I needed a lot of reconstructive work done on my teeth after a car accident. I went to a prosthodontist because they’re supposed to be the experts at this. I brought pictures of my old smile. I just wanted to have my beautiful smile back. I thought it would be fairly simple as they’d know exactly what I wanted ahead of time. When it came to the process of fitting, it looked like everything would be too dark. I mentioned that and they said it was because they weren’t the permanent ones. A common theme, whenever I brought up an issue, was the dentist saying, “He’s been doing this for twenty-five years and I should trust him.” Then, when I noticed the color didn’t match on the top and bottom he said, I didn’t understand how it worked and he was doing what was clinically correct.
When it came time to put in the permanent ones on the try-in, I couldn’t see them because they would fall out. He was mostly checking for fit. I told him one of them felt weird. He snapped at me at that point and said, “Everything is clinically perfect and fits just as it should.” He also told me I’ve been overly demanding and if I don’t like it I can leave without the teeth. I was humiliated and couldn’t bear the thought of leaving without teeth. At that point, most of my teeth had been ground down to nubs for the teeth needing crowns. I just let them do the work and booked it out of there as quickly as possible.
Now that I’m home, the teeth don’t look anything the way I wanted. The top teeth are actually darker than the bottom teeth, which looks completely insane. One of the teeth still feels funny. The teeth are shorter than my old smile, which makes me look older. I hate this. Is there any way to get it fixed without spending a second fortune?
Mandy
Dear Mandy,
I hate it when I hear these cosmetic dentistry horror stories. All that time and money and the patient is left disappointed at best and in a horrible situation that destroys their bite and leaves them in pain in some of the worst cases. You haven’t been unreasonable and hard to please. When you talked about the difference in color from the upper and lower arch I cringed. While you can get away with the lower teeth being slightly darker than the upper teeth, the other way around just doesn’t work. You can get this fixed, but you’re going to have to be tough. If you think you can handle it, I’ll explain how you can get the smile you deserve.
First, what he did is essentially malpractice, though I’m certain he won’t see it that way. He has a dental school mentality of “I’m the dentist, therefore I know best”. One of the standards of dentistry is informed consent. What he ended up doing, though, is coercing you into a smile you didn’t want. That’s not informed consent.
It’s obvious he didn’t care what you think to begin with. During the try-ins, you never got to see the crowns. He only cared about the fit, not whether or not you liked the appearance. If he did, there are temporary try-in pastes he could have used to let you get a good look and approve everything before moving forward.
Based on the arrogance you’ve described, I don’t think you’re going to get far with him on your own. Instead, you may need to involve a lawyer. His lawyer will immediately suggest he settle. I don’t want you to just ask for a refund. Instead, what you need to do is have him pay an expert cosmetic dentist to fix this.
While a prosthodontist studies reconstructive dentistry, not enough of them invest time developing the training necessary for the cosmetic side of things. You are more likely to find an expert cosmetic dentist with training in reconstructive dentistry than you are the other way around. I’d start by looking for an AACD accredited dentist. These are the top cosmetic dentists in the country and will certainly give you a stunning smile. Many of them also have reconstructive training as well.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.