I've been reading prior posts within this newsgroup about tooth
sensitivity and pain after a filling.
I had a few fillings done... some metal some composite about two
months ago. I have been having general sensitivity for the last two
months and a few weeks back I had excruciating pain in the area. I
have adapted to chew on only one side of the mouth so the pain is gone
and I'm also not a wimp so that kills 90% of the pain if there is any.
>From what I've read there shouldn't be any pain or sensitivity even
after a few days... and if there is the dentist made a mistake. I
would like some insight into this and how long I should have pain or
sensitivity after filings.
I did go back in a week after the original fillings and described the
sensitivity and the dentist made sure the bite is correct and ground
down the tooth a bit; he said everything looked fine. He said give it
a month or two to see how it feels.
Well, this is why I post this. I wasn't planing on paying this
dentist until this got resolved. I live in a town of 6,000 and there
are not many dentists in the area and most are booked up by 1/2 year
or simply don't take new patients. Unfortunately every single time
I've went to this dentist over the last two years there is a problem.
I had a root canal a few months back because the original filling
didn't work (which led to considerable pain). A few of the crowns he
put on cracked... infections came in (and there still is one again)...
and after reading through the posts on this newsgroup I learned that
he doesn't use a dental dam or any other kind of protection from
water.
Anyways... I've paid him a few thousand over the last two years and
enough is enough - I'm pissed with the backing of my wife. I want
these issues taken care of (the sensitivity and the infection. I just
received an invoice in the mail today that had a rubber stamping on it
stating "if payment is not received in 5 days this will be turned over
to small claims court" or something to that effect. I've already left
a voice mail for them stating why I didn't pay yet and that the
dentist told me to wait a month or two to see how it plays out.
They've charged me interest for the last two months and I've never
stated I wouldn't be paying. I simply told them on the message the
reasons and that I would be happy to pay if they'd schedule me an
appointment and resolve the issues. I told them that I was in fact
thinking of taking them to small claims court if these matters didn't
resolve.
My questions are:
1) Do I need to consider changing dentists even if that means driving
1 hour (I already answered YES to this but want opinions).
2) Do they have any case against me to bring me to small claims court.
I've never heard of a company bringing an overdue invoice to small
claims court. Collection agency is one thing. What are my options
here?
3) Would I have a case against them to bring them to small claims
court. Under what circumstances. What makes me made is that every
time they screw up I have to pay for them to refix it. I own a
business myself and am very careful about placing blame so I need
professional opinion from other dentists that could tell me, based on
what you know and questions you could still ask, if what I am
experiencing is normal or if I have a slightly incompetent dentist.
Even if it is not his fault, should I be liable for continually
correcting issues (e.g. I get root canal, it gets infected, they have
to operate a little to get out the infection, then two weeks later I
need to go in again and get charged every time.
As a side note, I brush my teeth multiple times a day, use Listerine
daily, but do not floss (shame).
This is tough because I never had a cavity until a few years ago! My
last dentist (in another state) was so much better (in my limited
experience which doesn't say much).
Thanks for reading the very long post.
Steven Bornfeld - 29 Sep 2007 03:27 GMT
> I've been reading prior posts within this newsgroup about tooth
> sensitivity and pain after a filling.
[quoted text clipped - 72 lines]
>
> Thanks for reading the very long post.
Obviously I can only answer in general, and based on your side of the
story.
If there is a clear pattern as you describe of problems with
sensitivity, breaking restorations etc, and this is a new situation for
you, I can understand your losing trust and in this circumstance you'd
best find another dentist.
Restorations can crack for many reasons--faulty placement, lab
problems, or grinding and clenching. Likewise teeth frequently are
sensitive after a new filling. But if you've had several fillings over
the years without this problem, and especially if the cavities filled
weren't very deep, there may well be something with the dentist's
technique that may be causing the problem. However it is very difficult
for even another dentist checking you after the fact to know if (for
example) insufficient water spray was used during cavity preparation and
he fried the nerve.
Submitting to treatment may be considered an implied contract, and
dentists may well take a patient to small claims court. I'm not a
lawyer, and I have no idea how that may turn out. You can be sure that
many patients taken to small claims court will claim dissatisfaction
with treatment. I have no statistics on how these cases tend to go.
