10/25/05

    I would like to document my experience at the dental office managed by
Dr. Dennis Tarnow, currently at 150 East 58th. St., NYC.  I went to Dr.
Tarnow for implant surgery because I was told that, as a researcher and
dental school instructor, he ws the best prosthodontist in the city.
He promised he would provide "the best" dental care.  I believe the
"care" I received was rushed, substandard and, at times, bordered
on malpractice.
    When I first went to Dr. Tarnow's office I was seeking replacements
for three missing teeth in positions nine, ten and eleven at the front
top left side of my mouth, and two other adjacent missing teeth on the
bottom left side.  While I was sitting in the dentist chair I remarked
that I felt some pain under the teeth next to the missing top teeth.
Dr. Tarnow said that I had a "fixed bridge" there, in positions
twelve, thirteen, and fourteen, and that he would remove it, eliminate
the cause of the pain, and replace the bridge.  When I told him that my
insurance plan would cover the cost of the bridge replacement if done
by a plan affiliated dentist, he said that I should let him do the work
because the number twelve tooth was very damaged and weak and might not
support another bridge without an added implant, which was his
specialty and which my insurance would not cover.  While I was sitting
in the chair waiting for the anesthetic to take effect Dr. Tarnow
quickly added up the prices, and I agreed to let  him do the work.  He
assigned his associate, Dr. Rudolfo Sanchez, to make the temporary and
final crowns.
    Dr. Tarnow removed the fixed bridge and installed implants at tooth
positions nine, eleven and thirteen on top and at the two missing tooth
positions at bottom left.  He led me to believe that the implant at
position thirteen would support the new fixed bridge along with the
strong root at position fourteen, so that the weak root at position
twelve would be relieved of the burdon of supporting the new bridge and
would be protected by it..  He also removed the crown at position
fifteen and Dr. Sanchez made and installed a one-piece temporary bridge
over tooth positions nine through fifteen, the entire top left side of
my mouth.
    As Dr. Sanchez put the new temporary bridge into position, screwing
the front tooth section in number nine position into the installed
implant, I said "the only thing I care about is that the two front
teeth are even, so that I can play saxophone".  He replied "Sure,
no problem", until he realized that the front tooth of the new
"temporary" was shorter than my other front tooth.  He had made the
new temporary bridge using the old removable bridges, that I had found
so objectionable, as a model.  He said that he would fix the difference
in length of the two front teeth in the future, but he never did.  I
requested Dr. Tarnow match the length of the two front teeth at a later
date, but he said the bridge was just a temporay one and brushed off
the request.
    Shortly after I returned home with the new temporary bridge installed
I bit deeply into my lip while chewing.  The bite was so deep, and
caused such pain and bleeding, that I found the experience quite
shattering.  I found it almost impossible to chew food without this
happening again, resulting in repeated pain and discomfort over the
next few weeks.  While I never actually bit off a piece of my lip, the
bite was so deep each time that, if more than one tooth had been
involved, it actually seemed possible.
    I returned to see Dr. Sanchez in Manhattan on several  occasions,
complaining about how deeply and frequently I was biting into my lip.
On each occasion he repositioned the temporary bridge, but the problem
persisted.  I finally told Dr. Tarnow that I had no faith in Dr.
Sanchez, and was considering going to another dental office.  He
replied that Dr. Sanchez would no longer work with me, and he assigned
Dr. John Zamzug to finish the crowns.  As I will explain, Dr. Zamzug
added nothing positive, and I wound up with Dr. Sanchez actually doing
most of the work that followed.
    On my next visit both Dr.Tarnow and Dr. Zamzug looked in my mouth and
tried to figure out why I was biting my lip so severely.  Dr. Tarnow
thought the problem was caused by the temporarily missing bridge on the
lower left part of my mouth, but I was sure this wasn't the case.
They handed me a mirror, and when I looked into my mouth I noticed that
one tooth on the temporary bridge was longer than the others.  When I
showed this to Dr. Zamzug he replied "What do you want me to do?  I
asked him to file it down.  After he filed it down I no longer was
troubled with biting my lip.  Dr. Tarnow continued to insist that the
trouble had been caused by the temporarily missing lower bridge, but I
am certain that he was wrong.
    Dr. Zamzug then noticed the "weak" tooth at position twelve and
suggested I have Dr. Tarnow extract it and replace it with an implant.
I went to another dentist to get his opinion, and he assured me that
the tooth in position twelve would be sufficiently protected by the
bridge that was to be installed, which was Dr. Tarnow's original
plan.  When I told this to Dr. Zamzug, he replied, "In no way will I
cover that tooth with a bridge.  That tooth will stand alone!"  Faced
with this, I felt compelled to allow Dr. Tarnow to extract and replace
the tooth with an implant.  I requested a reduction in price for this
additional, unexpected expense.  Dr. Tarnow agreed to charge only for
the implant and do the extraction at no charge.  Dr. Zamzug refused to
discuss it, answering repeatedly, "we'll see", before abruptly
walking away from me.
    After the extraction and implant installation I returned for the
required follow-up visit.  Dr. Tarnow said "Hi.  How are you doing?
