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OT: Please tell me if this would be considered negligent UPDATE

Victoria

(website)

Veteran

Sorry for whining and for posting tales of my problems but I have had a horribly bad week and really need advice. Wednesday I had 3 teeth that started hurting all at once and we are talking about majorly bad pain. I took myself to a dentist(a different dentist because I didn't feel comfortable going to the same guy who cracked my tooth recently (and you can look at my previous post about that)even though I am sure it wasn't intentional). My new dentist have told me that I had 2 teeth that needed major root canals. Both teeth my previous dentist have worked on and according to 2 other dentists opinions, there should have been a root canal done there at the time he did the crown which he neglected to do so as a result, both teeth became badly infected. I also was diagnosed with having another tooth so badly decayed that I was told it will need to be extracted. Keep in mind that I was coming in for a regular checkups and exrays, last of which was only last week when i was told that everything was fine. Clearly nothing was fine as I found out. Now I just had a root canal yesterday and will have another one tomorrow and so far have been popping painkillers like candy. I am upset because all that could have been avoided. I guess I am wondering whether I should consider filing a complaint against this dentist for negligence. If I did not take care of my teeth and didn't get checkups, I would have had noone but myself to blame but I honestly don't know how can someone competent miss 3 bad problems that I could have taken care of long time ago as I am very proactive when it comes to my heatlh. I can understand dentist missing one problem but three? If anyone has advice, I would appreciate it
P.S. My DH is raving mad because the dental work I already had done this year(with the dentist in question) have already exausted my insurance coverage so now I have to pay out of pocket and approximate bill so far looks to be about $5000(2 root canals, extraction and a new bridge). He wants to sue. I am not sure that lawsuit is realistic
UpDATE: I just found out that appearantly I can't even file a complaint with dental association because I was told you can only file complaint if dentist actually did bad work. If he was simply negligent and did nothing, you can't complain. Really!? The man from dental association told me that clearly my "dentist" was just taking more "conservative" approach so I don't have cause for complaint

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20 replies

Latest reply was from biscuitsmom

Jenava

(website)

Veteran

I would be HOPPING mad about this. Yes, file a complaint, if only to make sure others are warned of this terrible dentist! That is completely unacceptable!

catgirl

Veteran

I think I'd file a complaint. It would be one thing to warn someone of impending doom re: teeth isssues and have that advice ignored. Here he never told you it was a problem, and you have suffered a lot of pain and financial cost as a direct result. I'd be furious too.

ironkurtin

Veteran

I'd speak to an attorney, one that specializes in medical malpractice. Typically consultations are free.

velvetychocolate

Veteran

Hmm...the only thing I know of is that I read recently that if you end up needing a crown on a tooth, then it can get infected later on if it's not root-canaled first. To me, it doesn't make sense to put a crown on a decaying tooth, without doing the root canal first.

I'm not sure about lawsuit though, but then again, I'm not one for lawsuits to begin with. I'm more likely to complain like heck first, and hope that the person/company who didn't do a good job will either refund money or help pay for any damage done. Have you considered this and have you asked the first dentist about the fact that (I'm guessing that this is what happened) crowning a tooth that needed a root canal was maybe not the best idea?

Personally, I would ask questions, complain and talk to the first dentist about the latest goings-on, to see if he or she can help a wee bit with the situation now, before going all legal. I wouldn't even mention legal anything - but I *would* make an appt. with the first dentist or talk to the staff there and explain what's going on.

Be friendly, and just explain what's been happening lately with your teeth. You might be surprised that your old dentist may offer to help fix things up somehow.

I had a crown break awhile back, and when I called my dentist about it, he immediately said, "It's my crown and I'll re-do it at no charge, this shouldn't have happened."

Sometimes, all it takes is some communication - but it's my opinion that this 'communication' shouldn't be all threatening right off the bat. Just phone the first dentist and let them know what's going on - there's a very good chance that they'll make things right.

Expect the best of people, you will most likely get it. It's ok to give someone a chance to fix things up.

Even though it's clear that the first dentist probably messed up, talk to them and see what they think, and do this in a non-threatening, personable way. I really don't believe people do a bad job on purpose, and if informed that something has gone wrong - they'll most likely do their best to make things right.

What do you think of this idea? Let the first dentist know about what's going on lately, and even ask them for their advice.

People can't fix a problem if they don't know about it - and it's a good idea to communicate what's been happening to your first (regular) dentist and see what he or she says first, before jumping to "they are negligent" or what have you.

