Dental onlay failing within 6 months

miniemma

Hi

I am hoping for some advise about an onlay I have on a back molar.

It has been a problem tooth for a while and my private dentist kept having to replace a filling on the back of the tooth as it would not stay.

I ended up changing dentist to an NHS one due to leaving my job and when the filling fell off again plus another chip off the tooth, I saw a locum at my new dentist who recommended a crown.

New dentist comes back from honeymoon, he had married the other dentist at the practice :T , he recommended an onlay.

This was July- Sept last year: Impressions made, weeks later metal onlay arrives, dentist shaves it to fit but has to shave off so much that he says it will fail so sends off for a white one. Weeks later the white one is fitted and he still has to shave a little off the tooth above to correct the bite once the onlay is fitted.

A month or so later a little chips off the back of the onlay so I go back to the dentist and he says it is ok and rounds it off. I express my concern at having paid a band 3 charge for a broken product and he says it is ok there is a year guarantee.

Last month another piece falls off but my dentist and his wife have left the practice I am told I have to pay £18 for an assessment. I argued this and rang the PCT who said pay for it and get a refund.

Dentist then tells me that an onlay was the wrong treatment for this area due to the heavy bite and that I need a crown (see locum's advice above) and that I will have to pay a new band 3 charge because the old treatment has been closed off and this would be a new set of treatment! And then tells me that a crown could be problematic as the tooth has not had a root canal and if it was needed in the future then they would have to drill through the crown! This whole situation made me cry in the chair

Dentist suggested speaking to Practice Manager. She was on the desk and gave me the email address. I wrote immediately but received no reply. I rang last week and she has left! Turns out the company had quite a few practices and has been split in 2 due to a divorce, my dentist and his wife were asked to leave, they have no reception staff or nurses! I email the new company directly and still receive no reply.

Long story, sorry, tried to keep to the main points, probably missed a few. I just want to know if this should be sorted under the original band three payment and I would quite like my £18 back for the assessment.

brook2jack

The problem is that the money will have been paid to the old dentist for the band three treatment not to the practice which would appear to be under new management. So in effect you would be asking the new dentist to correct the problem for free.

However sometimes when a practice is sold a sum of money is kept back to correct problems such as this. So write to the practice manager of your current practice explaining the situation. For this purpose it has to be snail mail not e mail. They then have to reply to you within two weeks, I think.

miniemma

Thanks brook2jack

As I was writing the original post I realised that I should have used snail mail. And having read a few other dental threads on here I came to realise the way dentists were paid

The practice manager has left so I will have to ring again and see if they have replaced her I guess.

welshdent

I wouldnt be overly hasty saying an onlay was the "wrong" treatment. I do stacks of them and do very few crowns findings that in my hands they are a better option as they retain far more of the natural tooth potentially giving you a stronger option provided the preparation was right. Offering an onlay or a crown can be as simple as what the dentists think work better in their hands. We can not say for sure without seeing you and examining you but I know most possible crowns I have see would work IMO well as an onlay. The key os to make sure enough of the correct reduction is done to give space to place the restoration. The other consideration is making sure the correct material is used. Metal is very strong and does not require the same level of reduction of the tooth as composite or ceramic.

The £18 however is reasonable given you are not seeing the same dentist and the new dentist would have to examine you to assess any problems ... effectively without the £18 you are asking them to take responsibility for free for someone elses work.

It may not seem like it as you are going to the same physical building but in effect what you have is a problem with an item bought from tesco but taking it back to sainsburys. Like it or not, that is the system we have. Expecting the second dentist to replace for free is unfair because not only would they have to provide their time for no remuneration whatsoever but they would also have to pay the lab fee to have the crown or onlay constructed which could be anything from £30 to a couple of hundred.

If a root filling is needed then that is a different kettle of fish. That would not be the fault of either dentist at all. Sometimes the nerves of teeth just die off when heavily restored. If a bit of the onlay broke though its not as likely that within a few months this would cause the nerve to die ... but the previous decay etc COULD do this.

miniemma

Thanks Welshdent,

It makes sense when you say it, I wonder why this was not explained to me in these terms when I was there.

As for the root canal, the dentist was just saying that if it needed root canal in the future then a crown would be in the way.