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 was 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 burden 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 temporary 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 occurrence, 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 burning 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 was 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.

                             Robert G. Morgenstern
                             Brooklyn, NY