Will I have to pay for this crown? What leverage do I have?
February 7, 2017 5:50 AM   Subscribe

I don't think I should have to pay full price for the crown I'm possibly getting today. Not sure if I'm right.

  • December 29: Get crown on molar. Swollen painful sensations continue.
  • January 10th or so: Revisit dentist who confirms I need a root canal.
  • January 25th: Endodontist performs root canal, drilling through top of crown and sealing with a temporary filling.
  • February 7th: Scheduled to see main dentist who will either do permanent filling on tooth or replace the crown entirely.
I'm upset that the original expensive crown lasted for under a month and that she did not spot that I needed a root canal before putting on said crown. I have insurance, so nothing that happens today is going to completely break the bank, but, y'know...the principle of the thing.

Am I being unreasonable? If I am reasonable, how do I bring this up? I'm a deeply conflict-averse person and am not sure how to talk about this with the dentist. I've been coming to this practice for ten years, and this dentist is a new member of the team to whom I was recently switched.
posted by HeroZero to Health & Fitness (10 answers total) 1 user marked this as a favorite
I dont think this is unreasonable. before the procedure begins ask to clarify what they'll be charging you for today and that you think you shouldn't have to pay for anything because you already paid for the first one that failed.

I recently had an expensive root canal to try and save a molar that failed, resulting in an extraction. I had to ask,but the dentist refunded me a significant portion of the fees and only charged me for costs.
posted by Karaage at 5:55 AM on February 7, 2017

I had a similar-ish situation happen this past fall and ended up getting the new crown for free, but the difference in my case is that after the endodontist did the root canal and drilled through my crown, the crown actually broke about a week later while I was awaiting the permanent filling.

In my case, my dentist said that the replacement crown would be free because the original one he'd installed had outright failed (broke). To me, this seems reasonable, and if you are having actual issues with the crown I would definitely talk about that. If this is just a root canal that turned out to be necessary despite the dentist trying a less invasive tack first, my completely uneducated feeling is that you probably aren't going to have any luck getting this for free. Never hurts to ask, but I wouldn't get my hopes up.
posted by DingoMutt at 6:24 AM on February 7, 2017

I also had a similar experience recently, though mine went longer and had a happier outcome.

We did a crown in the summer, but with the understanding that a root canal might still be required.

Crown was fine for a bit, but after Christmas sensitivity was clearly getting worse, not better, so I had to go see the endodontist for a root canal, which meant drilling through my crown.

About a week later, I went to get the temporary filling replaced with a permanent one, which took like 20 minutes and cost only $60, so I didn't quibble about prices or failed crowns or whatever.

I don't know under what circumstances a crown must be completely replaced here, but it seems at least possible that it might not be required. Have you discussed this with your dentists? If you end up needing a second crown, I think you should be open with your dentist about your frustration here, and insist on a discount.
posted by uberchet at 6:26 AM on February 7, 2017

Of course you should ask. If the crown that was put in Dec. 29 was a temporary crown there would be less reason for the charge. But I would definitely ask.
posted by JayRwv at 6:28 AM on February 7, 2017 [1 favorite]

You are not being unreasonable. One thing my dentist insisted (I guess you could call it his due diligence) was that I see an oral surgeon to make sure I wouldn't need a root canal BEFORE I got the crown. The oral surgeon gave the green light and I went ahead with the crown. He made it seem like standard practice, but it doesn't seem like that happened in your case.

Your dentist should have prepared/warned you like mine did. I would definitely bring this up to the office staff.
posted by NoraCharles at 7:32 AM on February 7, 2017 [1 favorite]

~15 years ago I had a solid metal crown put on a root-canal'ed tooth. Last year-ish I got an abcess that wouldn't go away. Referred to endodontist 1. I got a root resection, he didn't see any cracks in the tooth, and he only resectioned one root. The absess didn't go away. He recommended a root canal, or resectioning more roots; I was annoyed that he didn't do more while I was opened up.

I was referred to endodontist 2 (slightly further away). She said definitely a root canal, and warned me that my x-rays looked odd; my previous resection looked off to her. I got a full price root canal (through the gold crown that's lasted me forever), but during the process, she said the resection looked really poorly done. She'd sealed as well as she could via the root canal, and it *might* solve the problem, but really strongly recommended getting the resectioning redone, and getting all of the roots with a proper biocompatible cement put in.

She did the resectioning at half price, and she wasn't even the one who messed up the first resection.

After all this was said and done, my dentist put in the permanent filling - she said that endodontist 2 did a great job on the root canal, so the crown was still in great shape; they just put in a filling to the crown rather than recommending a new crown. Absess went away and I've been good for 6+ months.

So, 1) if the endodontist took care doing the root canal, your crown should hopefully still be good and just need a permanent filling. I believe metal crowns are more resilient than ceremic. Perhaps consider a second opinion if your dentist wants to fully replace the crown.

2) From my (limited) experience, the crown on a questionable tooth is ... questionable. If it was swollen and painful, to my understanding it should have been drilled, an a temp tooth constructed, and a crown only done when one's sure the problem is solved. If a second new crown is needed so soon, I'd want some consideration from the dentist (if I was trusting them to place the second crown. (on preview: similar to NoraCharles' comment)

Also, from your insurance, they might not cover a second crown on the same tooth so soon. For instance my wife's insurance didn't cover the procedure code for a second root canal, even though it was 15+ years from the first root canal, and we weren't insured by them at the time we had this done. Potentially there might be a one crown per tooth (possibly per unit of time).
posted by nobeagle at 7:39 AM on February 7, 2017

I'd definitely try to negotiate something on this. As others have said, a permanent crown prior to a root canal is doing things out of the order they should be done in.

Nthing insurance, if you have it, as a potential lever.
posted by randomkeystrike at 9:22 AM on February 7, 2017

It's not clear that there's a problem here. You got a crown, which you needed, and you are going to be keeping it. You're also getting a root canal, which will be performed through a hole in the crown. The hole in the crown will then be sealed up. Then you'll be fine, and the crown will be fine.

You're paying for the crown and the root canal, both of which you needed. It's true that you would have preferred them to be done in the opposite sequence, but there's no real basis here for assuming you're going to be paying any extra costs. Of course you can ask the professionals about this.

On preview, what DingoMutt said.
posted by JimN2TAW at 9:26 AM on February 7, 2017

When I got a crown last summer I was told there was a non-zero chance of needing a root canal later. That turned out to be the case. The root canal needed to be retreated (twice) and the endodontist refunded most of the costs at that point but I did pay for the crown - the service was provided and the root canal didn't destroy it.
posted by leslies at 10:03 AM on February 7, 2017

Thanks all for sharing your stories and advice. Resolved happily: before I had a chance to even bring it up, the dentist said that in normal circumstances they'd put a filling in the crown, but since it was so new they were just going to replace it gratis.
posted by HeroZero at 7:50 PM on February 7, 2017 [4 favorites]

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