Prev: Wholeflaffers = Dr Richard X. Frager, Verdict: LIAR!
Next: science-med-dentistry---
From: a_riot on 2 Aug 2008 15:12
Hi,
I am wondering if I might get some perspective from others on a dental
issue I am having.
I went to a few dentists to get quotes and treatment plans to have
some silver fillings replaced after moving to a new city. After
seeing 4-5 dentists I selected one and made the appropriate
appointments. The first appointment scheduled was for a complete
occlusal adjustment (I was unfamilar with this term).

I had mentioned to the dentist on my consult appointment that I had no
TMJ symptoms at all, in fact I liked my bite, and only wanted the
fillings replaced. He told me the adjustment was so that the
restorations he was going to put in wouldn't get damaged and was just
a minor sanding down where there was some wear marks so I didn't think
much of it. After the appointment though, I realized to my horror
that he completely sanded down all the molars top and bottom. Now the
molars don't touch so I have no support for my jaw, my lower front
teeth keep hitting my upper front teeth causing a lot of pain, my
entire bite has been completely altered and my mouth is basically
dysfunctional now. I am now getting TMJ symptoms and apnea after
never having them before, and eating, talking, smiling, and just
resting my jaw causes pain and discomfort. He essentially changed my
head anatomy in one 30 minute procedure. This was all because I had a
supposed slide, which if true, was completely asymptomatic.

I never consented to this radical procedure and have only found out
afterwards that the dentist unilaterly decided to change my bite to
what he thought would be an optimal "canine rise". I recall him
mentioning a "canine rise" to me at the consult but dismissed it as my
bite had no problems after 35 years of bite development, and I made
sure to mention this to him.

I am furious that this was done to me without my premission and now
need to get my bite fixed along with the original dental filling
replacement. I am not a lawyer but it would appear to me to be a case
of dental malpractice, in that informed consent was not obtained, and
then the procedure was done so incompetently that it has resulted in
much pain and discomfort requiring a splint just to get my jaw into a
comfortable position.

Any suggestions as to how to proceed with this? I have seen a TMJ
specialist and am continuing to interview dentists to find one that
can rebuild my bite and replace the fillings. Would it be worth
pursuing a claim against this dentist to pay for all this work now
that I am having to pay for? Every dentist I have spoken to just
shook their head in disgust when I tell them what happened so it would
seem to me that some restitution should be paid for this. Any one
have any suggestions as to how to proceed to get a successful outcome
in a situation like this?
From: Steven Bornfeld on 2 Aug 2008 23:23
a_riot wrote:
> Hi,
> I am wondering if I might get some perspective from others on a dental
> issue I am having.
> I went to a few dentists to get quotes and treatment plans to have
> some silver fillings replaced after moving to a new city. After
> seeing 4-5 dentists I selected one and made the appropriate
> appointments. The first appointment scheduled was for a complete
> occlusal adjustment (I was unfamilar with this term).
>
> I had mentioned to the dentist on my consult appointment that I had no
> TMJ symptoms at all, in fact I liked my bite, and only wanted the
> fillings replaced. He told me the adjustment was so that the
> restorations he was going to put in wouldn't get damaged and was just
> a minor sanding down where there was some wear marks so I didn't think
> much of it. After the appointment though, I realized to my horror
> that he completely sanded down all the molars top and bottom. Now the
> molars don't touch so I have no support for my jaw, my lower front
> teeth keep hitting my upper front teeth causing a lot of pain, my
> entire bite has been completely altered and my mouth is basically
> dysfunctional now. I am now getting TMJ symptoms and apnea after
> never having them before, and eating, talking, smiling, and just
> resting my jaw causes pain and discomfort. He essentially changed my
> head anatomy in one 30 minute procedure. This was all because I had a
> supposed slide, which if true, was completely asymptomatic.
>
> I never consented to this radical procedure and have only found out
> afterwards that the dentist unilaterly decided to change my bite to
> what he thought would be an optimal "canine rise". I recall him
> mentioning a "canine rise" to me at the consult but dismissed it as my
> bite had no problems after 35 years of bite development, and I made
> sure to mention this to him.
>
> I am furious that this was done to me without my premission and now
> need to get my bite fixed along with the original dental filling
> replacement. I am not a lawyer but it would appear to me to be a case
> of dental malpractice, in that informed consent was not obtained, and
> then the procedure was done so incompetently that it has resulted in
> much pain and discomfort requiring a splint just to get my jaw into a
> comfortable position.
>
> Any suggestions as to how to proceed with this? I have seen a TMJ
> specialist and am continuing to interview dentists to find one that
> can rebuild my bite and replace the fillings. Would it be worth
> pursuing a claim against this dentist to pay for all this work now
> that I am having to pay for? Every dentist I have spoken to just
> shook their head in disgust when I tell them what happened so it would
> seem to me that some restitution should be paid for this. Any one
> have any suggestions as to how to proceed to get a successful outcome
> in a situation like this?



