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  • FIRST POST
    • Sammy2018
    • By Sammy2018 7th Jan 18, 2:37 PM
    • 26Posts
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    Sammy2018
    Dentist refuses to replace old crown
    • #1
    • 7th Jan 18, 2:37 PM
    Dentist refuses to replace old crown 7th Jan 18 at 2:37 PM
    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?
Page 1
    • brook2jack
    • By brook2jack 7th Jan 18, 2:58 PM
    • 4,200 Posts
    • 3,854 Thanks
    brook2jack
    • #2
    • 7th Jan 18, 2:58 PM
    • #2
    • 7th Jan 18, 2:58 PM
    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
    • By Sammy2018 7th Jan 18, 3:07 PM
    • 26 Posts
    • 1 Thanks
    Sammy2018
    • #3
    • 7th Jan 18, 3:07 PM
    • #3
    • 7th Jan 18, 3:07 PM
    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.
    Originally posted by brook2jack
    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
    • By brook2jack 7th Jan 18, 4:01 PM
    • 4,200 Posts
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    brook2jack
    • #4
    • 7th Jan 18, 4:01 PM
    • #4
    • 7th Jan 18, 4:01 PM
    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
    • By Sammy2018 7th Jan 18, 4:34 PM
    • 26 Posts
    • 1 Thanks
    Sammy2018
    • #5
    • 7th Jan 18, 4:34 PM
    • #5
    • 7th Jan 18, 4:34 PM
    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.
    Originally posted by brook2jack
    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
    • By brook2jack 7th Jan 18, 4:37 PM
    • 4,200 Posts
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    brook2jack
    • #6
    • 7th Jan 18, 4:37 PM
    • #6
    • 7th Jan 18, 4:37 PM
    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
    • By Quentin 7th Jan 18, 4:42 PM
    • 37,323 Posts
    • 21,512 Thanks
    Quentin
    • #7
    • 7th Jan 18, 4:42 PM
    • #7
    • 7th Jan 18, 4:42 PM
    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.
    Originally posted by Sammy2018


    Lots of options:


    eg:
    Fixed Bridges, Removable Partial Denture... Implants..Partial Denture
    Last edited by Quentin; 07-01-2018 at 4:44 PM.
    • jack_pott
    • By jack_pott 7th Jan 18, 4:58 PM
    • 4,653 Posts
    • 6,017 Thanks
    jack_pott
    • #8
    • 7th Jan 18, 4:58 PM
    • #8
    • 7th Jan 18, 4:58 PM
    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.
    I'm not upset that you lied to me, I'm upset that from now on I can't believe you.
    Friedrich Nietzsche
    • Sammy2018
    • By Sammy2018 7th Jan 18, 4:58 PM
    • 26 Posts
    • 1 Thanks
    Sammy2018
    • #9
    • 7th Jan 18, 4:58 PM
    • #9
    • 7th Jan 18, 4:58 PM
    Thanks guys. Much appreciated.
    • Sammy2018
    • By Sammy2018 15th Apr 18, 1:05 PM
    • 26 Posts
    • 1 Thanks
    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
    • By Toothsmith 15th Apr 18, 7:08 PM
    • 8,945 Posts
    • 10,669 Thanks
    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.
    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.
    • Sammy2018
    • By Sammy2018 15th Apr 18, 9:41 PM
    • 26 Posts
    • 1 Thanks
    Sammy2018
    Thanks TS. And my last visit was last November. And the pain's not that bad really. It's just that now and again I can feel the tooth underneath the crown in an odd position (hence why it's unaligned).

    Also when I bite down towards the bottom teeth, because of that unalignment, the crown is the first part that makes contact instead of the other top teeth.

    Do you think that *that* would be a good reason for the dentist to replace it?

    If not, I'll probably be forced to say it's just too painful, especially before going to sleep and the morning after, since it's causing a pretty bad headache.

    Presumably they can't refuse on the grounds of constant (and rather severe) pain?
    • Money maker
    • By Money maker 15th Apr 18, 10:26 PM
    • 5,077 Posts
    • 11,548 Thanks
    Money maker
    I had rather severe pain beginning of this year and it wasn't a case of leave it for a few weeks, I think I managed about 11 days, eventually ending up on the strongest over the counter tablets, unable to even move when the pain started - just about able to breathe. I ended up a crumpled mess of pain and tears so just remember that tooth pain can get REALLY REALLY BAD. Just to add a crown has come off one of my teeth (unrelated to the pain), not enough tooth to replace it onto, teeth each side too healthy to chop around for a bridge. Options are a denture (over my dead body) or implant (costs a fortune), so be careful what you wish for.
    Please do not quote spam as this enables it to 'live on' once the spam post is removed.