In the meantime, I do know what it's like to deal with dental problems - it's not fun at all, so I am sending over some virtual gluten-free Kozy Shack pudding (as per Jenava's suggestion), some calming chamomile tea and some Advil. Maybe a good book to read too - something to take your mind off things so you can actually sleep.

Hang in there, and I hope you feel much better soon.

Lyn D.

Veteran

The above advice seems very sound to me.
As an ex-Dental assistant I have some knowledge re. Root Canals etc. and it sounds as though there might have been a communication break-down from the start.
Not all teeth that are crowned require root-filling- it depends on the reason : a tooth that has been broken rather than dramatically decayed may be O.K. with crown only. However, there are no guarantees with major Dental work as traumatised teeth can after many years 'die' and require further treatment, and x-rays don't always reveal nerve damage and deterioration.
This should have been explained to you at the time.
That said serious decay is more obvious, particularly when an x-ray has been taken.
I am sorry you are going through this physical and financial pain at the moment!

rae

(website)

Veteran

I feel it's worth a consultation with a lawyer since you have two dentists telling you it should have been addressed before.

Aziraphale

Veteran

Victoria, I'm so sorry you're going through this! I hope I can help here. I'm going to speak on behalf of the dentist, to try and explain why he may have done what he did. He was not necessarily negligent, although it seems to me he could have explained a few things to you -- in particular, the risk associated with placing a crown on a live tooth, vs. the risk of performing a root canal. It should be a calculated decision, and the patient should have a say.

First of all, it's absolutely possible to place a crown on a live tooth. I've got several crowns on live teeth. They were placed ten years ago and they're doing fine. Dentists prefer not to do root canals unless they think it's really necessary, because it's expensive, it weakens the tooth and there is always a chance the root canal will fail (90% success rate for maxillary teeth, 95% for mandibular teeth). But having said that, the process of prepping a tooth for a crown traumatizes the pulp (all that drilling!), so that it itself may be enough to trigger pulpal inflammation that doesn't settle down and eventually leads to the need for a root canal, which means you'll then have to drill through the crown for access -- or replace the crown. Costly.

You've got to keep in mind that dentists don't place crowns on pristine teeth. Crowns may be necessary due to advanced decay, breakage from impact trauma, or even severe wear -- basically you put crowns on teeth that have already sustained a certain amount of damage. In the case of decay, there is constant, slow trauma from bacteria seeping into the pulp, but you'd never know, because often the teeth are totally asymptomatic. So you go into your dentist, he tells you your deep fillings need to be replaced with a crown, and he puts the crown on your tooth, hoping that the additional trauma associated with the crown prep itself doesn't push that tooth over the edge into what they call "irreverisble pulpitis", which is basically the situation where the tooth is so inflamed that it can't recover. It's a calculated risk. This is what your dentist should have told you.

The other choice, which is also a calculated risk, is to root canal the tooth first, wait to see if it takes (usually two weeks is plenty), then place the crown. This is more costly up front, and there's a chance the root canal will fail -- although in the hands of an endodontist, probably not. Especially on a tooth that is not yet symptomatic.

It sounds to me like what has happened to you is that you got crowns placed on teeth that were damaged but still alive, but you ended up with irreversible pulpitis, after which the pulps died and then got infected. I doubt there was infection there when your dentist placed the crowns, and he doesn't have a crystal ball -- he didn't know for sure that they would eventually die. But he should have told you that EVERY TIME you drill a tooth, especially if it's extensive drilling on a tooth that has already suffered a lot of decay, there is a risk of causing pulpal death, which can lead to the need for a root canal filling.

The thing that perplexes me is that you didn't notice any pain while the teeth were in the process of dying. Usually what happens is that the pulp tissue gets really inflamed, but the tissue can't expand like everywhere else in your body because it's encased inside a rigid tooth, so it just squeezes the nerves and OW! It hurts like a hot damn. This can happen weeks, months or even YEARS after having a crown placed. You never know how long it's going to take a tooth to die. (I've had this happen twice, and both times it was over a year after the initial crown placement). Eventually the swelling effectively strangles the nerve and it dies. The pain suddenly subsides, and you think the problem has gone away, but noooo, now you've got dead tissue which rapidly starts to decay and leads to a huge pocket of pus called an abcess. I've never had one of those, but I hear it's through the roof painful. The bacteria in the abcess produce noxious gases which put huge pressure on the nerves in your jaw, which in turn causes severe pain.