If the dentist is a member of the local dental society, you may
consider calling the society and seeing if they have a peer review
committee. It is a way to keep conflicts like this out of court, and
though these committees are composed of other dentists I've heard that
most of the time they find at least partially for the patient.
Good luck,
Steve
The Webby - 29 Sep 2007 04:40 GMT
> It is a way to keep conflicts like this out of court, and
> though these committees are composed of other dentists I've heard that
> most of the time they find at least partially for the patient.
>
> Good luck,
> Steve
Hey Steve,
Some "stuff" goes on forever and ever here in our newsgroup. But the
subject matter isn't always the "same" ...
Do you have a copy of "The TMJ Iatroepidemic"? If not, would you like a
copy? I am more than happy to send you a copy. All you need to do is
send me the address you'd like it to be sent to ...
Webby
GG.and.UN. - 29 Sep 2007 05:10 GMT
Thanks Steven,
Your insight will be very helpful; just the type of response I was
looking for (hoping for more though of course!).
It's helpful to know that another dentist won't be able to tell much
from a previous dentists work.
I would like some comments, if possible, from someone who might know
some of the legal protections for myself in this situation. What kind
of protection is available; is it an applied contract in the sense
that it's my risk if I go to a dentist and though I may not seek said
services in the future that I am still liable for past services
performed under good faith even if the doctor is (not saying he is)
not up to par in his workmanship.
Any litmus tests that I can present to a dentist before I pay to find
out his work may not be too good?
Again, thanks for your comments on limited one-sided knowledge.
Mark & Steven Bornfeld - 29 Sep 2007 15:14 GMT
> Thanks Steven,
>
[quoted text clipped - 11 lines]
> performed under good faith even if the doctor is (not saying he is)
> not up to par in his workmanship.
Not precisely what I'd meant to imply. The dentist is obligated to
provide competent treatment, and to reasonably make provision for
problems related to that treatment. From a practical perspective,
postoperative sensitivity and even pulpal involvement leading to root
canal treatment do happen, and they do not necessarily imply negligence.
But when there is a clear pattern of postoperative problems where they
ordinarily would not be expected, it MAY imply negligence. Getting
evidence of that negligence is tough, and small claims is probably not
where this is going to be fleshed out. If it is possible to get copies
of x-rays just before treatment was started, and then after it was
completed, there may be some evidence. But unless there is a great deal
of money involved, it is not usually worth it to bring a suit, and I
doubt that subtle issues of competency will be dealt with in small
claims. That's why I suggested peer review.
I should point out that (thankfully) my experience in this area is nil.
A lawyer will know more, but I'm assuming you don't wish to go that
route, since you're talking about small claims.
Good luck,
Steve
> Any litmus tests that I can present to a dentist before I pay to find
> out his work may not be too good?
>
> Again, thanks for your comments on limited one-sided knowledge.

Signature
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
Shyster - 30 Sep 2007 10:04 GMT
> I've been reading prior posts within this newsgroup about tooth
> sensitivity and pain after a filling.
[quoted text clipped - 19 lines]
> are not many dentists in the area and most are booked up by 1/2 year
> or simply don't take new patients.
That's some town you live in lol
Unfortunately every single time
> I've went to this dentist over the last two years there is a problem.
> I had a root canal a few months back because the original filling
[quoted text clipped - 10 lines]
> stating "if payment is not received in 5 days this will be turned over
> to small claims court"
Why worry about that? Let him do it, he'll have to waste money sending an
attorney. You file a counterclaim.
or something to that effect. I've already left
> a voice mail for them stating why I didn't pay yet and that the
> dentist told me to wait a month or two to see how it plays out.
[quoted text clipped - 35 lines]
>
> Thanks for reading the very long post.
Steven Fawks - 30 Sep 2007 14:17 GMT
> 1) Do I need to consider changing dentists even if that means driving
> 1 hour (I already answered YES to this but want opinions).
If you care about your teeth, an hours drive isn't out of the question
at all.
> 2) Do they have any case against me to bring me to small claims court.
> I've never heard of a company bringing an overdue invoice to small
> claims court. Collection agency is one thing. What are my options
> here?
Yes. You recieved treatment and haven't paid the bill. There is no
disclaimer that you only pay if you are happy with that treatment.
You can pay the bill. You can speak with the office and express your
displeasure, at which time you can offer some kind of deal (You will
pay half of the fee...1/3...2/3...etc.) The law, justice, and fair
treatment don't always coincide.