    If you quote me, don't forget the capital 'M'

    Declutterers of the world - unite!
    • brook2jack
    • By brook2jack 15th Apr 18, 11:54 PM
    • 4,200 Posts
    • 3,854 Thanks
    brook2jack
    Small amounts can be shaved off a crown if it is contacting first.

    The crown fits the tooth underneath very accurately, the tooth cannot move underneath the crown.

    There may be many reasons why the crown may not be replaced. Lying about quality and intensity of pain may end up with you having totally unnecessary treatment that damages or ends up in the loss of the tooth.

    The photo is of little use but from what I can see even if you have the crown replaced you may not get the cosmetic result you are obviously after.
    • Toothsmith
    • By Toothsmith 16th Apr 18, 1:02 PM
    • 8,945 Posts
    • 10,669 Thanks
    Toothsmith
    Thanks TS. And my last visit was last November. And the pain's not that bad really. It's just that now and again I can feel the tooth underneath the crown in an odd position (hence why it's unaligned).

    Also when I bite down towards the bottom teeth, because of that unalignment, the crown is the first part that makes contact instead of the other top teeth.

    Do you think that *that* would be a good reason for the dentist to replace it?

    If not, I'll probably be forced to say it's just too painful, especially before going to sleep and the morning after, since it's causing a pretty bad headache.

    Presumably they can't refuse on the grounds of constant (and rather severe) pain?
    Originally posted by Sammy2018
    Am I misunderstanding you Sammy?

    It seems from what you're writing that the tooth isn't causing you much pain - but you feel that if you lie and exaggerate the pain, you will get the cosmetic treatment you want subsidised by the taxpayer?

    You have a duty to report your symptoms honestly to the dentist so that he can make the judgement on what treatment is best for you. If you don't - then you will either be found out, and asked to go elsewhere, or inappropriate treatment might be carried out.

    From the poor photograph you put up - it doesn't look like the fit of the crown is what's responsible for your 'pain' if it exists - and changing the crown won't fix this 'pain'. It's either going to be a root filling, gum treatment, or extraction that will be your options. One or more of those will probably get you out of pain and restore your 'health'. If it's not extracted, then something might then be done privately to improve the looks, but that is a conversation you need to have with the dentist. Honestly.
    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.
    • Sammy2018
    • By Sammy2018 16th Apr 18, 8:06 PM
    • 26 Posts
    • 1 Thanks
    Sammy2018
    Hi TS.

    If there's any costs involved, they'll be upon my shoulders. I don't qualify for free dental care. I'm willing to pay for a new crown without reservation.

    I guess what I'm also trying to say is, when I had the crown originally all those years ago, it was a perfect fit. No gap, no pain, no nothing. It was just right.

    Now what I can't understand is how or why it's become unaligned, hence the gap being formed (as well as some pain that comes and goes).

    Wouldn't the above be valid reasons to sort the whole thing out? - i.e. fix the alignment, gap, and pain, by doing what a dentist should be doing?

    If something went out of place in the real world and it was causing issues, surely it'd be only right to rectify it?
    • Toothsmith
    • By Toothsmith 17th Apr 18, 6:14 PM
    • 8,945 Posts
    • 10,669 Thanks
    Toothsmith
    From the little I can see on your picture, the crown still looks to fit the tooth perfectly well. What seems to have happened is that the tooth itself has moved - so what needs to be sorted out is why that has happened.

    That could be a gum problem, or and/or an infection on the tooth. These things may well also be causing the pain you may or may not have. Replacing the crown wouldn't sort that out.

    When that is sorted out, the tooth may well still be misaligned, and that 'gap' may well still be there, but you would not be in pain - so therefore your 'health' would have been restored.

    You would still have the cosmetic problem though - but that isn't for the National HEALTH Service to fix. And yes, just because you're paying 'full costs' I'm assuming you mean full NHS charge of 240 odd? That is still an NHS subsidised price, and so governed by the rules of what can be provided by the NHS, so the dentist can, and should, refuse to fix a cosmetic problem on the NHS.

    He may consider changing it if you were willing to pay privately for it, but again, that would depend just how much of a future that tooth has though. Recrowning privately may well still be refused if the tooth probably isn't going to last very long - which is where alternatives like a denture or a bridge or an implant may need to be had.
    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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