Getting the Shine and Color Back in My Dental Crown
I had a crown placed on a lateral incisor. It was fine for the first seven months. Now, it has lost its shine and has started to pick up stains. I was hoping to get it back the way it was. Will teeth whitening take care of the color and shine or will I need a separate procedure for each thing?
Callie Anne
Dear Callie Anne,
I am sorry this happened to you. Unfortunately, teeth whitening will do neither of the things you are hoping for. It only works on natural tooth structure so it won’t do anything for your porcelain crown. What protects a dental crown from stains and also gives it that shine is the protective glaze placed on it. It sounds like something removed yours.
Given the timing you mentioned, that was enough time for you to have a dental cleaning. If you did, I suspect that your dental hygienist may have used something like a power prophy jet or acidulated fluoride during your appointment. The first will remove your glazing entirely. The second will etch it which could make it look more dull and cause it to pick up stains as well, just not as quickly.
If your hygienist did that, then I would say they need to bear the responsibility to replace your dental crown and the dentist will need to do some training with his staff on protecting dental work.
If that is not what happened, I would make sure you are not using anything like a whitening toothpaste. Almost all of these “whiten” your teeth by using an abrasive, which damages both the glazing on your crown as well as your natural tooth enamel. The only whitening toothpaste I know of that is safe for dental work is Supersmile toothpaste.
No matter what the cause, the solution would be to replace the dental crown. It’s only been seven months, so I do think the dentist should take this.
This blog is brought to you by Douglas, AZ Dentist Dr. Gilberto Tostado.
Read More...Can a Long Dental Appointment Give You TMJ Disorder?
I had a rather long dental appointment. Four of my upper teeth were prepared for dental crowns and the rest were prepared for porcelain veneers. I’ve got my temporaries now. While I like the way they look, my jaw really hurts. The appointment was three days ago and I’m still needing to take pain relievers twice a day. My dentist is on vacation. I don’t know if I should just wait this out or if this is a sign that I’ve developed TMJ Disorder and need to find a dentist who is available. Any advice?
Molly
Dear Molly,
TMJ Disorder can be aggravated by a long dental procedure, but won’t develop because of one unless there was some trauma to your jaw. You did not mention anything unusual about the appointment. Four crowns along with porcelain veneer prep is a lot of work to have done at once. I’m not surprised that your jaw is hurting.
My suggestion is for you to take the following steps, some of which you are already doing.
- Continue taking your anti-inflammatories.
- Throughout your day, take notice as to whether or not you are clenching your jaw. Most people do not notice when they are doing it and clenching will not only prolong but even increase your jaw pain.
- A cold compress will help reduce swelling, if there is any; a warm compress will relax strained muscles and increase blood flow. You can switch between them as needed.
If, after a week, you are still struggling that would be the time to call your dentist to determine if further evaluation is necessary. In all likelihood, you’ll feel better in a day or two. It’s never fun to hurt so I understand the desire for it to just go away.
This blog is brought to you by Agua Prieta Dentist Dr. Tostado.
Read More...This Full-Mouth Reconstruction is Going Badly
I have been going to my dentist to fix my teeth. He’s doing crowns on every single tooth. I wasn’t convinced this was necessary because this whole thing stemmed from me mentioning my morning headaches. He said its probably from TMJ, then before I knew what was happening this was scheduled. I feel like everything is spiraling out of control. What has me worried at this point is the temporary teeth. My jaw hurts so much. On one side of my mouth the teeth don’t touch at all. The other side feels swollen, like the teeth are touching too soon. I pointed this out to my dentist and he said this first fitting is just to make sure the crowns fit in my mouth. The touching comes with the permanent ones. I know I am not a dentist, but this just doesn’t seem right to me. Do I go through with this? Though, now that I ask the question I’m wondering if I even have a choice. The real teeth are already ground down.
