The second option is to replace it with a fixed bridge attach to the teeth next to it. The third option (and cheapest) is a removable partial denture. For the loose crown you are probably going to need a new crown as soon as possible, before is too late.
Alfredo Hernandez, DDS, MS
Assistant Professor of Comprehensive Care
School of Dental Medicine
Case Western Reserve University