> 3) Would I have a case against them to bring them to small claims
> court. Under what circumstances. What makes me made is that every
> time they screw up I have to pay for them to refix it.
I think it would have to be a malpractice case (but I'm no lawyer).
I've seen quite a few cases where I think the previous dentist really
messed up. None of these people sued the other dentist. It just
isn't usually worth the money and heartache (plus then you have to
find a GOOD lawyer! <G>).
The trick here is determining when the dentist really did screw up
(if at all). It is possible for patients to present themselves with
such problems that they are very difficult to repair. This can be
complicated further when the patient doesn't want to 'sink a fortune
in their mouths' for the best treatment.
Certain 'dental plans' foster an environment where the dentist will
fall into a mode of doing the cheapest treatment or ignore problems
to increase the profit. In the profession, we often call this
'supervised neglect'.
A lifetime of dental problems will continue to be more dental problems
unless some major changes are made. That has to do with your diet,
home care, and dental treatment. It isn't usually *all* of the
dentist's fault when things go bad.
There was a show on TV the other night about shady housing contractors.
It detailed a few cases where people had spent thousands of dollars and
the work had not been completed or was pure crap. All of the victims
said, "I trusted them". One contrator (who was one of the 'good' ones)
said that there were only 20% of the businesses who were reputable. I
am not saying that's true, but there are obviously many ways to get
screwed dealing with any service provider.
One of the pieces of advice was to know when to cut your losses! If
things don't look right or sound right, STOP. Yes, you may have lost
a few thousand dollars. However, you won't lose $50K and still have
an inferior product or service.
Sometimes you get what you pay for...sometimes you get less.
Steve
Vaughn Simon - 30 Sep 2007 20:22 GMT
> I've seen quite a few cases where I think the previous dentist really
> messed up. None of these people sued the other dentist. It just
> isn't usually worth the money and heartache (plus then you have to
> find a GOOD lawyer! <G>).
Not only a GOOD lawyer, you need to find a WILLING lawyer. Some folks tend
to forget that attorneys, like dentists, actually have to make money to stay in
business. No lawyer is going to take your case on contingency unless
significant $ recovery is very likely. I have seen very clear medical liability
cases that involved death of the patient that did not "make the cut" to be taken
on contingency. By that standard, there are not many dental cases that will
excite an attorney.
Of course, virtually any attorney will be very happy to do whatever you want
(to whomever you want) if you are willing to pay their fee up front...
Vaughn
dacconverter - 30 Sep 2007 16:16 GMT
> I did go back in a week after the original fillings and described the
> sensitivity and the dentist made sure the bite is correct and ground
> down the tooth a bit; he said everything looked fine. He said give it
> a month or two to see how it feels.
You wrote a long post but you're still not specific enough. Where were
the fillings placed? Were you warned of possible root canal treatments
after excavation of certain cavities because they were large/deep? And
can you describe more of your symptoms? ( i.e. when exactly do you
feel sensitive and for how long. Does it hurt? Or is it a strong
sensation to cold/hot? ) Do the restored teeth feel "unnatural" in
any way? And how old are you?
Someone here can hopefully provide you some limited judgement if you
can answer the above.
> Well, this is why I post this. I wasn't planing on paying this
> dentist until this got resolved. I live in a town of 6,000 and there
> are not many dentists in the area and most are booked up by 1/2 year
> or simply don't take new patients.
Where exactly do you live? You don't have to tell me the exact name,
even a nearby town would be helpful.
Unfortunately every single time
> I've went to this dentist over the last two years there is a problem.
> I had a root canal a few months back because the original filling
> didn't work (which led to considerable pain).
I've actually seen two patients who experienced the same issue. Before
the filling, they were warned that the decay might lead to pulpal
exposure or, if it didn't, can cause constant pain/sensitivity after
placing in a filling. The latter happened to both patients.
The teeth were eventually extracted.
These were patients on capitation/Medicaid plans and none of the staff
dentists wanted to bother with a root canal, for which their
insurances might not even reimburse.
But then again, the teeth were periodontally involved anyway. And
these were highly unreliable patients, where both had disappointed for
at least four appointments in a row. Clearly, these guys don't care
themselves either and there's no point in restoring teeth that won't
be tended to properly.