Casey
Dear Casey,
Please do not let this dentist bond the permanent crowns on you until the temporary crowns fit you perfectly. The permanent crowns are modeled after the temporaries, so nothing will be different. If he does not agree to that, tell him you are going to finish this procedure out with another dentist. When crowns are done properly, you won’t notice them at all. How your teeth meet together is called occlusion. Both sides should meet together at the same time. I’m worried your dentist is in over his head.
When it comes to TMJ treatment, generally a full-mouth reconstruction is a last resort sort of treatment when all other less invasive treatments have been unsuccessful. Based on what you wrote above, it doesn’t sound like he even tried other solutions.
I’d like you to look for someone with extensive post-doctoral training in reconstructive procedures such as dental implants, crowns, and TMJ. This is one of the most advanced procedures a dentist can do and I’m not convinced yours can.
If you do decide you need to go to a different dentist, you do not have to start from scratch. Your dentist is ethically obligated to provide all the diagnostics and notes on your treatment with whomever you choose to continue the care.
This blog is brought to you by Douglas, AZ Dentist Dr. Tostado.
Read More...Failed dental crown: Is my dentist responsible?
One of my back teeth has had a silver filling in it for years and it recently developed a large crack. My dentist said I should get it crowned, and I agreed to treatment. But placing the crown turned out to be a very painful experience since I couldn’t get numb no matter how much novocain my dentist gave me. And when he finished placing the crown, I could tell something wasn’t right. My tooth kept hurting even though my dentist said it was normal to have some sensitivity and that my tooth would feel better soon.
A few months later, I had to come in to get another tooth crowned, but I wanted my dentist to look at the painful tooth that he had crowned last time. It was still so painful that I couldn’t bite on it. He made some adjustments to my crown, but it was still sensitive no matter what we tried. The dentist kept pushing me to get that second crown, but I didn’t want to move forward with any new treatment until I got relief from the pain.
The office scheduled me for another appointment to try adjusting the crown again, but it got postponed a few times due to the pandemic. When they finally were able to see me the other day, I learned that my tooth now has a periapical abscess. I plan to get it pulled, but my dentist wants to charge me for the extraction on top of what I already paid for the failed crown.
This whole experience has been so frustrating and painful. If I knew how severe the damage was, I would have opted to pull that tooth months ago. I feel like my dentist owes me a refund for this failed crown and for the pain I’ve had to endure for months.
Is this my dentist’s fault? Why didn’t they tell me at the start that I would need a root canal or extraction? I’d like to know if I could get a refund.
— Tammy
Hello Tammy,
Based on what you’ve told us, we can understand just how frustrating your experience has been.
Your situation is a tricky one. There are signs that the dentist who placed your crown was a bit careless, but you may not have enough proof to allege malpractice or justify a refund.
Without reviewing your X-rays and dental records and hearing your dentist’s perspective, we can only guess at his rationale for crowning your cracked tooth.
Most dentists wouldn’t put a cap on a tooth that had sensitivity and showed signs of needing root canal treatment. And an ethical dentist wouldn’t ignore your pain in order to push the placement of a new crown.
It isn’t unusual for teeth to unexpectedly flare up and take a turn for the worse after being crowned. This is something that happens to even the most well-intentioned dentists, on occasion. So it’s possible that your dentist genuinely did not anticipate that your tooth would have such a severe reaction after being crowned.
It’s also possible that your dentist felt that urgent treatment was necessary to protect the second tooth from more serious damage. That could explain why it seemed your dentist was “pushing” you to get another crown, even though you weren’t yet happy with the first one.
All of this is to say that you may have a hard time proving that your dentist did anything wrong.
But this doesn’t mean that your feelings about the situation are wrong.
In fact, we can point out a few red flags worth noting:
- Your dentist, indeed, should have told you right from the start that there was a possibility you would need a root canal. The fact that he did not is concerning.
- Your dentist should not have dismissed your post-crown discomfort. A little temporary sensitivity to temperature changes is normal; pain while biting on your crown is not normal.
- When you returned months later with your first crowned tooth still causing you pain, your dentist should not have ignored that to move forward with placing a new crown. This suggests that the dentist could have been putting income ahead of patient concerns.
