Bad dentist?

bardering

In July I went for a dentist check up. She saw my root canal tooth from 4 years ago took some x rays and recommended a crown to ‘strengthen the tooth’. She took an X-ray of the tooth and it was ok- root canal seemed to be holding. It’s taken me ages to finally get the crown but 2 days ago I finally got the crown fitted. I now have some pain in this tooth and I’ve just realised she didn’t take any further x rays since June. No x ray before placing the crown or going ahead with the shaving down of the tooth. Is this negligent? What if I have an infection that’s come about because of all the work done on my tooth to crown it and she has basically missed this by not doing an x ray and has now crowned it. Bad dentist? I should also add that she didn’t advise me it wasn’t a crown I was getting but an onlay. I only found out about this when I got home with my ‘crown’ and wondered why it didn’t cover my entire tooth only the bottom so I googled it and it is an onlay- although she only ever used the word crown the entire time. Should I be pursuing this bad dentistry further and make a formal complaint?  

brook2jack2

X rays should only be taken when really necessary , to keep exposure to radiation as low as possible. 

Your dentist took an x Ray before treatment , found nothing on it to indicate concern , there would seem to be no reason to take another only a few months later and this would not be normal dental practice to retake an x Ray so soon . 

Preparing a tooth for a crown/inlay/onlay will not cause an infection . It is good practice in many cases to place a crown/onlay/inlay on a root filled tooth as root filled teeth are more likely to break or crack. Unfortunately breaks or cracks can often not be spotted on x rays and can be difficult to spot on the tooth. 

Sometimes a tooth can be a little uncomfortable after placing a crown/inlay/onlay but it normally settles down. If it doesn't contact your dentist. 

Until you start preparing a tooth it can be difficult to know how much tooth you will need to remove. It is good practice to remove no more than necessary to protect it. There is no difference in cost , or outcome or technique in a crown/inlay/onlay (actually an inlay/onlay preparation may be more technically demanding) except a tooth that is less damaged will be better served by an inlay/onlay because less tooth needs removing. 

MalMonroe

The questions you have asked need to be directed at your dentist before you start making any accusations or complaints. 

If you are not happy with what the dentist has done, you should make an emergency appointment to see her again. Pain is not good. I had a crown fitted on a front tooth a few years ago because the original was broken in an accident. After taking an Xray, my dentist was able to file the remaining tooth, take a mould impression of upper and lower teeth and place a temporary crown on the filed down tooth. Two weeks later I went back to have the permanent crown fitted.

There was no discomfort or pain. Once the anaesthetic had worn off, I was able - and advised - to treat my crowned tooth as a 'normal' one. It's still working well. 

Your dentist has supplied a service and product for which (presumably) you have paid. If you are not happy, then you should phone to make an appointment as soon as they can fit you in. My dentist has a system whereby if we have tooth pain or trauma, we are able to phone as soon as they open and we are normally able to book one of their emergency slots the same day. Hopefully so does your dentist. If you don't know or understand why your dentist is doing anything in your mouth, you should always ask. 

Toothsmith

Sorry you haven't won the 'bad dentist' lottery. It actually sounds like you've got quite a good one. 

I would just see how that problem goes though, and get back in good time if it doesn't seem like it's settling. Root filled teeth are quite unpredictable, and you can only go with the evidence you have. It's more likely to be a settling in thing for the crown/onlay though, there might just be a slight high spot that needs adjustment too. 

bardering

Thank you all for your replies it has been very helpful to hear. 

My dentist is closed for the Christmas period now so will have to wait for the new year. The pain is intermittent and low so hoping it’s a settling issue. 

I think what annoys me is that I spent £530 on this crown- because the dentist advised that over time on an nhs crown- the metal would show eventually on the gumline. Now the onlay I have is all at the back of the tooth so you wouldn’t even be able to see it even if it was full metal!! So I do believe she pulled a fast one on me in that respect and I have now paid double £ for a crown that is basically an onlay that you can’t even see in the front but paid for full private porcelain. 

Toothsmith

Ahh - now a bit more info comes in and I can see why you're feeling as you are.

I still feel your dentist has done the right thing, but the NHS/Private upsell card has been thrown into the mix, and it really muddies the waters.

This is why I think dentists should just abandon NHS dentistry completely. It in such a mire! It can make patients feel badly towards them even when they've done the right things for the right reasons, but not found a good enough way to explain why! 

If she was doing an NHS crown, it would have been a crown, not the more precise onlay, whatever material it was made in. The fact you'd gone for the private option meant she could get a bit more clever about things, and she's preserved something that no amount of money could buy back for you - your own tooth!

You, as the patient don't see what she's 'done' for you by saving tooth, you see what she's not done - she's not whacked off tooth and replaced it with something you feel you've paid for. 

Patients don't have dental training, and you can't expect them to understand the things that dentists are looking at when they're planning a treatment. 

If there were just a single fee rate that depended on factors like how much time was spent, how much the materials cost, and how much the training and experience to provide more advanced things cost - then explaining things to patients would be much easier.

When your trying to work 2 fee systems one of which is held artificially low by regulations, and generally costs the dentist or dental practice money if anything other than the most basic items are provided - yet you're not allowed to actually tell patients why one is really better than the other - then it's really easy to get misunderstandings such as yours. 

welshdent

FWIW id usually have an onlay over a crown regardless of the fee system being used. They are more conservative and usually give further options down the line should they fail. 

Communication sounds like it needs to be better but placing a crown or an onlay usually involves the same time needed, the same procedures needed with a few minor differences in preparation design, the same materials can usually be used and the costs to the dentist are usually the same. There would in normal circumstances be nothing to gain in giving you an onlay over a crown that could be down to underhand shenanigans. 

wondercollie

Reading all of this makes me think OP wants a refund to equal what the NHS crown would have cost.

They should be thanking their stars they are in the UK.   My husband just had a bridge fitted with four teeth.   Total cost of nearly $7K which we wound up paying $2300 out of pocket and that was with two private dental insurance plans.

Vivianjames_91

Hello,
I had a crown placed in my mouth a few months ago. After my dentist installed the temporary crown, I was in excruciating pain, so I made an emergency appointment with the dentist to see if there were any infections or anything else I should be concerned about.
As far as I recall, my dentist only took an X-ray once. Taking more X-Rays is not beneficial because it can result in radiation and other complications. They will be able to diagnose your issue based on one or two X-Rays alone because they are professionals.
If you are in pain after the fitting, you should see her right away, and if you have any doubt about her, you should see another dentist.