Problem with NHS metal crown on lower molar

[sparkledust]

Hi everyone

My lower back molar broke diagonally so no fillings would stay intact. Have suffered with this tooth for almost 2.5 years. Finally found a dentist who does private and NHS work who was prepared to fit an NHS crown. (Had previously had private dental work until I lost my job). X-rays were taken and the dentist said the remaining tooth was in good health as were the roots, so no need for a root canal. The dentist mentioned having a white private crown at £500 as opposed to a metal NHS crown. As spending this amount was not an option currently and appearance wasn't that important being a back tooth, I opted for the NHS crown, having read online that the quality of NHS crowns is good. This turned out to be a very bad decision, not that I really had a choice. But I would rather have had no crown and waited till I could afford a private crown, had I known what would happen.

The crown was fitted a month ago. It felt huge. Dentist said it would take time to get used to it. While I waited, I had pain from extreme sensitivity for many hours a day. The dentist told me to expect this and said it would subside in a couple of weeks. I am still getting the pain and it is still very bad but for less hours per day.

I went back to the dentist this week to get the crown filed down, knowing metal crowns can't have much taken off them. When the dentist drilled it to file it down I had terrible pain. He couldn't file it much as he said it would make a hole in it. But the pain showed me the crown is not effective enough.

The crown still fits badly height wise. It fits ok at gum level but is way too high and nothing can be done about it. Part of it crashes into my top teeth. The dentist said he could file down my top teeth but I am not prepared to have enamel taken off good teeth to accommodate an awful crown.

I asked the dentist if I would have had these problems with a private metal crown and he said probably not as more care is taken in shaping them. I asked him what he would charge to replace it with a private metal crown, thinking all the prep work has been done....but he said £700.00 due to the time it would take to remove the metal crown.

I can tell this crown is too thin, and with a "live" tooth its not enough cover. The dentist didn't fill the tooth either as he said the crown would fill it. All my privately crowned teeth were filled before the crown was fitted. So I think there is not enough insulation over my tooth. And I know it can't be filed down any more than it has been. I daresay the metal in a private crown would be better too.

So I am left with a crown that feels too big/high and my tooth is super sensitive and very painful at various times throughout the day. I know it's pointless asking for another NHS crown and wouldn't want one anyway.

Any suggestions as to what I should do would be very welcome.

Thanks

 

[comfortdentist]

Basic expectation for any crown
Before you leave the office when you bite down all of your teeth should touch. At least the ones that touched before you had the crown.
There should be resistance to flossing between the teeth
It shouldn't bother your tongue or feel rough.

 

[brit]

Your dentist doesn't sound very ethical to me. Even under the NHS you have the right to a crown that fits. It almost sounds like he did a shoddy NHS crown deliberately so you would switch to a private one. I think you should follow the NHS dental complaint procedures. Good luck and hope you get out of pain soon. You are right not to damage the above teeth - it is the crown itself that needs to be redone.

 

[sparkledust]

Basic expectation for any crown
Before you leave the office when you bite down all of your teeth should touch. At least the ones that touched before you had the crown.
There should be resistance to flossing between the teeth
It shouldn't bother your tongue or feel rough.

If I try and bite down on all my teeth, I can't do that. If my new crown is touching the teeth above it, the back teeth on the opposite side don't touch each other whereas they did before. I can either chew food on my right side or my left but not all of them. If I try to chew food like I did before, using both sides of my jaw, the crown hits the teeth above it. I have to be very careful when I chew.

When I saw my dentist this week to get the crown filed down a bit, he said eventually things will level out. I asked him how this was going to happen. He said the tooth is on a kind or rubber band and the teeth will sense the crown is too high and it will adjust and move down. I don't think that is going to happen. I've never had a problem with my other 3 crowns.

The crown feels smooth and the dentist said it fits well. The problem is, it is much higher than the tooth that was beneath the crown. I think the space between the crown and the tooth next to it is OK as I can floss and the gap isn't too tight or too loose.

