How to find dentist to do good bridge

Looks like I have flushed $6,000 away on this. I needed a bridge and a crown for my front teeth. So I had the dentist do the single crown to make sure he could do a good job. It was good so I let him do the bridge. But he has not gotten it right. The bite isn't even good. And the bite even shifts after I have eaten. It seems to me that it doesn't fit well, but he claims it's the best he and his lab can do. Someone somewhere HAS to be able to do it better. Is there anything else I can do but go to dentist after dentist paying $5000 each time in the hope of getting something better?

Go to another dentist in your

Go to another dentist in your area for an second opinion. If they're able to make a bridge that fits correctly try to get a refund.

It's not that easy. I've been

It's not that easy. I've been ripped off by a couple of dentists already. And second opinions can be insincere - to put it politely. I had one dentist put in unglazed crowns. Unglazed porcelain is like having chalk in your mouth. I went to another dentist and he backed up the butcher - said the crowns were glazed fine. Another dentist told me to get braces. Huh?? I needed some good crowns so he recommended braces? It's like that in VT - many incompetent and crooked dentists. I may have to go out of state. But I still have no idea how to make sure the dentist is honest. The one I have been seeing just told be to stop flossing around the bad bridge and that might help. That makes NO sense.

I'm sorry to hear about what

I'm sorry to hear about what you're going through.I got bilked out of bunch of money by two dentists,one knowingly put crowns on me that didn't fit properly and the other one that was supposedly doing the repair work made things even worse.I agree it's hard to find a trustworthy dentist. What I ended doing was going to see a dentist who was on the ethics committee at the dental college and who also got good reviews on this website. I've had the repair work done and I'm very happy with the results but it took me over 2 years to get the mess fixed.Good luck!

Jonny73 wrote: I'm sorry to

Jonny73 wrote:

I'm sorry to hear about what you're going through.I got bilked out of bunch of money by two dentists,one knowingly put crowns on me that didn't fit properly and the other one that was supposedly doing the repair work made things even worse.I agree it's hard to find a trustworthy dentist. What I ended doing was going to see a dentist who was on the ethics committee at the dental college and who also got good reviews on this website. I've had the repair work done and I'm very happy with the results but it took me over 2 years to get the mess fixed.Good luck!

I've been trying for eight years to get my mess fixed up. I tried to get a dentist on the state dental society to do some work. He talked to me and said he would look into getting materials that were suitable for someone with my allergy problems. But then he never got back to me. When I called him back the secretary told me he said that all dental materials were made out of the same thing. The state dental society here in VT is a joke. When I complained about the dentist who butchered me 8 years ago they didn;t even answer my letters or e-mails.

But I may have found a guy - 2.5 hour drive from where I live though. I got the name of a lab that is supposed to be good at bridges made out of old fashioned PFM from a rep. They gave me the name of a dentist.

Just what I figured. The

Just what I figured. The dentist refused to treat me. That's what they do when you tell them you have allergies. I drove 2.5 hours to see this guy and then he tells me it wouldn't be a good idea for him to work on me because I'm too far away. WTF?? Then why did he even agree to talk to me in the first place? he even had the nerve to tell me that the awful bridge I have is fine. The bite isn't even right. There is no contact to my bottom teeth from #9. And the porcelain on the back got shaved through by the dentist who did it. This dentist looked at it and said that I had chewed through it in the back and I explained that the other dentists had done it. But he still said it was a good bridge.

I don't see how I am going to find a dentist to work on me.

I don't know where you are,

I don't know where you are, but my dentist did a whole mouth restoration for me and he is amazing. Something is wrong for a dentist to leave you with an ill-fitting bridge and say it's the best he could do ... and seems to be a clue you need to find someone to do the job right, or tell you what needs to happen in order to get it done properly.

I did have a crown come out during a time I had to be away from my dentist in Northern California for a year - and THREE dentists struggled to get it back on right, calling what my dentist did 'heroic dentistry.' When I was finally able to get back to him, he put it back on with such ease, and perfectly the first time, that it gave me a real appreciation and point of comparison. Plus, the other dentists on the road who struggled with it, all commented on the gorgeous work in my mouth. My bite was a mess, and is now perfect.

Not sure how to tell you where to find an excellent dentist - took me a near lifetime to find mine, but they're worth gold when you find them.