I have heard that it IS possible for a tooth to die quietly, without you knowing, and then inevitably an abcess forms. It sounds like this has happened to you. A friend of mine had a tooth die ten years (!!) after the crown was initially placed, and she had no warning. Just a mild toothache in the morning that by nightfall was searing, throbbing pain that had her pacing the house all night long. She said that when the endodontist drilled into the tooth, it made a hissing sound as foul-smelling gas escaped from the abcess. Yikes!

Anyway, that was long, but hopefully arms you with some knowledge for when you talk to your dentist. I deeply sympathize with your dental woes, and hope it works out to your satisfaction.

GGB

Sorry to hear this, Victoria. I recently needed to have a root canal and it took weeks (actually a few months from when it first started bothering me) to diagnose. It did not show on Xrays and my dentist and the endodontist could not tell for certain which tooth it was (there were two adjacent that they suspected). For a while we even thought it was a problem with my jaw, so I was given muscle relaxers. The worst part was the pain and the fact that I was getting very little sleep each night (the pain was much worse when lying down). In the end they did determine which tooth it was (one that had gotten a crown quite a few years earlier) and I got the root canal. For now, all is well. Not sure this helps you a lot, but wanted to share my recent story.

Jenava

(website)

Veteran

Ugh, all hese stories about tooth problems are making my teeth ache in sympathy! It seems odd that none of your problems were detected during subsequent checkups. If he knew it was a risk I would have thought he'd be keeping his eye on the crowned teeth.

Ana

(website)

Veteran

Victoria, I have no words of wisdom in this area, but I'm sorry you are going through this and I hope you feel better soon.

Elizabeth, that was really interesting. Thank you for sharing that information. Is it possible to detect pulpitis or whatever in an x-ray? I wonder if it's possible to head off this kind of problem at the pass.

Aziraphale

Veteran

Ana -- unfortunately, nope, you can't diagnose pulpitis on an x-ray. You can usually see an abcess, if there is one, but by then the patient usually (but not always) knows full well that something is up because of the pain. (Some abcesses find a way to drain into the oral cavity, which allows pressure release, so no pain). Sometimes, on an asymptomatic tooth, you can see a sort of cloudiness inside the pulp chamber which can be an indication of something ominous -- or not. But usually pulpitis is diagnosed by symptoms. The dentist can do some simple tests, using sticks of ice, or an electric current, or a roll of cotton wool that she tells you to bite down on. Basically what she's looking for is sensitivity to cold that lasts for more than ten or so seconds; sensitivity to heat (more ominous); and pressure sensitivity. Teeth can have reversible pulpitis too, where the pulp gets inflamed but calms down. But the longer a tooth is sensitive, the less likely it will recover.

Gosh, I wish I didn't know so much about dental problems.

Victoria

(website)

Veteran

Elizabeth: I appreciate the detailed explanation and advice. actually in the case of one tooth needing a root canal-i was told by specialist I was sent to this weekend that this infection has been brewing there for at least a year which is when my former dentist did the crown on it. I complained to him several times after that I had some pain in that tooth but he told me its probably sore because of the new crown. That's why I am livid-because he should have checked it to find out if anything was wrong. As for my other tooth that also needs a root canal-my former dentist just took an exray of my front teeth because I needed a bridge so I was told by specialist that he should have seen that there was infection brewing there as well.
And then of course, the matter of the tooth that decayed beyond the point of no return while I had regular checkups with him.
Velvetychoclate: thank you hon for the sympathy I actually already tried to talk to my former dentist and he COMPLETELY denied that he did anything wrong. No appologies, no offer of discount of any kind, nothing. And no, he never told me that I needed a root canal on that tooth. It seemed like any concerns I brought to him, he just shrugged it all away I haven't told him I want to file a complaint but that's what I intend to do

Aziraphale

Veteran

LOL sorry, I was a bit long-winded. Once I get going on the topic of teeth, it's hard to get stopped.

Was the tooth hurting before the crown prep? From what you say it sounds like there was an infection before the crown prep even started, in which case your dentist may have been negligent. I hope it gets solved soon -- hope the pain is soon a thing of the past!

velvetychocolate

Veteran

Just wanted to chime in and say a great big 'thank you' to Elisabeth for explaining how these things happen - very, very useful information - thank you!!! That said, I don't want to know how or why you know these things...ouch!