I replied "I bit my lip."  Before I could continue and explain that
it was not severe and may have been a normal occurance, he asked,
"has John Zamzug seen it?"  I said "no" and Dr. Tarnow quickly
walked away.  I guessed he was going to find Dr. Zamzug.
    After twenty minutes Dr. Tarnow returned alone and said "Well,
you're not in pain, so there's nothing else.  Go home and come back
in two months for a final exam."  I explained that I felt a little
pain in front and on the side and I thought that the "temporary"
might be loose.  He replied that a little pain was normal and sent me
home.  At his request, I came all the way from Brooklyn for him to
examine me, and he sent me home without ever asking me to open my
mouth!
    Within a week I called the office and asked to speak with Dr. Tarnow
because the temporary bridge still was loose and I was feeling an
occasional burning sensation at the front tooth, where the bridge was
screwed to an implant, and slight occasional pain on the side of the
bridge.  After Dr. Tarnow didn't return my calls I made an
appointment to see him.  He wiggled the "temporary", which was
attached only at the front, position nine implant, and said that it was
supposed to be that way.  When I insisted the bridge was loose and I
was feeling a buning pain at the front tooth position, he took an
x-ray, said that one of the rear teeth might possibly need a root
canal, and everything else was fine.  He sent me home.
    A week or so later I went to a local dentist to inquire about the
possible need for a root canal..  This dentist immediately commented on
how loose the bridge was, and tried to remove it, inadvertently pulling
on the front implant attachment.  This caused further loosening and
more burning pain at the front implant.  I called Dr. Tarnow when I
returned home and his secretary said he was standing right next to her
talking on the phone to another patient and would call me back in a few
minutes.  After waiting about thirty minutes I called the office again
and was told that Dr. Tarnow had walked away saying I should come to
the office.
    When I kept my new appointment and told Dr. Tarnow what had happened
he said that Dr' Sanchez, who was no longer supposed to be working on
my teeth, would just remove the loose bridge and then he, Dr. Tarnow,
would "be right back" to do the necessary work.  I again mentioned
the pain at the front implant position.  Dr. Tarnow checked the bridge
and finally agreed that it was loose.  He then left and did not return
that day.
    Dr. Sanchez felt the bridge, which was, as always, connected only at
the front implant number nine position, and said it ws very loose and
that the glue he had used must have been too weak.  I honestly don't
remember it ever being glued at all, and had mentioned repeatedly to my
family that I was feeling pain because the contact point at position
nine was the only attachment point and took the impact of any stress
that might have been placed on the entire bridge.  Dr. Sanchez removed
the bridge, and after about twenty minutes returned and hurriedly put a
large amount of glue on the "temporary" and screwed it into place.
My "bite" didn't feel right, there was more pain in front, and my
top and bottom teeth seemed to be hitting too soon, but I was somewhat
worn out from the experience and assumed I would get used to it.
    By the time I returned to Brooklyn I realized that Dr. Sanchez had
altered the bridge so that when he rushed to screw it in place it was
pressing so hard against the other front tooth that that tooth had
moved and was now hitting the lower front tooth, causing pain and
preventing me from chewing properly.  I called Dr. Sanchez from
Brooklyn and he told me to return to the office, so I got back on the
train and rode all the way back to Manhattan.  When I returned to the
office and Dr. Sanchez removed the screw in the front implant I
immediately felt the pressure relax as my other front tooth was freed
to return to its normal position.          The bridge was still glued solidly
in place, however, and the front tooth was still in contact and putting
slight pressure on the other front tooth.  Dr. Sanchez began twisting
and yanking on the bridge that he had glued into place just an hour and
a half before with the "stronger" glue, trying to remove it.  He
kept doing this until I heard a distinct "cracking" sound from the
bridge area, and he gave up.  Apparently no additional damage wqs done,
but the experience was extremely painful and upsetting.  When Dr.
Sanchez realized he couldn't remove the bridge he had just glued in
place, he used sandpaper to sand away the area between the bridge and
the front tooth next to it so that there was no contact.  I was
scheduled to return a month later for a final exam before the crowns
were installed.  At this visit I told Dr. Tarnow that I still felt some
pain at the front implant and a bit on the side.  He x-rayed the front
and assured me there was nothing wrong.
    During virtually every visit to Dr. Tarnow's office I felt extremely
rushed.  On more than one occasion I had to chase after Dr. Zamzug
while trying to discuss my case, while he strode rapidly away from me
to work on another patient.  Dr. Tarnow never returned any of three
telephone calls I made to him.  Dr. Zamzug returned one of two. I was
often left sitting unattended for relatively long periods of time
during treatment sessions.  When I told Dr. Tarnow that I was going to
a different dental office for the final crowns, he charged me $6020 for
the temporary crowns (in addition to the implant costs), including
$4,620 for the top unit that was giving me so much pain and
aggravation.  Of course, both "temporaries" were thrown in the
garbage, as planned, when the final crowns were installed.  I still
feel the same occasional pain at the front implant position, and
don't know if anything can be done to alleviate it.  In retrospect,
my experience at Dr. Tarnow's office generated a great deal of
anxiety, and gave me the feeling that I was in a rushed, high speed,
high cost, economically efficient dental factory, where my personal
care and comfort were of minor importance.