So in a nutshell, it appears that your dentist may have made some mistakes in judgment in your treatment, but you might have a difficult time getting compensated for that. You can try using some leverage to negotiate with your dentist for a refund on your failed crown. For example, you can complain to your state dental board or threaten to leave a negative review online. These tactics may only get you so far, however.
The best thing you can do at this point is to start looking for a new dentist.
The right dentist will take the time to answer your questions, will prioritize your comfort and concerns, and will carefully explain all of your treatment options before moving ahead with any procedure. Your new dentist can also help you weigh the pros and cons of treating a tooth with a root canal versus extracting it and replacing it with dental implants.
This post has been published on behalf of Dr. Gilberto Tostado, a dentist near Douglas, AZ.
Read More...My dentist is struggling to get the right color for my implant crown
About a year ago, I was so excited to get a dental implant to replace my missing right upper front tooth. Everything went fine with my implant procedure, but I’m disappointed in the resulting esthetics. My dentist has really struggled to get the crown color right so that it matches my left front tooth, and we’ve redone this crown at least three times now. Sometimes it’s been too dark, at other times it was noticeably too light.
I don’t know why my dentist can’t get this right. He’s getting frustrated with me, telling me I should just be grateful the implant is doing well and that it’s not his fault that my tooth color is hard to match.
He also told me that continually manipulating my implant to change the crown could compromise the implant itself.
I don’t mean to be so difficult; it’s just that I want my new implant to look like a natural tooth since it’s so visible. But I also don’t want to risk damaging my implant.
What should I do at this point?
Thanks for any advice you can share,
Paul from Phoenix, AZ
Getting matching dental crowns makes a world of difference!
Dear Paul,
Getting a dental implant is an exciting step that can change your life for the better, so we’re glad to hear your procedure was successful. But we’re sad to hear that you’ve had such a frustrating experience with your current dentist.
The good news is that your situation is not as hopeless as it may seem. You can safely get a new crown for your implant that matches the neighboring teeth!
There are three things we want to make sure you’re aware of.
Point number one: it may help you to hear that you are not being unreasonable. Given that the tooth in question (maxillary central incisor) is one of your most prominent teeth, it’s only natural to want your implant restoration to blend in seamlessly with the rest of your smile, so there’s no need to worry that you’re being a “difficult” patient.
Point number two: it is perfectly safe to grind off your current crown in order to replace it with a new one. Get a second opinion from a dental implant dentist who has extensive experience in esthetic implant restoration.
This brings us to:
Point number three: your current dentist doesn’t seem to be a very experienced cosmetic dentist, and this could be the reason he’s not interested in creating a closer match for your implant crown.
It’s not an easy feat to get a perfect match. Even skilled cosmetic dentists need to try in a crown more than once to make sure the color match is true before they bond the crown in place.
Many general dentists rely on an industry-standard shade guide to pick colors for their crowns. This guide, however, doesn’t account for all the subtle variations in color that can occur naturally in human teeth. Dentists who rely heavily on this guide and have little to no interest in achieving an exact match don’t put in the time to customize the hue or to communicate specific color instructions to their dental lab ceramist.
So in short, it sounds like your current dentist may not be putting in the effort necessary to create a well-matched restoration for your implant. You need to work with a dentist who takes an artistic approach to restoring dental implants and is willing to try in your dental crown and make needed adjustments multiple times before permanently cementing it onto your implant.
Posted on behalf of Dr. Tostado, a cosmetic dentist near Douglas AZ.
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How to Get a Refund from a Dental Chain for Faulty Dental Work
I’ve been visiting a large dental chain in Tucson for my dental checkups and treatment since 2015. I normally visit the chain’s location that is near my place of work, and I had multiple dental fillings placed there last year.
But I recently booked a checkup at a different location that’s closer to where I live, and at that location, the dentist told me I needed to crown a tooth that was filled only four months ago. When I told the dentist that tooth was recently filled at the other practice location, he got really quiet, and that’s when I started to get a little suspicious.
