Dentist refuses to replace old crown

Sammy2018

Hi all

I have some pain that comes and goes on a 20+ year old crown. In that time, it's also become unaligned and formed a gap between the two top teeth. The whole thing looks crooked. And the crown itself sits on one of those teeth.

Now the (NHS) dentist is saying to just live with the pain. I can't believe he resorted to that. Is he allowed to say such a thing?

brook2jack

Have you been back again since your last posting when you had x rays and nothing could be seen and because it was only occasional mild pain the dentist advised leaving it alone?

If , for instance , the tooth has been root filled and has a large post in it , or there is gum disease going on around the tooth the dentist may feel that replacing the crown is not viable and the only alternative is to take the tooth out.

However this is something you need to discuss with the dentist who can see you and your x Rays.

You can pay for a second opinion from another dentist if you are not happy with what the first dentist is saying.

Sammy2018

brook2jack wrote: »

Have you been back again since your last posting when you had x rays and nothing could be seen and because it was only occasional mild pain the dentist advised leaving it alone?

If , for instance , the tooth has been root filled and has a large post in it , or there is gum disease going on around the tooth the dentist may feel that replacing the crown is not viable and the only alternative is to take the tooth out.

However this is something you need to discuss with the dentist who can see you and your x Rays.

You can pay for a second opinion from another dentist if you are not happy with what the first dentist is saying.

I've not been back since Nov. 2017. I'm going to make another appointment in a few weeks time, and on this occasion I'm going to say the pain's too much to handle. How would he able to refuse *that*? - I mean, I'm actually paying for the stuff. It's not as if I'm getting everything done for free.

The X-rays on the last visit showed no problems; no infection etc...

And with respect, why would I need to see (and pay for) another dentist to see what's going on? - It's hard enough finding one that'll take you on in the first place. I really shouldn't have to do this.

brook2jack

If the dentist can see a reason why replacing the crown may be problematic ie for some of the reasons previously explained, they may suggest extraction instead, that would get you out of pain . It is not always easy or appropriate to replace a crown .

A dentist cannot be forced to do treatment that is against their clinical judgement , even if the patient pays for it.

However give any problem to two dentists and you will get three different opinions. There are very few rights and wrongs in dentistry and very few dentists will come up with identical treatment plans.

Sammy2018

brook2jack wrote: »

If the dentist can see a reason why replacing the crown may be problematic ie for some of the reasons previously explained, they may suggest extraction instead, that would get you out of pain . It is not always easy or appropriate to replace a crown .

A dentist cannot be forced to do treatment that is against their clinical judgement , even if the patient pays for it.

However give any problem to two dentists and you will get three different opinions. There are very few rights and wrongs in dentistry and very few dentists will come up with identical treatment plans.

Thanks. And if there was an extraction to be done, how would they 'cover' the empty space that'd be left? - Presumably another crown is out of the question since there'd be nothing for it to peg on to.

brook2jack

There are various options from implants (only available privately circa £2000) to dentures and if the tooth needed to come out the dentist should discuss this with you.

Quentin

Sammy2018 wrote: »

Thanks. And if there was an extraction to be done, how would they 'cover' the empty space that'd be left? - Presumably another crown is out of the question since there'd be nothing for it to peg on to.

Lots of options:


eg:
Fixed Bridges, Removable Partial Denture... Implants..Partial Denture

[Deleted User]

I've got a crown. At the time he put it in, the dentist told me that the tooth will have to come out when it eventually fails.

Sammy2018

Thanks guys. Much appreciated.

Sammy2018

Hi folks.

Sorry to bump up this thread of mine but I was thinking of going back to the dentist's in about a week's time to see if he'll have another look at the situation and whether he's going to do something about it.

In fact, I thought I'd post a pic of the 'offending' crown here:

https://ibb.co/i3FWnS

---

As you can see, it's in a pretty bad way. The bottom set of (rather crooked) teeth I could live with. They're not really causing any major issues but it's that old crown that's affecting me. For one, I can't smile confidently, knowing the state that particular crown is in.

How can a dentist, any dentist, refuse to correct that?

Toothsmith

So did you go back a few weeks after your Jan 7th posting when the pain was "too much to handle"? Or have you handled it for the last 3 months?

That picture isn't even in focus - so it's really not possible to tell anything much from it. Plus - to see underneath it, you'd need the x-ray as well to form any judgement.

I can see there is a bit of gum recession around it, and if you say it's gone crooked, then maybe gum disease is an issue to. From what can be seen, the crown looks to fit perfectly well on the tooth - so I can certainly see that the dentist may well be right in saying replacement of just that crown isn't going to solve the 'health' problem associated with that tooth.

I can see what you mean that the tooth doesn't LOOK good - but The National HEALTH Service isn't the National AESTHETIC Service - and it really is very easy to spot someone over-egging pain and problems with a tooth to try and get it replaced for cosmetic reasons, and I think your dentist has probably called it right.

If this tooth is a HEALTH problem to you, then taking it out and replacing with a little denture is probably appropriate. It might well be that just sorting out any gum problem and/or infection will save the tooth as it is, with no need to replace the crown - but that won't make it look any prettier.

To get what you want, would probably need having any infection sorted out, which the NHS would pay for with your contribution to the cost as well, and then you properly paying privately to have the crown replaced yourself - if the dentist agreed it was a worthwhile treatment.