A few of the crowns he
> put on cracked... infections came in (and there still is one again)...
When were the crowns done? And where/how did the fractures occur?
Again, this info is needed to provide you with limited opinions.
> and after reading through the posts on this newsgroup I learned that
> he doesn't use a dental dam or any other kind of protection from
> water.
I rarely see dental dams being used either. Patients here absolutely
have a phobia with dental dams and I was actually instructed not to
use them by the supervisor due to time/financial constraints and
patient preferences.
But I never experienced any procedural problems from not using a dam.
> Anyways... I've paid him a few thousand over the last two years and
> enough is enough - I'm pissed with the backing of my wife. I want
[quoted text clipped - 6 lines]
> They've charged me interest for the last two months and I've never
> stated I wouldn't be paying.
Where I work, the patient is required to pay before the procedures.
This clinic actually had thefts of dental services, where the patients
disappear before paying their bills or pay with counterfeit money.
I simply told them on the message the
> reasons and that I would be happy to pay if they'd schedule me an
> appointment and resolve the issues. I told them that I was in fact
> thinking of taking them to small claims court if these matters didn't
> resolve.
What was their reply?
> My questions are:
Describe the teeth in question very specifically to the best of your
knowledge and someone can actually offer you some guidance.
GG.and.UN. - 30 Sep 2007 18:58 GMT
Not good; I was just finishing writing all the replies (a long reply)
with all the info and it erased somehow and I couldn't get it back.
So... this is going to be shorter and no longer multi-threaded to each
reply like before.
Quick Replies:
1) I'm not opposed to having a lawyer... the small claims court to
them was more or less a bluff. I had entertained it once for about 5
minutes during a time of pain but I as well know it would not be worth
it... neither would a lawyer. If I had to pick one though... for the
amount of money this is for a lawyer would NOT be worth it. I would
only take them to small claims courts as a counterclaim.
2) I have a good diet; I eat mainly organic and non-GMO foods. I eat
vegetables, fruit, dairy, bakery, and nuts and I am in good shape. I
don't take prescriptions... never broke a bone... don't take pain
medication or aspirin, rarely drink pop (only juice and tea), don't
smoke, don't drink alcohol. I am 25.
3) I've only had one cavity (at the age of 20) before going to this
dentist. I've always had healthy teeth. I was never a problem patient
- I tend to want to pay more for a certain option/item/thing because I
like to do things right the first time. Money was never an issue even
though it all comes out of our pockets. I never missed appointments
and always paid my bills the day of up until this final issue.
4) Some details may be inaccurate, I'll have to check with my wife:
The original appointment was for a filling in the upper-right-back of
my mouth for the tooth next to the molar. I was now given the option
to have composite filling (I would have taken that and didn't know it
was an option until after - I thought all dentists give composite by
default nowadays) so it was a metal filling. I was not warned there
could be repercussions that would result in a root canal. I went home
to discover excruciating laying-on-the-floor-in-feta-position pain
(all the time). I went back the next day and they said I had to get a
root canal and started the procedure. When I finally got my permanent
crown on it chipped within a day (not eating hard food) and I had to
go back to get another one. The latest crown has been fine but within
a week an infection developed within the root canal area. I went back
within another week to have surgery on the infection. It's still
puffy in that area today and sometimes, though rarely, bleeds in the
area when I brush my teeth. I had another small cavity done on the
bottom right back (two away from molar) with metal fillings that gave
me sensitivity to hot and cold foods (primarily cold) for a month but
that has gone away. Then I had some composite fillings (small) on the
left bottom middle that are still sensitive to pressure and cold
foods. I had a chip in the upper left back (near the molar) when I
was eating ice cream and drinking tea (I think the contraction-
expansion did it) on a tooth that had a cavity. That was filled and
that hurts frequently... the pain is with pressure and cold foods. I
don't eat on that side anymore. The surface feels rough and I can
feel an edge in the center portion of the tooth. I explained this to
the dentist, along with the pain, a week after it was done and he
ground it down and made sure the bite was ok and said it looks ok.
About three weeks after that was when I had the extreme pain in the
tooth for about a week. Now the top tooth feels ok, if there is a pain
it is a blunt general pain. The lower teeth have more of a sharp
pain.
Hope that helps!