If you're in N. California (SF Bay Area) or close, I'll be glad to tell you who mine is, but don't want to post it here and give the impression I'm advertising which I'm not. Just a very grateful, satisfied patient.

sara j wrote: I don't know

sara j wrote:

I don't know where you are, but my dentist did a whole mouth restoration for me and he is amazing. Something is wrong for a dentist to leave you with an ill-fitting bridge and say it's the best he could do ... and seems to be a clue you need to find someone to do the job right, or tell you what needs to happen in order to get it done properly.

I did have a crown come out during a time I had to be away from my dentist in Northern California for a year - and THREE dentists struggled to get it back on right, calling what my dentist did 'heroic dentistry.' When I was finally able to get back to him, he put it back on with such ease, and perfectly the first time, that it gave me a real appreciation and point of comparison. Plus, the other dentists on the road who struggled with it, all commented on the gorgeous work in my mouth. My bite was a mess, and is now perfect.

Not sure how to tell you where to find an excellent dentist - took me a near lifetime to find mine, but they're worth gold when you find them.

If you're in N. California (SF Bay Area) or close, I'll be glad to tell you who mine is, but don't want to post it here and give the impression I'm advertising which I'm not. Just a very grateful, satisfied patient.

I'm not sure why a crown would be hard to get back on if it was well made. I had one of my good crowns come out a few years back and it was no problem to put back on. The fit was so good that it held on well with no cement. I just put toothpaste on to keep it sealed from bacteria until I got a dentist to cement it in. The problem can be with the lab as well as the dentist. I think that may be the main problem with the bridge. The lab did not do a good job. But it's also possible that the impressions were not good. This dentist stands by his lab and says they are a great lab though. But they aren't. They can't even get the bite right much less the internal fit which is even more important.

In my case, the crown is on a

In my case, the crown is on a tooth that didn't have much remaining, and at the time I chose the inferior crown route rather than an implant. A dental hygienist really pulled on it, and that's why I think it came out a day later. The dentist (not mine) couldn't get the crown back on because (don't know the terminology) of some curved somethings that had kept it on. So - he had to snip one of them off, making the crown pretty unstable. When it would come off, other dentists had trouble cementing it back correctly. Anyway, that tooth has to come out now because it's a root canal gone bad and there really isn't much tooth left. Even after all the crown trouble though, there's no decay underneath.

Can't believe you're still struggling with that bridge - frustrating! And I do understand how at the prices for dental work, it's not exactly an option to experiment with shopping around.

I e-mailed the dentist the

I e-mailed the dentist the other day and asked him to either contract with another lab or refund my money. He indicated that he would give me some kind of refund. I don't know how much it will be. But it still doesn't help me find a dentist who will do a good job. I wonder if it's possible that there isn't enough tooth structure left. It looks and feels to me like there is. The dentist did not say that there wasn't.

My dentist did not hesitate

My dentist did not hesitate to return a crown to the lab, which did not fit properly. He was noticeably pissed off at the lab. He set aside a certain amount of time to put the crown in, then had to waste another appointment putting the new one in. I imagine he lost some money in business, because of the shoddy work of the lab.

It reflects poorly on the dentist if he doesn’t make sure the lab is doing good work.

Hi there, dentist John Clark

Hi there, dentist John Clark from Brisbane Australia here. It is really easy to find out who is both a skillful and ethical dentist in your area.

How? Look up who are the local dental technicians in your city and ask for a recommendation as to who are the more skillfull dentists. Dental technicians are the only people who will give unbiased assessment as to who has 'good hands'. The dental profession worldwide has no quality assessment protocol or organisation in place to ensure patients are being looked after skilfully and I can assure all reading this that a huge proportion of dentists have very poor skills..

The other thing that will come from the recommendation of your local tech is an assurance that the dentist is using a locally made dental appliance (ie a crown, denture etc) and not something made by factory workers in China, Mexico etc. Almost universally, the sort of dentist that uses dental labwork from these countries is motivated by greed as the enormous savings made by using the cheap product ARE NOT passed onto the patient. So, unknowingly, patients are getting a lesser quality product placed in their mouth which is also costing the jobs of local dental techs. The industry in Australia is collapsing and I'm sure it's the same in the USA. More info on this subject is available at dentalaware.com.au Do not go by the word of your dentist that they "use the best lab in the USA based in XXXXX". Ask for the name of the lab and go and visit them. An ethical dentist who uses a local quality lab, will be more than happy to identify the lab he or she uses.

So it's easy, ring up your local tech and see who they recommend.

regards
John

Great suggestion Dr Clark!

