Hi Didi,

Sorry for the delay in replying, I was away for a few days.

I am not familiar with the term "cant". Are you sure you have this term correct? Did he say slant??

There are ways to compensate for a slanted smile. But the treatment depends on why it's slanted to begin with.

Some reasons for a slanted smile:
1) The jawline could be slanted yet the roots of the teeth are really all the same size. This would appear in the mouth as if some of the teeth were embedded in the gumline more than others. When it's actually the jawline itself is not symetrical.

2)The gumline has either overgrown some of the teeth for some reason and these teeth appear shorter or not in line or the gum has receeded with some of the teeth and these teeth appear to be longer or not in line with the others.

3) Crooked teeth or an over bite can cause the teeth to look out of line or slanted.

4)Teeth that have unnatural wear patterns on the biting surfaces due to malocclusion (uncorrected bite issues) will look out of line or slanted.

5) Periodontal disease can also affect the appearance of the teeth as some teeth can drift downward from the gumline as the bone deteriorates. This makes other teeth look shorter and out of sync with the rest of the smile.

Sometimes there is not much that can be done to correct what we were born with as far as our skeletal system unless we undergo invasive or major cosmetic recontouring.

The first dentist was able to make your bite look cosmetically appealing where as the second dentist was not able to do that same thing. Again, there are many reasons why this could occur and it may or may not be fixable to your liking.

Please keep in mind that the more you alter these teeth with new crownwork, the more likely they are to die and require either root canals or extractions. Root canals are not a healthy long term fix by any means. It is just a temporary procedure which will need to be readdressed in a uncertain amount of time.

The least invasive corrections are best as far as the health of these teeth.

Please let us know what you hear from your correspondence with the dentist and update us on your appointment in July. If you find out what that word was that he used, let me know....... I'll try to help you with it!

Bryanna

Thank you Bryanna, I will keep you posted on the outcome of my visit with the prosthodontist and also what comes of the certified letter that I am sending today. I greatly appreciate your prompt and thorough replies. You have been a storehouse of unbiased information. I don't know what I would do without your advice! Thanks again, Didi

Hi Bryanna,

Well I finally sent a certified letter to the dental office and got immediate replies from both dentists, both the owner of the practive and the dentist who did the work. They are now working on determining what amount they will refund to me and how they will refund my insurance companies. They told me my coverage for 2007 will be lost once they reimburse the insurance companies. I told them that this is unacceptable to me and that I need full reimbursement as the cost to fix this will be exorbitant. I have contacted a couple of attornies and am thinking of filing suit. It may cost a lot out of pocket but the end result may be worth it if I can rectify the pain and unsightly work. I told one attorney that I had gotten a great deal of support and objective information online regarding my case. He asked if the person I was consulting with was a dentist and I said I didnt' know. He said it would be of great benefit to me if you were a dentist. Bryanna, you are a great source of information regardless of your credentials. I can tell you have volumes of information....if you are not a certified dentist that does not matter to me. I hope you will continue to provide your opinion.

The attorney I spoke with this a.m. indicated that if the dentist who perfomed the emergency root canal would be willing to state that my situation was due to malpractice, he would take my case. Basically, I need someone to look at my mouth to verify that the work is unacceptable. Hopefully, someone in the dental community will not be afraid to do so. Thanks again Bryanna for everything. I will keep you posted. Didi

Hi Didi,

I am not surprised that both dentists have contacted you. A certified letter from a dissatisfied patient who had extensive dental work like you did, always gets their attention. They would be fools not to respond to you!

As for working on how much they owe you........... usually the dentist will try to negotiate what "they" feel is a fair amount which will take into consideration their lab fees and/or chair time. You certainly don't have to agree to that, it's up to you.

As for your 2007 insurance coverage, it will be lost at this point simply because the year is over. They are going to have alot of explaining to do if they reimburse the insurance company which could send up a red flag for them to be audited by the insurance company. That can get very messy for them if they have other cases like yours.

