How to handle this messed up dental implant! Help!
August 26, 2013 4:23 PM   Subscribe

I just got back from getting my dental implant crown. Unfortunately it's awful and doesn't look at all like what it should. It's very messed up and needs to be fixed. How best to procede? Full story and photos inside.

Timeline: In February, I had some pain in a tooth. I went to a dentist that was in the Care Credit network - as I can't afford out-of-pocket dental bills. The dentist informed me and showed me that I had an abscess. I had the optons to get it pulled, pulled and implant, or root canal.

It's a very back tooth, and since he had a slight deal on implants I went with the implant route.
-Antibiotics and tooth pulled. Dental post placed in jaw the same day
-X Ray followups over the next 5 months to check progress
-2 weeks ago he places the metal post (photo)
-Today I go in for the final crown and the following happens:

I have had crowns before. He took a long time drilling down the crown prior to putting it into my mouth. When we would put it in I could tell it was too high for my bite (again, I have a crown on another tooth so I know what's going to be too high. Then he cemented it in and did more shaping. This HURT LIKE HELL by the way. Everything up to this appointment has all gone well. Dentist and staff were super nice.

So here I am getting this thing drilled in my mouth, and I am literally sweating from pain, but "it will be over soon" passes through my mind and I tough it out. I can tell when I bite that it's sore and he says we can adjust it later, but the "bite looks fine" according to the blue wax paper I've been biting on. He says we can adjust it later on in the week after things settle also. (Again I've had a crown so I know sometimes you get it tweaked after a few days.) I told him it hurts a bit when biting down and he said it will be sore for a few days.

The tooth already felt uncomfortable, like it didn't sit right. It felt a little big on my cheek side and it felt flat along the top, but I was like "maybe it looks different than it feels." Not the case. When I got in the car I almost burst into tears checking it in the mirror and immediately knew it wasn't right. I took a photo and sent it to my dad.

PHOTOS OF BAD CROWN:Photobucket album, including implant pics and full bottom. The second to last tooth on the opposite side of my lower jaw has a crown so I know what they should look like.

This is horrible. It has no shape and it's drilled down to the post for some reason. Right when I got home I started sobbing and my dad agreed that it's totally messed up. Also I am in pretty bad pain. I know it will hurt but I hope it stops hurting soon.

He never told me that it was down to the post, or that it didn't look like a crown or anything. I am really confused by this. This is my final crown also. I waited for 2 weeks while it was being made. At the same time, he is a cosmetic dentist in addition to general dentistry.

We already called and they said they would "Fix it for free, but the dentist was busy so he couldn't be reached." I honestly don't know how comfortable I feel going back there. We are also in a bit of a bind as my husband doesn't have time off right now and I don't feel comfortable without some backup so to speak. All in all this was $1300 that was put onto a credit line.

1: Go back to him and get it "fixed" for free. (Really kind of uncomfortable with this.)
2: Get a second opinion from another dentist and go back to dentist 1 to get a refund/fixed and refund.
3: Go to a new dentist and get a second opinion. Have dentist 1 refund me while getting it fixed by dentist 2.
4: Other??

What would you suggest I do? I am leaning toward getting a new opinion and getting it fixed elsewhere, plus trying for a refund. What's the best way to go about this? How bad is this crown and can it be fixed? Ouchie!

I am really upset. It hurts. It looks horrible. I know that to fix it, they will probably have to drill it down and then place a crown on top like you would with a regular crown - and I'm pretty scared of the pain.
posted by Crystalinne to Health & Fitness (10 answers total) 2 users marked this as a favorite
Similar thing happened to me once with a porcelain crown on a metal base - the dentist had drilled all the way down to the metal, though a little less visibly than yours. When he was done he was going to send me on my way without offering that I see it - every other time I've had work done a mirror was proffered in the end so I would admire the result. I had to ask for a mirror myself.

It's hard to tell a dentist after all the hours of effort that what they did is unacceptable, but I did it and so should you.

Call tomorrow first thing and say you'd like to make an appointment for a revision because the post is showing and you had not seen that while you were in the office.

He may be right about the pain subsiding in a day or two, but the excessive drilling can't be undone. You need that crown replaced, and free of charge.
posted by Dragonness at 4:46 PM on August 26, 2013 [2 favorites]

I have a single tooth implant to a back molar and like yours, my post goes through the middle of my crown, it's how the crown is screwed onto the post. However, unlike yours, my post doesn't show because my dentist filled in the top of the screw access hole with material that matches the crown, similar to what is described here. I don't know if this fill-in is standard procedure but it can be done. FWIW, this final fill-in wasn't done until a few weeks after my crown was installed (I vaguely recall being told this was keep easy access to the screw for any additional adjustments to the crown) but even then my dentist gave me a temporary filling in the interim.