I've had some bad dental experiences and I'm just so glad that things are overwith and healed up - and yet, when I read what you were saying about how crowns and root canals are both somewhat risky - I got all nervous! I got nervous because one of my root canals failed, and this happened years after the fact. The root canal wasn't done properly in the first place, and I ended up with an infection and had to have it re-done - very traumatising and I really don't want to "go there" again, if you know what I mean.

...

In the meantime, Victoria - I'm so sorry that your regular dentist didn't offer to help when you mentioned that you were still feeling pain, post dental-work, and just kind of blew it off as adjusting to a new crown or whatever. ACK! It sounds to me like you've done everything you could in communicating back to the dentist that things just weren't working...and that he just kind of brushed it off. That would make me mad.

I suggest just focusing on getting better, getting the best treatment you can and healing up. After that, you can maybe consider filing complaints and the like.

Just for the record - I go to the dentist about every three months, and am obsessive about cleaning and flossing my teeth. Some people just end up with rotten luck with dental issues. My husband has never even had a cavity, let alone a root canal. He goes for his twice-yearly cleanings and that's it.

Me? I've had some dental issues, despite regular brushing, flossing, cleaning appts. and the like. I go for cleaning appointments every three or four months, just to be on the safe side. My dental hygienist tells me that some people just need extra care and attention, and seemed to think that everyone was a little bit different, and that it might have something to do with saliva or something? Who knows? All I know is that I go three or four times a year for cleanings and ever since that awful failed root canal, I'm extra-careful when it comes to dental care. I pay extra for the cleanings (beyond what dental health insurance will cover), but it's worth it to me. The extra cleaning or two doesn't cost me that much, and I feel better having someone keeping an eye on things.

I hope you feel better soon Victoria - I know how awful dealing with dental stuff can be. I can't wait until you get everything cleared up and are feeling better again. That's the most important thing. Focus on this first, and then deal with "what to do" (if anything) about your old dentist later, after you're safe and sound.

Baked wild Alaska salmon tonight, with fresh lemon and dill - very soft, no skin, no bones ...easy to eat. Shall I send some over?

Also - try some luke-warm chamomile tea to relax your muscles. Pain always has us dealing with inflammed and clenched up muscles - although it's tough to do, it's important to relax and try to seek 'calm' when feeling like this. Have some tea, let it cool off a bit, sip it gently, and go to bed early. Relax - it will make a huge difference if you can find a way to relax through this.

It will all be ok. You'll get it fixed up, and you'll be feeling much better sooner than you think.

biscuitsmom

Veteran

Im SO sorry you've been going thru this and think itt's HORRIBLE you can file a complaint! I'd use your local consumer review sites and warn others and file your complaint with the BBB - even if you cant collect damages, it'll still be a warning to others and a mark on their record. Have you tried *slowly* rinsing your mouth with lukewarm salted water ? I use a teaspoon of salt in a 8 ounce glass. I have had many extractions (including a massive abcess that made me get an upper denture when I was 19)and a very painful root canal done and it seemed to help with the inflammation and speed healing... really hope you're feeling better soon!

rae

(website)

Veteran

What?? Can't file a complaint? That sounds utterly ridiculous to me. How is it "conservative" to not inform you of infections and not advise you on your dental health? He *works* as a dentist; if he's not doing what he should, that's "bad work" in my book. >:(

ironkurtin

Veteran

I still think a conversation with a personal injury attorney is not a bad use of your time.

Ana

(website)

Veteran

I think you can probably still complain to the BBB and at least leave negative reviews on review sites like Yelp. I also second Ironkurtin's suggestion.

Victoria

(website)

Veteran

thanks ladies for all the sympathy and support:)
velvetchocolate: I feel you on this one-I am same as you-because I tend to develop issues with my teeth, I am very proactive and go for cleanings as often as you. My DH is the same as yours too! Not a problem ever, no cavaties, nothing, his teeth are perfect. What a lucky devil he is.

Ironkurtin: I actually called several lawyers and so far noone wants to deal with a dental case. Appearently dental malpractice is very unpopular amoung attorneys because its very hard to prove that dentist is at fault(so I was told).

Rae: I too find it utterly crazy that you can't even file a complaint for negligence. I want to check what the guy from dental association told me because its sounds ridiculous

biscuitsmom

Veteran

ACK! I meant that you CANT file! Im sorry you cant find anyone to help