Failed dental implant with possible incompetence...recourse?

July 20, 2012 12:38 PM

Over the past 6 months I've been having a dental implant installed, and it has now failed. The dentist has been rather dismissive of the pain, and I'm pretty sure I can identify specifically when the implant failed and I believe it to be his fault. This should have taken 4 appointments to finish, and has now been 9, and will end with the 10th…hopefully. There are other instances of his (possible) incompetence past the break (please read if you are going to reply). He has said that after I heal when it's removed he will do the process again for free…but I'm rather terrified of him now. Do I have any legal recourse to ask for a refund? Again, details after the break.

6 months ago I broke off a chunk of a tooth while eating. This happened because I'm missing both my secondary molars, and my wisdom teeth on my lower jaw (congenital defect). I was told about 6 years ago that I would need dental implants because the one set of molars there was doing double duty and would wear through much quicker than they should.
I found the only dentist who was open in NYC on a Sunday and went to him after breaking the tooth, he ground off the sharp edges of the tooth I broke, and we made appointments to start the implant process.

The first part of the surgery was mostly fine. He drilled into the jawbone, mounted the implant, realized that he hadn't drilled deep enough, took it out, and then put it back in. Upon the second drilling he came close enough to the nerve that I felt it twinge. One of the most disconcerting things was that he was giving a stream of consciousness commentary as he was doing the whole thing, featuring such phrases as "hmm…." and "well that's not great". He said that I didn't have quite as much bone as he would like, but that "it would be fine".

The pain after the 1st part of the implant lasted about 8 times longer than he said it would - he told me about 3 days, which actually turned into 3.5 weeks of pain. Eventually it seemed to calm down. After the 3 months of healing, he cut the gum back open and installed the healing cuff. He said that I should have almost no pain…however the pain after that was so intense that night that I couldn't even sleep, but seemed to calm down over the course of a couple of days. A week after the healing cuff was put in I went back in to get the post put in. To this point there had been no "wiggling" of the implant. As he was tightening the post, all the sudden there was a lot of pain. His response: "well, that shouldn't hurt", and he went back to tightening it and it hurt again…a lot, I'm pretty sure this is when the implant started to fail… He was going to take a bite impression to start building the crown, but after the pain he said that he was going to hold off on it because he didn't want to have to spend the money if the implant was going to fail.

Over the next few days the implant started to de-integrate from the bone and got more and more wiggly. I went back a week after getting the post put to have a burr on the side of it ground off. As he was grinding off the burr, he said that the implant had failed and he would need to take it out, we made an appointment for a week later for him to do that.

Up until this process started I had never been afraid of the dentist. Now I get panic attacks when I'm there. I told him that I was getting exceedingly nervous, and that from this point on, if he is going to use local anesthetic he needs to start using nitrous as well because I can't emotionally handle it. At this point I don't trust him a lick when he says "this shouldn't hurt at all". He said that he would give me gas when I went back in to have the implant removed, but that I might not need any anesthetic at all.

I went in a week later, had to remind him about the gas (every time I went in he seemed to have never reviewed my records, and had to constantly be reminded of facts).

He tried removing the implant, and it hurt…A LOT. He said he'd use some local anesthetic, and shot me up with it, and I reminded him about the gas. He went to turn it on, and there was a lot more hissing than it seemed like there should be. I heard him mutter a "hmmm…that's not good", as he continued to futz around. He came back and talked to me and said that he wouldn't be able to give me gas because a hose had lost its seal and would have filled the whole room with nitrous while he was working on me. He followed up with a line that really was the last straw in terms of my trust in him:
"I haven't used the gas in a while, so I guess it just must need some maintenance." So basically, he hadn't tested his equipment before I got there. I work in a field where I can't do people any serious physical damage and I test all of my gear EVERY DAY.

Anyhow, he tried using more local to get it out, still getting pain, panic attack accelerating to epic proportions. I finally told him that we had to stop, he offered to use more local, and I told him that I needed to come back when he could sedate me, but that benzodiazepines were not an option.

SO…in the end, I've lost all faith in this dentist; Every time he says it shouldn't hurt it does hurt. Every time he says it should only hurt for X amount of time, it actually hurts for 8-10 times longer. He did not check his gear before I came in to get work done. He placed an implant in bone that he ADMITTED was the absolute minimum depth, if not a little short for what I needed (for the record, he said that he needed a minimum of just over 9mm of bone, and I had exactly 9mm of bone). I have wasted almost half of my days off in the last 6 months going to appointments with him, and had to leave work once to get work done.

I'm at a point where I want to get a second opinion, and then find a dentist that I have more trust in, who uses gas more than once in a blue moon. The problem is that I have now spent $2200 on this implant with him, and if I can't get a refund I won't be able to afford to get it done with another dentist.

