Hi,

I'd appreciate some feedback on this because I'm not sure if what my
dentist told me is legitimate.  Here's the details:

I recently changed to a new dentist after moving.  I talked to some
co-workers and neighbors for some referrals, and I made 2 consultation
appointments with different dentists before deciding on the 3rd one I
met, who was a graduate of USC and who seemed to be very competent.

So, I just had two new caps fitted to my upper right front side incisor
and the right front eye tooth (Teeth 6 and 7?).  These caps were done
because both these teeth had a few pretty old tooth-colored 'patch'
fillings on the sides and along the gums, and they were also worn down
quite a bit -- about about 1/8 of an inch compared to my other front
teeth (the rest of which already have caps on them).  They looked,
honestly, pretty bad, and I've always been unhappy with how short they
were and uneven they made my smile.

The dentist drilled the teeth and fitted me with temporaries that he had
off a model of my original teeth.  Just before I was about to leave, I
asked if the new caps could be made longer to make my smile even,
because the temporaries looked shorter than I remembered the teeth were.

He said he could make the caps longer to even out my smile, but that
since I had a 'tight excursive' , or something, on those teeth he might
have to shave off some of the lower teeth to 'match' my bite.  Given
that tooth wear was already a problem for me, I was reluctant to have
him intentionally take away some of the lower front teeth.  He told me
he could have the lab make the caps longer to match my smile, and at the
fitting I could tell him if I preferred to have him shorten the caps or
the lower front teeth to match my bite.

I went to get them fitted, and he let me see them on my teeth how they
came from the lab.  They were a lot longer than the old teeth, and they
did make my smile perfectly even with my other caps, and the color match
was really good too.  But while I could bite my back teeth OK, when he
had me bite 'like you're eating a sandwich' the new caps were the only
ones that touched big gap between the lower front teeth and my other
front caps.

He told me I had to decide if I wanted him to shorten the caps or my
lower teeth.  I told him to shorten the caps, but try to to keep them as
long a possible.  He adjusted them for nearly 20 minutes, and I must
have "tap tapped"  and "slide slide" my teeth together a few dozen
times.  Anyway, he finally got them to where he was happy, and my bite
felt pretty good, and he was able to keep some of the extra length.  He
gave me a mirror and asked me to make sure I liked them and wanted them
glued in.

I looked at them  for about 5 minutes while he left to do an exam, and I
was happy with the look, color and bite, so when he came back I said OK
to glue them in.  He then had me sign the chart giving my approval
(which I thought was odd, I'd never done that at my old dentist) then he
glued them in.  He told me to be sure to let him know if my bite felt
uncomfortable because they might need further adjustment.

So, after a day or so, I noticed that one felt a little rough.  So I
took my wife's small compact mirror to see what was causing it.  Unlike
my other caps which only have a small line of metal near the gums, the
new caps have the metal going half way up the back!  They looked
horrible on the inside compared to the other caps.  If they hadn't felt
rough, I never would have looked to see what he had done.  I was also
mad because I never noticed the insides when I had looked at them before
he cemented them.  I feel like he suckered me, and had me sign my
approval to cover himself.  I made an appointment to see him and
complain.

He listened to my complaint.  He said that bites with 'tight excursives'
it was pretty standard to design the caps with half metal on the inside,
especially if one is an eye tooth.  I asked him why my other caps
weren't like that, and he said that my 'bite clearance' is better on the
other teeth, so there was room for the porcelain to cover the metal.  He
also said since my lower left eye tooth had a porcelain cap, it was OK
that the upper left cuspid had porcelain on the inside because the
materials "matched."  But since my lower right eye tooth was natural,
having half metal on the upper right eye tooth was "much better" for
"long term wear."

Then I asked why he couldn't have made more space for the porcelain on
the new caps, and he said the the original teeth were already too worn,
and drilling them that much more would have made them 'too thin' and
possibly have damaged the nerve.  He said that them feeling rough didn't
mean anything was defective, only that he probably didn't get them
polished as well as he could have given all the adjustments.  So I let
him re-polish them.

He got them really smooth.  They feel as good or better than my other
caps now.  He joked that only me, "my dentist and my hygienist would
ever know" they looked different on the inside, and "don't stand on your
head when you introduce yourself."  It was funny but a little rude too.  
He said I could have them redone, (paying again of course!) but that if
he drilled more to have room to cover the inside with porcelain may risk
the need for root canals!  No thanks, I've had a few of those!!

So, I left feeling I somehow got inferior caps, and even though I can't
feel it anymore and no one can see the metal inside, I know it's there
and it bugs me.

Comments appreciated

Jon