I wouldn't have faith in having another NHS crown made even if I could insist on it as the shape was all wrong, which is down to the NHS technician. I also feel it must be too thin as I get the same sensitivity through the crown as I did without it.

 

[sparkledust]

Your dentist doesn't sound very ethical to me. Even under the NHS you have the right to a crown that fits. It almost sounds like he did a shoddy NHS crown deliberately so you would switch to a private one. I think you should follow the NHS dental complaint procedures. Good luck and hope you get out of pain soon. You are right not to damage the above teeth - it is the crown itself that needs to be redone.

The dentist is fairly young and has excellent qualifications, i.e. more than some dentists. He was trained at a major London dental school and he enjoys doing root canals, which I didn't need, but it would seem he has experience of crowns. He seemed to take the impressions OK. I feel it was really the people that made the crown that were at fault. On the other hand, he shouldn't have fitted it knowing how hard they are to remove when he saw it was too high. When he fitted it he said it will feel "proud" until I get used to it. Well, I am never going to get used to it because it hits the tooth above it. He never tried to pressure me to get a private crown. He didn't even suggest getting it replaced with a private crown. It was me that suggested it, but the cost is unaffordable at the moment.

Apart from it affecting my bite and feeling uncomfortable, I don't think the pain will ease up as I feel the tooth needs something more substantial covering it due to having a "live" nerve in the tooth.

Two other dentists didn't want to fit a crown on the NHS and told me I needed to see an endodontist, which was too expensive, but it was like they knew there wasn't enough profit in doing it as the tooth was a tricky one. The current dentist said I didn't need a root canal and was willing to do the crown. But I think the problem is they don't get paid enough for NHS work and perhaps that is why the dentist wouldn't have wanted to get another crown made when this one was not quite right.

I grind my teeth in my sleep on the side of the crown so every morning the tooth under the crown aches, apart from the sensitivity pain I get at various times of the day.

If I make a complaint against him it would only entitle me (possibly) to a new NHS crown and after this, I would never want another NHS crown, having seen the shoddy workmanship and thin construction. I have more or less resigned myself to suffering until I can find a job and save up enough for a private crown as I am not sure if a private dental plan would cover the removal and replacement of this crown.

 

[comfortdentist]

This is crap.
Your dentist needs to grind down that crown until the bite is even. No excuses!!!
If the dentist makes a hole in the crown it is because the dentist under prepared the tooth. The dentist would need to cut off the crown, prepare the tooth more and then take a new impression. It is the fault of the dentist and the doc needs to do the right thing.
Having said the above the problem of under preparing some spot and needing to redo a crown has happened to every dentist including me.

 

[carole]

Your experience is not standard as an nhs patient. I am a nhs patient and it is entirely down to the dentist as comfortdentist has already said. It is up to your dentist to correct this. I had a crown/bridge made for me by the lab that my dentist uses and when she came to put it on it was terrible and rocked. She wasn't prepared to try and make it fit, she took more impressions and had it re-done the second one went on like a glove and has been fine.

I would look for another dentist until you find one that will make your mouth comfortable and treat you properly, they can all talk flannel with a caring smile and do nothing, the ones that care will just do the job right. Even within the restrictions of the nhs.

Also I would contact the practice manager and see if they can help you get this problem sorted out, that is the first procedure in a complaint. If you get no joy then take it further as brit has suggested. They can't get the work done for you but they can make sure the dentist does his job properly.

If you put up with this it will cause you problems with your jaws and eventually make the jaw really painful.

 

[sparkledust]

This is crap.
Your dentist needs to grind down that crown until the bite is even. No excuses!!!
If the dentist makes a hole in the crown it is because the dentist under prepared the tooth. The dentist would need to cut off the crown, prepare the tooth more and then take a new impression. It is the fault of the dentist and the doc needs to do the right thing.
Having said the above the problem of under preparing some spot and needing to redo a crown has happened to every dentist including me.