Do I have any recourse to ask for a refund (I mean of course I can ask for one, but I have a feeling he will not be receptive to the idea)?

I also understand that 5-10% of implants fail, but I just feel like through his actions he has destroyed any confidence that I had in him, and I started off REALLY liking the guy (he has Star Trek figurines in a display case in his office, I guess I just generally trust nerds).

Any input would be greatly appreciated, thanks.

posted by aloiv2 to health & fitness (7 answers total)

What you can do is go to another dentist and have him/her assess the damage. That dentist can repair the work the first dentist did badly, and provide documentation. What the heck, get two or three opinions.

Have someone you trust do the work and sue dentist #1.

To collect damages, you'd have to prove the dentist #1 did something incorrectly, or was egregiously incompetant.
posted by Ruthless Bunny at 12:44 PM on July 20, 2012 [1 favorite]

I think it would be worth consulting a lawyer and ask what recourse you have. They will know best what documentation is needed, and send you to a dentist that is willing to provide it. If you simply want a refund, a strongly worded letter from the lawyer may be all that is needed.
posted by Wordwoman at 1:22 PM on July 20, 2012

It is clear that you do not have enough bone for an implant so he should have done a bone graft (expensive, painful and time-consuming) before the implant. Your implant is probably too close to the inferior dental nerve. If he has not damaged it, this may not be a problem in the long term but is painful in the short term and could become a problem later. You need to have it looked at by someone who knows more what he is doing than this guy.
posted by TheRaven at 1:53 PM on July 20, 2012

Yes, A bone graft should have been done first. My experience of one was no especially painful or expensive, but the healing is time consuming.

Find a new, gentle, caring dentist and go from there. Good luck.
posted by Requiax at 2:00 PM on July 20, 2012

I had a dental implant (upper, front) placed by an oral surgeon, who did a good job...although it did take more than 4-6 months for it to feel solid and non-sensitive. However, when it came time for the final restoration, my general dentist who was to place the crown turned out to be really inexperienced. She basically was really flustered by the whole process (e.g., dropping things on the floor and in my mouth), caused me a lot of unnecessary pain, messed up a couple of different provisional crowns, and generally acted like she didn't know what she was doing. After a bunch of unnecessary visits, I started feeling panicky about seeing her, just like you've described; I had really lost all confidence. I finally told her, "You know what, I'm going to find another dentist to do this. I'd like a refund of what I've paid you so far." And she apologized and paid me back. If she'd refused I was prepared to tell her: "I think the quality of patient care you've provided is poor. I'm going to file a complaint with the state health department." And then escalate from there. Mind you, I don't know if this would have been the best approach for my situation (I just felt like she was not up to the job and I wanted my money back), or what a lawyer might tell you to do, but I definitely don't think it would be an overreaction in your case. The Board of Regents licenses dentists in New York State. They even have a complaint hot line.

Whether you get your money back or not, or get a lawyer involved or whatever, you should definitely seek out another dental professional that you trust. The person I ended up going with was totally confident and competent and knew exactly what to do; I felt taken care of--not just by him, but by his entire staff. Look for someone who is active with professional associations (like your state dental association or the ADA), and maybe even teaches. If their office tries to provide a "spa" atmosphere and their practice seems mainly focused on unnecessary cosmetic dentistry, I would be skeptical. Office staff should exude excellence. The dentist should also have many years of experience...which tends to lead to the conservative, measured care you need with this sort of procedure. I personally would only have an implant placed by an oral surgeon or periodontist; usually a general dentist works with a lab to create the final crown, but I suppose the person placing the implant might do this too. It sounds like you're going to end up needing bone grafting and some time to heal anyway. Best of luck! Feel free to memail me.
posted by bennett being thrown at 5:36 PM on July 20, 2012 [3 favorites]

Try NYU Dental school. No kidding.
posted by yoyo_nyc at 11:55 PM on July 20, 2012

Update: I got a recommendation for a dentist from a friend who said she was amazing and gentle, and always gave him all the information about what was going to happen.

I left a message with her yesterday, she called back today and had a 20 minute conversation with me on her day off. She's sending me to a real oral surgeon to have the implant out, and then we'll discuss the next steps of whether to try another implant or look at other options. She was extremely friendly, and very concerned about my comfort and said that they would do whatever they needed to do to ease any anxiety I had.

She also talked to me about how I can go about asking for a refund from my dentist, and said that she would help out in talking to him any way she could. All in all an excellent talk, and did a whole lot to calm my nerves.

Both this dentist and surgeon are in midtown Manhattan so I'll probably be paying more...but I guess it's worth it when I'm going to have someone drilling a hole in my jawbone to install a permanent fixture.

Thanks for all of your replies.
posted by aloiv2 at 5:44 PM on July 21, 2012