However, the crown you have doesn't look correct at all. As you know, it should look like a tooth (mine is indistinguishable from my natural teeth both in look and feel).

In your shoes, I'd start with Option 2, so at the very least you know what your options are (like, yes, there is going to be a post hole but no, it shouldn't show when you are all done) so you can decide what to do next.

Also, you shouldn't be feeling any pain on a properly healed implant post. Back in the dark ages when I had mine done, I had to wait a few months after the post installation before I was given even a temporary crown to give the jawbone time to integrate with the implant's base. I know in recent years it's become common for the waiting time to be cut shorter between stages of an implant but FWIW, when this is all done and healed some months from now, you shouldn't experience any further pain no matter how much grinding is done on your implant's crown.
posted by jamaro at 5:18 PM on August 26, 2013

Response by poster: The implant itself healed in my jaw for 6 months. It doesn't hurt down in my jaw but it's kind of a sharp pain - similar to a bad cavity - around the top. I will be monitoring the pain, but any pressure, even my cheek touching it, hurts.
posted by Crystalinne at 5:23 PM on August 26, 2013

Ow, yeah, that doesn't seem right. All I've ever felt from mine is transmitted pressure (as in "yes, I'm biting on something"), not pain.
posted by jamaro at 5:26 PM on August 26, 2013

I have an implant in the exact same spot as you and can't figure out what this dentist was doing. When I went to get my final crown I sat down and they screwed my crown on and checked my bite and I was done. There was no drilling at all by that time. My crown has a layer of gold on it to make it stronger but otherwise it's like all my other teeth.

There was also absolutely zero pain because the post had been done months prior and was healed. My dentist waited months after my metal post was installed because he said that studies are showing that they longer you wait the higher the chance of success. (I can't cite any articles or anything, it's just what my dentist told me at the time.)

You should definitely get it fixed for free.

I would go with option 2 and get to a second dentist asap and find out what is causing the pain. It doesn't sound right at all.

Good luck!
posted by sadtomato at 5:28 PM on August 26, 2013

You need to go get a second opinion before (and if) you go back to your first dentist. I agree it doesn't look right, and it would seem almost any dentist, not even a specialist, should be able to take a look and give you a sense of what happened and most likely they can do it without a big appt. expense.
posted by nanook at 6:11 PM on August 26, 2013

Yeah, I'd be pitching a fit first thing in the morning to the dentist. It looks wrong and it hurts, either of which is enough to get them to fix it.
posted by zug at 7:38 PM on August 26, 2013

Ugh, sorry, missed that you'd already called. You seem really uncomfortable with this dentist, so go get a second opinion and let what the new dentist says determine what you do next.
posted by zug at 7:41 PM on August 26, 2013

I am not a dentist but those pictures indicate something is clearly wrong. I would also be concerned about the post's "sharp pain". That doesn't sound good.

The American Dental Association has a process called "peer review". You can file a claim asking to be reimbursed and to cover the cost of any "new" repair work (beyond the original issue with that tooth).

If that were my mouth, that would be my next step since his office blew off your call. They also had to know things weren't right when you got up out of the chair.

I'm sorry you are going through this. Good luck!
posted by 99percentfake at 11:51 PM on August 26, 2013 [1 favorite]

Response by poster: Update: I just went to a dentist who specializes in implants and aesthetics. He took an Xray and said that the abutment is not seated flush with the implant post. He also said the crown is not flush with the gum line. He also had some slight concern with an area of the implant itself and said if he would have done it, he would have used a slightly shorter implant. He also said he would be more concerned about the pain if it were lower in my jaw and if it gets worse to come back in. It's slightly better today but still like chewing on tin foil!

Right now I am going to wait about a week for the pain to subside and then go back to this new dentist to get the implant shaped so I can chew and not be grabbing my cheek when I bite down. They are getting my records from my old dentist.

New dentist said I could technically go years with this implant as long as my bite is fine, but if he were to re-do it it would be the abutment and implant, and cost about $1600. He said he would fit everything properly, and although the tooth may need to be shorter, it should still look more shaped than this thing.

I'm going to try to get a refund from my old dentist. If I can get some part of a refund I can get the new implant done sooner. If not I may have to wait until I get a new job or we have more savings. Any info on a good way to try to get a refund, stories of implant pain or healing tips, or anything else is very useful.

I used Care Credit and am in Utah, if that matters for refunds.
posted by Crystalinne at 10:28 AM on August 27, 2013

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