As for suing them........ it may cost you more than it's worth and I'll tell you why. In all probability your dental treatment will be considered within the acceptable range of what is called "standard of care". This means that if your dental work was done according to the textbook, then they will not be found at fault and you could be reimbursed nothing. It is almost impossible to prove that it was done with any diversion from that "standard of care" because it is acceptable to grind down teeth to put crowns on them and it is acceptable to alter a patients bite when trying to correct an overbite/underbite. Some dentists are more conservative than others and that too is acceptable. You would have to prove that your teeth were ground down excessively by "this dentist" and not the first one. Unless you have models of your teeth showing that stage of the work, there is no proof that she was the one who severely ground them down. It is very common for teeth that have been filed down in preparation for crowns to die and end up either root canaled or extracted. I think I may have mentioned that to you when you were considering have the crowns done a third time. So the root canals are typically seen in teeth that have crowns. The veneered teeth could have had problems prior to her work that you were unaware of and again, there is no way to prove that they were completely healthy. Radiographs will tell some of the story, but it will be her clinical notes that they will take into account in a lawsuit.

Getting a dentist to go against his peers is going to be nearly impossible. They just don't do it. Dentistry is not an exact science and flaws can be covered up very easily. So no one wants to get involved in a case that they didn't see from the onset. You can go to 10 different dentists and chances are you will get at least that many different opinions. They all have their own way of diagnosing and treatment planning.

Your best bet may be to get as much reimbursement as you can from that office and consider putting in a formal complaint to the state dental board and let them rattle their cage a bit. I've seen your situation so many times....... rarely does a patient win a lawsuit unless they were physically mamed or permanently disfigured for life and the case can literally go on for years. Your smile can be altered, not necessarily to your liking or without a huge risk, but it can be changed so it is not considered a form of disfigurement.

To answer your question about my credentials....... no I am not a dentist. I am a state certified chairside assistant and xray radiographer. I have over 30 years of vast experience in this field and that is where I have learned so much!

Didi, I don't mean to sound negative. I am just telling you like it is and hope that you consider all of your legal options at this point before you make any further decisions. I also cannot urge you enough to seriously reconsider redoing your crowns a third time. The teeth have been through so much trauma already and it is very risky to drill them again. Also at this point there may not be much that can be done to drastically improve them. The end result may not be any better and the teeth could all end up with irreversible pulpitis which would mean root canals and/or extractions. Please weigh the risks before undergoing another revision.

I wish you all the best!! Keep us posted on how things are going!!

Bryanna ~'.'~







QUOTE=Didi;327981]Hi Bryanna,

Well I finally sent a certified letter to the dental office and got immediate replies from both dentists, both the owner of the practive and the dentist who did the work. They are now working on determining what amount they will refund to me and how they will refund my insurance companies. They told me my coverage for 2007 will be lost once they reimburse the insurance companies. I told them that this is unacceptable to me and that I need full reimbursement as the cost to fix this will be exorbitant. I have contacted a couple of attornies and am thinking of filing suit. It may cost a lot out of pocket but the end result may be worth it if I can rectify the pain and unsightly work. I told one attorney that I had gotten a great deal of support and objective information online regarding my case. He asked if the person I was consulting with was a dentist and I said I didnt' know. He said it would be of great benefit to me if you were a dentist. Bryanna, you are a great source of information regardless of your credentials. I can tell you have volumes of information....if you are not a certified dentist that does not matter to me. I hope you will continue to provide your opinion.

The attorney I spoke with this a.m. indicated that if the dentist who perfomed the emergency root canal would be willing to state that my situation was due to malpractice, he would take my case. Basically, I need someone to look at my mouth to verify that the work is unacceptable. Hopefully, someone in the dental community will not be afraid to do so. Thanks again Bryanna for everything. I will keep you posted. Didi[/QUOTE]