Dartos - 02 Oct 2007 13:18 GMT
It is impossible to say anything defiinite over the internet about
your case, but it *sounds like* a combination of less than perfect
dental treatment on a clencher. (You don't need headache or TMJ
pain to be a clencher)
I got in the middle of a case that had similar symptoms after having
8 or 10 old amalgams replaced with composite. The guy was in misery.
(He ended up in my office because he was dating a girl that I had as
a patient when she was growing up)
I replaced 2 of the most sensitive fillings and made him a bite splint.
Almost immediate relief for those teeth, so I ended up replacing all
of the others.
One lower molar did not respond to just replacing the filling and
ended up with a root canal and crown.
I switched him over to an NTI from the bite splint as soon as I found
out about them.
This all happened well over 10 years ago, and he was back for his check
up this year and everything is going fine.
He is a construction worker and a big, strong guy. He was also a little
tough to get completely numb.
JME,
D
> Not good; I was just finishing writing all the replies (a long reply)
> with all the info and it erased somehow and I couldn't get it back.
[quoted text clipped - 58 lines]
>
> Hope that helps!
Amatus Cremona - 02 Oct 2007 14:08 GMT
-- > He is a construction worker and a big, strong guy. He was also a
little
> tough to get completely numb.
I, generally, find cleenchers are tougher to get numb.
Newbie - 02 Oct 2007 14:21 GMT
>-- > He is a construction worker and a big, strong guy. He was also a
>little
>> tough to get completely numb.
>
>I, generally, find cleenchers are tougher to get numb.
And tweakers are almost impossible to anesthetize
Dartos - 02 Oct 2007 19:20 GMT
> And tweakers are almost impossible to anesthetize
And might be dangerous to sedate.
D
Newbie - 02 Oct 2007 19:42 GMT
>> And tweakers are almost impossible to anesthetize
>
>And might be dangerous to sedate.
>
>D
Or to treat just in general.
Dartos - 02 Oct 2007 19:19 GMT
Yep.
Amazing what you pick up after almost 30 years of practice.
;-)
D
> -- > He is a construction worker and a big, strong guy. He was also a
> little
>
>>tough to get completely numb.
>
> I, generally, find cleenchers are tougher to get numb.
Shyster - 30 Sep 2007 23:55 GMT
>> I did go back in a week after the original fillings and described the
>> sensitivity and the dentist made sure the bite is correct and ground
[quoted text clipped - 41 lines]
> themselves either and there's no point in restoring teeth that won't
> be tended to properly.
Good rationalisation but whether you're being paid $1000 or a $1 you
standard of care must be the same. Ask your dental licensing board. What are
you running a Medicaid mill practise? Medicaid dental is just a racket
anyway to make the politicians look good and give patronage jobs to their
cronies who administer it. It would make better sense to just give the
patient a voucher for a certain sum yearly which can be spent at any dentist
of his choice.Frankly, I wouldn't trust a dentist who would work for 1/5 the
normal fee. He's either inexperienced or a quack and might actually cause
harm if he feels he has to work fast to make any money. He might also
extract teeth (quick money) when the tooth could easily be saved by root
canal and crowning (slow and unprofitable with Medicaid)
> A few of the crowns he
>> put on cracked... infections came in (and there still is one again)...
[quoted text clipped - 27 lines]
> This clinic actually had thefts of dental services, where the patients
> disappear before paying their bills
Not a crime
or pay with counterfeit money.
Could be if you can prove they knew it was counterfeit ut if you already
mixed it with other cash, forget it.
> I simply told them on the message the
>> reasons and that I would be happy to pay if they'd schedule me an
[quoted text clipped - 8 lines]
> Describe the teeth in question very specifically to the best of your
> knowledge and someone can actually offer you some guidance.
Simplicio - 01 Oct 2007 22:30 GMT
> But I never experienced any procedural problems from not using a dam.
>
> Where I work, the patient is required to pay before the procedures.
> This clinic actually had thefts of dental services, where the patients
> disappear before paying their bills or pay with counterfeit money.
I wonder about the legality of that, in that if you went to a hospital
would
you be required to pay before an operation? On the other hand would
it be fair to charge an uninsured individual 5 times more before the
operation?
Amatus Cremona - 01 Oct 2007 12:12 GMT
>>From what I've read there shouldn't be any pain or sensitivity even
> after a few days... and if there is the dentist made a mistake.
That is only true for small routine restorations.