I had to have zirconia crowns placed on my front teeth. My dentist sent me to a prosthodontist. I have a bit of dental anxiety and so he suggested dental sedation. He assured me I’d be able to see the crowns before they were bonded on. Unfortunately, that didn’t happen. He said I saw them and approved them, but I have no recollection of that. I am sure that if I had seen them, I would not have approved them. They are completely gray compared to the rest of my teeth. The dentist is absolutely refusing to replace them, saying that I approved them and they are fine. What do I do? I absolutely do not smile anymore. My teeth look ridiculous to me.

Marion

Dear Marion,

I’m very sorry for the experience you’ve had. We often see these type of cosmetic dentistry horror stories with people who get smile makeovers from an inexperienced cosmetic dentist. Most patients don’t realize that cosmetic dentistry isn’t a recognized specialty. If a dentist wants training in cosmetic work, they have to invest in post-doctoral training.

Unfortunately, this means every general dentist can call themselves a cosmetic dentist, regardless of the amount of training they’ve attained. This has resulted in some disastrous results. With a prosthodontist, it can actually be a worse scenario. This is because they think their extra training in restorations also makes them experts in cosmetics as well. Unfortunately, that is not the case.

This seems to be what you are facing. He fancies himself an expert and feels justified in not replacing his ugly work. Unfortunately, if the work is functioning it can be hard to get a refund, but I’ll give you some tips for that later. You do have one thing working in your favor.

He would be hard-pressed to say you were lucid enough to truly give approval. It’s never a good idea to use a strong sedation when there is cosmetic work involved, unless the patient is highly anxious. If that is what you are dealing with it is in both your and the dentist’s best interest to try you in provisionals for a while to ensure that you are satisfied with them, while you are in the best possible state of mind.

I’m also a tad curious about his choice of zirconia crowns for front teeth. These come in blocks and are milled into the shape needed for the tooth. Unfortunately, this has a very flat appearance. A wise cosmetic dentist would put a layer of porcelain on top of the zirconia. Porcelain can be done in varying levels of translucency which more mimics your natural tooth structure.

The best way to get a refund from one dentist is to get another one on your side. Often when a dentist won’t listen to a dentist they will listen to a peer. My first recommendation is for you to get a skilled cosmetic dentist, preferably an AACD accredited dentist, to look at them and share their opinion about the appearance. There are some more tips that you can find here.

I also think the dentist who referred you has some responsibility to make this right as well. If your teeth look bad, he or she could pressure the dentist into replacing them. After all, much of his patients will come from referrals. He should want to make sure your dentist is comfortable recommending him.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.