Dental problem

I am after a little bit of guidance after a dental procedure I have had in July 2019 please.
I have had two front NHS crowns fitted for 15 years and decided to have them replaced as they were a different colour to the rest of my teeth now and had started to get a slight gap along the gum line. 
I spoke to my regular dentist of 10 years who told me as I didn’t want to have the metal based NHS crowns I would need to go private this meant seeing the practice owner within the same dentist and pay for a better material (I opted for E-max crowns).
As this was my two upper front teeth I was very nervous but I was reassured all would be ok so went ahead with the procedure.
I had all the necessary impressions done and even visited the lab were the crowns were being made to colour match with the lab technician.
The day came to have my new crowns fitted and all seemed to go well, until the numbness wore off, I felt a bit of discomfort but put this down to having the procedure done.
I had them in for 3 months and still couldn’t bite down on even soft foods such as a sandwich, so I decided to go back and speak with my dentist with my concerns.
he looked around my crowns and after a long discussion he said I may need to have root canal on one of the front teeth and then advised me that with any dental work such as crowns there is always a chance of tooth loss! But he would try and save the tooth!  I asked him why didn’t he explain that before I had it done and he said as I already had crowns I will of had that discussion when I first had them done, I told him as I had them done at a different dental practice he should of explained that to me, so I told him before I have any root canal done I will go and get a second opinion, as it is my front teeth I want to make sure that root canal is the only option. 
I am now 7 months in and still can’t chew soft foods on my front teeth as I feel he may of filed my teeth down to much exposing a nerve?? I can’t even brush (soft tooth brush) or floss without my front gums bleeding.
I feel I have given the teeth enough time to settle. I am not sure if I should go and see specialist or would any dentist be able to give advise on what has gone wrong? 
Thanks in advance 

Replies

  • ToothsmithToothsmith Forumite
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    Whenever a drill is taken to a tooth, damage is done. There is always a chance that that damage might kick off a problem with a tooth, or even flare up a problem that was there anyway, but quiet.
    In fairness to your dentist - the chance of him 'filing down the tooth too much and exposing a nerve' is pretty remote - Just the act of changing the crown could easily have been enough to start off problems.
    They should have warned you of the more likely dangers of the treatment (You can't be warned about every single remotest possibility, for example, I never warn patients it is theoretically possible they could have an allergic reaction to the local anaesthetic that results in their death!! It is a possibility - but so vanishingly small, it's a bit pointless!) I would class possible reaction from the tooth as a risk I would warn about. 

    Did they take an X-Ray of the teeth beforehand? Some studies have shown that up to 20% of bonded crowns (The metal backed ones) result in the death of the tooth crowned. So with 2 of those crowns done at the front, there was probably a nearly 50% chance one of them had died anyway, but was just quiet. It could easily have been the changing of the crown that kicked something off there. (Crowns like Emax which are dentine bonded, do have a much lower chance of killing a tooth) 

    So, yes, I think you should have been warned about possible consequences. Just check there wasn't some sort of consent form signed that included it. It is a known phenomena that patients do only tend to take in the information they want to hear. 
    The dentist should have taken an x-ray of the tooth prior to re-crowning it to check that things semed healthy with it too.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
  • ToothsmithToothsmith Forumite
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    Sorry - I also meant to say in that reply...
    The thing you should also consider is what your reaction would have been if the dentist had said "There is a small risk that in doing this we might spark off something that might mean one or both may need root filling". What would you have done? The risk is small, and you didn't like the look of the teeth. Would you have left well alone, or would you have still gone ahead?

    It seems there may have been something lacking in their consent process - but would that something have made a difference to what you decided? Obviously it is easy now it hurts to say "I wouldn't have let them touch it". But if you felt you looked like Nanny McPhee, is that really the case?

    It is a valid complaint to say you didn't get proper warnings if you feel that is the case, but if you feel you probably would still have gone ahead had you known there was a small risk of this happening, then maybe  best not to go in all guns blazing and end up having to find another practice to be seen at? Raise it as a concern with them, and see what they suggest.
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
  • brook2jack2brook2jack2 Forumite
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    If your gums are bleeding it will be nothing to do with a potential root treatment problem. You need to get your dentist to demonstrate how to floss and brush correctly as inflamed gums will bleed and need 5 to 7 days of concentrated cleaning before the bleeding settles down. Most people back off cleaning when gums bleed but it's exactly the opposite that needs to be done.
    Current thinking is that 20 to 30% of crowned or bridged teeth will need root treatment and it is a well known risk . 

    E max crowns are very dense coloured crowns and little more tooth would have had to have been removed from your existing crown preparations , other than perhaps around the gum area.
  • UndervaluedUndervalued Forumite
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    Sorry - I also meant to say in that reply...
    The thing you should also consider is what your reaction would have been if the dentist had said "There is a small risk that in doing this we might spark off something that might mean one or both may need root filling". What would you have done? The risk is small, and you didn't like the look of the teeth. Would you have left well alone, or would you have still gone ahead?

    It seems there may have been something lacking in their consent process - but would that something have made a difference to what you decided? Obviously it is easy now it hurts to say "I wouldn't have let them touch it". But if you felt you looked like Nanny McPhee, is that really the case?

    It is a valid complaint to say you didn't get proper warnings if you feel that is the case, but if you feel you probably would still have gone ahead had you known there was a small risk of this happening, then maybe  best not to go in all guns blazing and end up having to find another practice to be seen at? Raise it as a concern with them, and see what they suggest.
    Although that is a very valid point can I play devil's advocate for a moment?

    As you say, even if the OP wasn't adequately warned about the risks she may well have been prepared to accept the risk and gone ahead with the treatment. Only she will know.

    However another patient may have made a different decision. If (big if I know) this dentist isn't giving sufficient warning of risk, either through a lack of training or worse a desire to sell an expensive procedure, then that seems to me to be a serious failing?

    I appreciate if must be very difficult  to know what level of risk you warn about. Take it to the ultimate and presumably nobody would have anything done unless it was to get out of unbearable pain! So I certainly don't envy dentists (or other medics) that one. Even if warned, how does the medical professional know the patient has fully understood what they have been told? Is the level of risk for a particular procedure universally agreed upon? Or, would some professionals argue it is exaggerated or minimised?

    Difficult! 
  • ToothsmithToothsmith Forumite
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    Those are fair points UV -  and valid consent is indeed a minefield.

    Even if a patient has signed something listing all the risks, and stating they were comfortable to take them - if it all goes pear-shaped then there are some negligence lawyers out there who would argue that it was signed 'under duress' as the patient hadn't had a chance to go home with it, or even that the patient simply didn't understand it. How can you argue against that?

    You're right - if a dentist is misleading a patient in order to sell more complex treatments, then that isn't right. But dentists like that will very soon come a cropper. 
     
    How to find a dentist.
    1. Get recommendations from friends/family/neighbours/etc.
    2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
    3. Assess the helpfulness of the staff and the level of the facilities.
    4. Only book initial appointment when you find a place you are happy with.
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