Great suggestion Dr Clark! It's nice to hear from a honest dentist. I had crowns placed by a dentist that never fit me properly.I was able to find out from the guy that made the original crowns a few years later when all the work was being redone that dentist had removed too much tooth structure during crown preparation and "violated the biological width", and because of this the technician was unable to make crowns that would fit properly and I was left with inflamed gums and tmj problems. The hack of a dentist pretended they had done nothing wrong and even blamed me for the problems I was experiencing.

Jonny73 wrote: Great

Jonny73 wrote:

Great suggestion Dr Clark! It's nice to hear from a honest dentist. I had crowns placed by a dentist that never fit me properly.I was able to find out from the guy that made the original crowns a few years later when all the work was being redone that dentist had removed too much tooth structure during crown preparation and "violated the biological width", and because of this the technician was unable to make crowns that would fit properly and I was left with inflamed gums and tmj problems. The hack of a dentist pretended they had done nothing wrong and even blamed me for the problems I was experiencing.

This is what I am afraid has happened. Maybe there isn't enough tooth left to make a good fit. But the bridge I had on before - the emax one - seemed to fit fine. I just had an allergic reaction to the material.

Labs around here will not talk to patients and that makes it hard to find a dentist who does good work with the materials that work for me. There are no local labs that use captek. It was really hard to get labs to even tell me THAT. I only found one lab who would talk to me - he doesn't use captek or the Ivoclar Inline ceramic that works. Other materials MIGHT work, but it will cost me $5000 for each trial witha different material. I want to use what I KNOW works.

john_boy1959 wrote: Hi there,

john_boy1959 wrote:

Hi there, dentist John Clark from Brisbane Australia here. It is really easy to find out who is both a skillful and ethical dentist in your area.

How? Look up who are the local dental technicians in your city and ask for a recommendation as to who are the more skillfull dentists. Dental technicians are the only people who will give unbiased assessment as to who has 'good hands'. The dental profession worldwide has no quality assessment protocol or organisation in place to ensure patients are being looked after skilfully and I can assure all reading this that a huge proportion of dentists have very poor skills..

The other thing that will come from the recommendation of your local tech is an assurance that the dentist is using a locally made dental appliance (ie a crown, denture etc) and not something made by factory workers in China, Mexico etc. Almost universally, the sort of dentist that uses dental labwork from these countries is motivated by greed as the enormous savings made by using the cheap product ARE NOT passed onto the patient. So, unknowingly, patients are getting a lesser quality product placed in their mouth which is also costing the jobs of local dental techs. The industry in Australia is collapsing and I'm sure it's the same in the USA. More info on this subject is available at dentalaware.com.au Do not go by the word of your dentist that they "use the best lab in the USA based in XXXXX". Ask for the name of the lab and go and visit them. An ethical dentist who uses a local quality lab, will be more than happy to identify the lab he or she uses.

So it's easy, ring up your local tech and see who they recommend.

regards
John

Labs won't even TALK to patients here. No way they would let me visit.

Getting excellent bridgework

Getting excellent bridgework and crowns depends on two things: the expertise of the dentist AND the expertise of the lab technician. Lab techs can't tell you who the *best* dentists are because of privacy laws - they'd lose their jobs for divulging privileged information. What they *can* tell you is that excellent bridgework and crowns depends on how well the dentist sculpted the underlying tooth with their drills and they would tell you that high quality crowns or high quality bridgework has several criteria (www.tc.umn.edu/~adar0002/SGIM%20SC/Download%20Modules/SGIM%20SC%20Level%201.pdf). But that's only half of the story - the other half is how accurate the dentist's impression is, because the lab can ONLY make an excellent bridge or excellent crown if the impression is excellent, and like sculpting a tooth, the quality of the impression also has several criteria (FYI - one study done in the UK examined over 200 impressions from 3 commercial dental labs and found that 44% of impressions evaluated were deemed *unsatisfactory* which is probably research-speak for "failing grade"). Any lab tech will tell you that to make an excellent bridge, they need an impression that is excellent in all the criteria. If the impression is substandard (even if the dentist's sculpting is excellent) then the lab technician is for all sakes and purposes handicapped from the starting gate by the compromised quality of the impression, which means that the quality of the final product of the lab technician is similarily doomed to be compromised (it's the old adage of Garbage In = Garbage Out). But even if a dentist with excellent sculpting skills provides a lab with an excellent impression, the fact is that your bridge may STILL be crappy if the lab tech doesn't have the skills to translate what they received from the dentist, into a quality finished final product. But that's unlikely to happen because according to the lab techs I've talked to, any dentist who does excellent sculpting and who takes the time to do excellent impressions that meet all the criteria of impression taking, simply won't do business with a lab that sends back a finished product that doesn't meet the same quality standards the dentist provided in the first place (i.e. Excellence In - Excellence Out, or else the dentist finds a lab that WILL do excellent work). So really, the question is not about the lab because excellent dentists insist on excellent lab technicians. It's really all about the dentist's ability. If you want to increase the likelihood of getting excellent bridgework or crowns, then phone around and ask the dental office secretary to answer one very simple question *magic* question that reveals all, namely:

DOES YOUR DENTIST GIVE PATIENTS THEIR IMPRESSIONS AND THEIR LAB MODELS AFTER A BRIDGE IS MADE???

The *excellent* dentists always do and the reason for that is also simple - it's because they have nothing to hide and they know that if you get your impressions and your lab models at the end of the day, that you could take these to ANY other dentist (or lab techician) who would be able to look at these and tell you whether the work was satisfactory, splendid, stellar or sucky. Without the lab models, no one can tell what the sculpting was like (because they can't see under the bridge) and without the impression, they have no way of knowing whether or not the lab technician was limited or otherwise *handcuffed* in their ability to provide an excellent final product. In other words, the impression and the lab models would become your "evidence" in the event that you think you got shoddy work, but a dentist who does shoddy work would have to be crazy to offer to give you that *evidence* if they knew you could use it against them, whereas the *excellent* dentist you are looking for would have no hesitation.

So before you spend $6,000 (again) phone around and ask the magic question.

I have been to many dentists

I have been to many dentists and have never had one give me the impressions and lab models. I know many people who have had crowns and no one has told me a dentist gives them the impressions and lab models. I think if I even asked the dentist would refuse to treat me because he would figure I would be a pain in the butt. The last dentist refused me after I told him I had allergies. Dentists just don't want to be bothered by difficult patients.

Not enough information is on

Not enough information is on the web - I need to know the specific materials the dentist uses. No one lists that on a website. No one even knows what is going in their mouth. The dentists don't even know what they are putting in people's mouths. I asked one dentist and he just said 'zircon.' That didn't tell me anything. I needed to know what the veneering ceramic was. It took me months to finally get that information. I had to find out what the lab was from the dentist - and he was reluctamnt to give me that information. Then I e-mailed the lab. At first they refused to e-maol me or talk to me at all. They told me to ask my dentist. I persisted but they still refused to tell me what the materials were and said it didn't matter because adverse reactons were impossible. I finally had to write a letter to the head of the lab and he instructed his people to answer my questions. Another lab totally refused to even aknowledge me. I left messages with the secretary but callse were not returned. E-mails and letters did no good either. They ignored those. I filed a complaint with the US Department of Health and Human Services and said the nature of the materials were medical records. I am supposed to have access to my medical records. But the dentist is considerd the end user so the composition of the crowns is not considered part of my medical record.

Aries, think solutions not

Aries, think solutions not failures. You need to look at what you're gonna do in future rather than get stuck in the the crappy stuff that happened in the past. While I appreciate your saying you have never (past tense) had a dentist *offer* to give you lab models and impressions, the point of my post was to help you *find* a dentist to do good crown and bridge (which is what you were looking for according to the title of your post, no?). I offered you that advice because that's exactly what my dentist offered, plus he also took the time to explain what his goals (read: criteria) were in how he sculpts the teeth *before* he even does the sculpting, so when the bridge or crown comes from the lab he sat me down and showed me the impression and the lab models with the bridge or crown on it and this allowed me to have a chance to critique his work *before* gluing it in, based on having already taught me how to discern the good, the bad or the ugly or in his case, the excellent. In all fairness, my gf worked for the guy so maybe I got extra special attention and maybe it's because he asked me enough about my hobbies and interests to find out I make minature models so I have an appreciation for fine detail. But I doubt he's the only dentist who does this, you've just got to do your homework and find one of those guys. It's like what other posters have said - ask around for referrals, maybe find some people who have had work done 10, 15, 20 years ago that's still holding up fine, then call *those* dentists but at the same time, ask their secretaries if the dentist is willing to give out the models & impressions. I'll bet that when you find a dentist who will (rather than assuming there aren't any like your last post) you'll also find someone who takes as much pride in sculpting teeth as I do in making minature models, because I love it when people show interest in what I do (doesn't everybody, if they love what they do?) Good luck to you and I hope this helps you get your teeth to where you want them to be.

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