Thank you for that information. Much appreciated.

 

[sparkledust]

Your experience is not standard as an nhs patient. I am a nhs patient and it is entirely down to the dentist as comfortdentist has already said. It is up to your dentist to correct this. I had a crown/bridge made for me by the lab that my dentist uses and when she came to put it on it was terrible and rocked. She wasn't prepared to try and make it fit, she took more impressions and had it re-done the second one went on like a glove and has been fine.

I would look for another dentist until you find one that will make your mouth comfortable and treat you properly, they can all talk flannel with a caring smile and do nothing, the ones that care will just do the job right. Even within the restrictions of the nhs.

Also I would contact the practice manager and see if they can help you get this problem sorted out, that is the first procedure in a complaint. If you get no joy then take it further as brit has suggested. They can't get the work done for you but they can make sure the dentist does his job properly.

If you put up with this it will cause you problems with your jaws and eventually make the jaw really painful.

Thank you for your advice. I am still having pain some 7 weeks after the crown was fitted and its getting worse. I can tell its the nerve that's hurting and sometimes it goes up to my ear and I'm in misery. I want to make a complaint so I guess I will have to complain to the practice manager although I am loathe to do that as I would not trust this dentist to rectify the problem. I imagine that if I complain and don't accept any corrective treatment offered, that I can't make an official complaint. This particular dentist has lied to me in the knowledge that it's a badly fitting crown and that I'm in considerable pain, telling me it would adjust itself over 2 more months, just enough time so he wouldn't need to correct it. I could hardly look at him again after that let alone allow him near my teeth again. I just wish I could complain without having to go through the practice manager as I know I would have to decline another offer of treatment from that particular dental practice.

I've had mostly private dental work in the past but with this tooth I've had NHS work done by 3 different dentists and I can definitely notice the difference in how nhs patients are treated. I can tell from the pain that this crown is all wrong, plus I can't chew on it as that causes pain as well, so I know I need a new crown and I don't feel confident in using the NHS to produce a properly fitting crown. It seems dentists hate doing work like this on the nhs as they are not paid enough.

 

[Tink]

I want to make a complaint so I guess I will have to complain to the practice manager although I am loathe to do that as I would not trust this dentist to rectify the problem. I imagine that if I complain and don't accept any corrective treatment offered, that I can't make an official complaint.

I'm fairly certain that's not true - your right to complain is in no way dependent on letting them retreat you. That would be dangerously close to coercing you into accepting treatment, which is in effect treatment without consent. You always, always, have the right to complain, and you have the right to choose what you will or won't accept. It would be entirely reasonable to say that as they have let you down so badly and provided such poor quality treatment, there's no way you would trust them to fix it.

This particular dentist has lied to me in the knowledge that it's a badly fitting crown and that I'm in considerable pain, telling me it would adjust itself over 2 more months, just enough time so he wouldn't need to correct it. I could hardly look at him again after that let alone allow him near my teeth again. I just wish I could complain without having to go through the practice manager as I know I would have to decline another offer of treatment from that particular dental practice.

I'm not sure what the procedure is for NHS complaints, although it's true that most procedures do encourage you to take it up with the practise first if you are able to. Again, you are in no way obliged to accept any offer of treatment though.

Hopefully somebody else can fill you in with a bit more info about NHS complaints procedures.

 

[carole]

Hi you don't have to accept any further treatment from the dentist that made the mess. It doesn't stop you making a complaint to the GDC after you have contacted the practice manager. The first step has to be to the practice manager. State in your complaint that you don't feel able to see this dentist again. You can go and see another dentist somewhere else.

Don't judge all nhs dentists on this one, there are a lot of good guys out there, I had mistakes made with my dental care by a dentist and found another nhs one. My new one is brilliant and couldn't do more for me. I also did complain and had it dealt with by the GDC. They are very good and the dentist do have to mend their ways, I will not benefit from the dentist that made mistakes on me, but a lot of other patients will.

I wish you good luck