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Jonathan Everett, DDS, Dentist, Kirkland Family Dentistry

When Dental Work Doesn’t Work: Fixing Problems Caused by Subpar Dentistry

By Jonathan Everett, DDS
Kirkland Family Dentistry

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Original Publish Date: September 13, 2016

Many people dread going to the dentist, but the one consolation they have is that they can usually be sure that the procedure they’ve had will help them in the long run and is beneficial to their overall dental health.

Unfortunately, this is not always the case. Instances of subpar dentistry causing problems or exacerbating existing problems are common. However, we all have a right to great dental care which we have paid for with our time, money, and energy. Thankfully, it is possible to fix most of the problems that subpar dentistry causes.

If you have a patient who has been negatively impacted by poor dental work, you can guide them through many options for solving these problems.

Why does subpar dentistry happen?

Many instances of subpar dentistry occur due to poorly done cosmetic dentistry procedures. The American Dental Association doesn’t recognize cosmetic dentistry as a specialty, so no additional training is needed to perform these services and dentists are automatically licensed to perform them.

Cosmetic dentistry is also difficult to define because many procedures toe the line between being practical and cosmetic in function. Many dentists spend much of their time repairing failed cosmetic work of other dentists, especially since some dentists are most concerned with function, not aesthetics, of the teeth. Dentists also are incentivized to encourage patients to undergo costly, unneeded procedures in order to boost their income.

What are the most common botched dentistry jobs?

When patients get veneers for their teeth, especially if they are done at different times, the new veneers may not match the thickness or whiteness of the old ones. It is also common to have veneers which do not fully match the color of the surrounding teeth. Poorly done veneers can also fall off, leaving an embarrassing tooth exposed and causing pain and other potential hazards.

Poor bonding technique is also a common problem among dentists who are not properly trained in cosmetic dentistry. The bonding may not match the color of the surrounding teeth and can look gray or brown. This is caused by the color of the underlying tooth showing through the bonding material. Bonds and veneers can also look different under different types of light, so a dentist may do a procedure in the office which looks completely different in natural outdoor lighting. Trained cosmetic dentists have experience in opaquing techniques which can reduce these issues, but many dentists do not and so try to improvise with the knowledge they do have, leading to unpleasant-looking teeth.

Botched extractions are even more harmful, because not only do they cause unwanted cosmetic effects, but they can lead to infection and extreme pain. Poorly done fillings can cause pain by interfering with a person’s bite, and fillings can fall out if the cavity was not properly prepared by the dentist beforehand.

Root canals can also fail for a variety of reasons. The seal may not be properly keeping contaminants out, leading to infection or further tooth decay. Likewise, the tooth may not have been properly cleaned before the procedure. Root canals are tricky because a tooth can have more canals than expected or canals that branch out, and these are hard for dentists to identify. If they are not identified, the canals can remain untreated and lead to pain and damage.

What can patients do?

Encourage patients to discuss concerns they have with their dentist at the time of the problem. Even the best dentist-patient relationships experience problems over time, and a dentist wants to know how best to serve their patient as soon as possible. Often, a simple discussion can clear up any concerns and allow both parties to establish a plan for the future to fix the problem.

If the dentist is not helpful is resolving the patient’s concerns, the patient can contact the state’s dental association. Dental associations have a network set up for peer review of a patient-initiated dispute, through which non-involved parties evaluate the situation and advise the dentist and patient on their best course of action.

Patients can ask for a refund from their dentist. Because refunds have to be reported on the dentist’s record, some dentists are hesitant about agreeing to give a refund. However, it is useful to know that if the request is given orally, and the dentist issues the refund himself, not through the insurance company, it does not have to be reported to the National Practitioner Data Bank. This knowledge can give patients some leverage in getting a refund and decrease the likelihood of a messy settlement and getting expensive lawyers involved.

Many dentists will agree to do something to remedy the treatment if it is obvious they have not fully fixed the problem. After all, dentists want patients to have healthy teeth and be happy with their service. It is possible that the treatment, such as a filling, needs to be removed, cleaned, re-drilled and repeated. While patients may not want to undergo a full second treatment, it can be crucial for their dental health, so dentists should encourage this.

In other circumstances of extremely poor dentistry or a particularly difficult tooth, further treatment may be needed. In these cases; such as a failed root canal or cracked tooth, the tooth may need to be extracted fully and replaced. While this is costly, time-consuming, and painful, it is sometimes the only option. Leaving a poorly treated or cracked tooth can lead to recurring infection, pain, and difficulty eating throughout the patient’s lifetime.

If all else fails, a patient can sue the dentist for malpractice. This is a specific type of negligence lawsuit and it is often very difficult to settle a dispute effectively this way. Lawyers can be very expensive, and in order to win the case, the patient must prove specifically that they were injured by the dentist’s care. An unattractive smile or discolored tooth is not considered an injury, and in some cases, even infections resulting from poor care that occurs far past the appointment cannot be proven as having been caused specifically by the dentist’s care.

Because of these intricacies and inconveniences in the legal system, it is almost always better to work as hard as possible to resolve the issue between the dentist and the patient as best as possible.

Fixing problems caused by subpar dentistry takes time, resources, and expertise. With some effort, patient’s pain and aesthetics can be restored.

Dr. Jonathan Everett of Kirkland Family Dentistry in Kirkland, WA received his Doctor of Dental Surgery from the University of Washington and completed his undergraduate studies in biochemistry at Washington State University. A member of the American Dental Association and Academy of Operative Dentistry, Dr. Everett strives to continue providing the most advanced and clinically-proven dental care available in the region. Dr. Everett is the recipient of the International Congress of Oral Implantologists Award.