I decided to get a second opinion from a dentist who isn’t part of that dental chain. After she reviewed my X-rays and looked at my teeth, she confirmed that I did need a crown, but she also said that I would need to have almost all of the other fillings redone as well.
I almost don’t know who to believe, anymore. This new dentist does seem trustworthy, but I want to be compensated for all of that poorly done dental work before I go ahead and agree to her treatment plan.
How can I get a refund from the large dental chain that did such a terrible job on my fillings?
Colin from Tucson, AZ
Dear Colin,
We’re really sorry to hear that you’ve had an experience that shook your trust in dental professionals. It is possible that you have been a victim of dental malpractice, but we should warn you that it can be difficult to wrestle a refund out of these corporate dental chains.
Even so, we hope that the advice we can offer in this situation will help you make a confident and informed decision about your treatment.
Step #1: Get A Third Opinion
Here’s the very first thing you should do: seek a third opinion and make sure it’s a blind one.
This is important because what you need most right now is an unbiased assessment of your dental treatment needs. We can’t provide you with that here over the Internet, but we do suggest that you schedule a dental exam and X-rays with an independent dentist who knows nothing of your dental treatment history. In other words, don’t tell this new dentist about the treatment recommended by the other dentists.
This way, you will have one more professional opinion to weigh against the two you already have and this can give you leverage in your case. Additionally, you can be sure that the new treatment recommendations are based on what this new dentist sees in your mouth and on your X-rays, and that the recommendations are not influenced by their knowledge of your treatment history.
Remember to do the following before choosing a new dentist for your third opinion:
- Request a copy of your dental X-rays and records from the other dentists you’ve seen
- Choose a dentist who has no connections to the others you’ve visited
- Do research to ensure that this new dentist has a solid reputation
After seeing this new dentist, make sure you leave with copies of your X-rays and records from that appointment.
Step #2: Enlist the Help of Your Current Dentist
It sounds like you may wish to let your current dentist provide your treatment. If you want to stay with her practice, tell her so and ask for her help in attempting to get a refund from the large dental chain. Let her know that you will be getting a blind third opinion.
Once you have that third (unbiased!) opinion, share the findings with your current dentist. She can then get in touch with the first dental practice which provided you with that faulty dental work and let them know that you have received professional evaluations from two independent dentists and use this as the basis for negotiating your refund.
Step #3: Confront the Dental Practice You Suspect Is at Fault
What if the original practice that provided you with the failed treatment refuses to refund you? Try to engage the practice in negotiations by doing the following.
- Threaten to leave a negative review. Let the practice know that you will be sharing a review of your negative experience online.
- Tell them you will file a formal complaint with your state dental board.
- Inform your dental insurance provider of the incident. If you had a dental benefits plan you used while visiting that original dentist, let them know what happened and ask if they can help support your case.
- Attempt to open a malpractice lawsuit against the practice. This is the final and most drastic option left to you, but it may not be worth pursuing unless you can furnish enough proof of significant financial loss and/or suffering. Simply mentioning that you will contact an attorney may be enough to motivate the dental chain to compensate you.
The Challenge of Visiting Dental Chains
Once again, we’re sorry to learn about your negative experience, Colin. It may comfort you to know that independent dentists are a very ethical group, on the whole.
Dentists who work in the corporate setting are also dedicated professionals, but they tend to see such a high volume of patients that it is hard for them to render the personal level of care that each patient deserves. Many of these dentists are under pressure to meet production goals that support the growth of the chain, and some may even be new dentists who have accepted a corporate position to gain some experience.
Such factors can sometimes result in an unfortunate lapse in the high standard of care that most dentists truly want to provide.
By choosing an independent dentist with a stellar reputation and extensive experience, you will work one-on-one with a professional you can trust and develop a long-term relationship with. You will then be able to move ahead with full confidence in the recommended treatment plan.
Having a dentist you can trust becomes all the more important when you are considering major treatment like dental implants or porcelain veneers.
This post is sponsored by Douglas AZ Dentist Dr. Gilberto Tostado.
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