There is no way to say what appropriate action is. You may or may not
have gotten informed consent. Of course if he was dishonest with his
description of the procedure it could be said that he did not obtain
informed consent. OTOH, how long were you sitting in that chair for him
to grind down all your molars before you began to get the suspicion that
something was amiss? Did he anesthetize all your teeth? Were you in pain?
Where I'm going with this is that the question of whether you granted
implied consent is very much up in the air.
What is not in the air is the condition of your teeth. You say you
have spoken to more than one dentist. Have they examined you? What do
they suggest?

Steve
From: a_riot on 3 Aug 2008 15:44
On Aug 2, 8:23 pm, Steven Bornfeld <dentaltwinm...(a)earthlink.net>
wrote:

>         There is no way to say what appropriate action is.  You may or may not
> have gotten informed consent.  Of course if he was dishonest with his
> description of the procedure it could be said that he did not obtain
> informed consent.  OTOH, how long were you sitting in that chair for him
> to grind down all your molars before you began to get the suspicion that
> something was amiss?  Did he anesthetize all your teeth?  Were you in pain?
>         Where I'm going with this is that the question of whether you granted
> implied consent is very much up in the air.
>         What is not in the air is the condition of your teeth.  You say you
> have spoken to more than one dentist.  Have they examined you?  What do
> they suggest?
>
> Steve

Thanks for your response Steve. I realize this situation may make me
look a little daft to put myself in this position but at some point
you have to trust that what the dentist tells you is the truth
otherwise you would never let anyone work on you.

I was in the chair for about 20-30 minutes, not all of which was
sanding of course, as he spent time putting paper between my molars
and asking me to clench my teeth. There was no pain or sensation at
all and no anesthetic was used. My teeth are not particularly
sensitive so I couldn't even feel the grinding, I could just see and
smell the enamel flying out of my mouth but had no way to determine
how much was being removed (note to self, always demand a mirror to
watch the entire procedure). I have now been examined by two other
dentists, one that says he specializes in occlusion and a TMJ
specialist and both are rather astounded that a dentist would go in
and remove a lot of cusp material in an asymptomatic patient with no
preparation such as casts, scans, measurements or even a simple wax
imprint of my bite, in preparation to change some fillings. Seems
like a 'scorched earth' dental policy, far beyond what was
necessary.

From my understanding now, the theory that the bite should conform to
the "canine rise" has been out of date for a number of years, and
having this bite thrust upon me when I had no desire to change my bite
seems like battery to me. The TMJ dentist speculated that it looks as
though he equilibrated my teeth while I was reclining in the dentist
chair so that when he looked at my bite during the procedure, my jaw
was too far back due to being in a reclined position, so he
accidentally gave me this weird bite where my lower jaw has to be all
the way back for my anterior teeth to not crash. When I sneeze, my
lower anterior teeth just smash into the upper anterior teeth with a
lot of force causing pain. There are so many different problems now,
that I am not sure if he could have done a worse job on purpose.
Since I can't feel the molars touch now, it feels like I have had them
all extracted. I can't chew my food correctly either since most of
the chewing has to be done by the anterior teeth but they are now
crashing. This must be what a cat feels like after its been declawed.

As far as consent is concerned, I told him that I never have had any
TMJ symptoms during the initial consult and that I like my bite even
if it doesn't conform to some theoretical dental ideal. He then
justified the procedure stating that he needed to remove a very minor
amount of enamel so that the restorations wouldn't get damaged once
they were in. "You don't want to have to pay for restorations all
over again in a couple years do you?" he asked. Any patient hearing
this would not suspect that this procedure would result in a complete
anatomical change in my bite and jaw geometry. I wasn't informed of
any risk (TMJ symptoms), alternative procedures (nightguard, splints
etc), or referred to a specialist (prosthodontist).

In fact while he was doing the procedure, he sensed I was somewhat
worried since I joked about trying to level a table with a saw, and
that we all know how that ends. He reassured me by telling me some
stupid story about a steamboat engine repairman who charged $1000 to
repair the engine. When he showed up he just hit the engine with a
hammer in a certain place which fixed it. The owner complained about
the high fee for such a simple repair, to which he replied that yes
its easy to fix but you have to know exactly where to hit it. I
suspect this analogy was meant to assure me that the $500 fee for 20
minutes of work was justified because of his extensive knowledge about
where and how much to remove. When I went back to his office a week
later, I challenged him and asked him what training he had in this
procedure. He just said "35 years experience". I pressed him and
asked if he had any training at an accredited dental institution to
which he just said "yes, a lot of training". It seemed like a dodge
to me, so I am guessing his "training" consisted of trial and error on
many patients over the years.

When I think back to other dental work that I have had which only
consisted of mercury fillings and one crown to replace an old mercury
filling, my occlusion must have been slightly altered every time
something was done, but I actually never noticed as I think my mouth/
jaw has been pretty adaptable to small changes. That's what makes me
think he did a real hatchet job since in the past I have never had a
problem with some minor occlusal adjustment. I now feel like I have
someone else's mouth like I had submitted to some strange plastic
surgery where they did a jaw transplant.

This cannot be what a successful complete occlusal adjustment feels
like.
Your perspective is appreciated.

From: Amatus Cremona on 3 Aug 2008 19:17
I don't know. I read the OP and wonder.

The description of the change is not consistent with an equilibration. It
is consistent with joint inflammation pushing the posterior teeth apart, or
spasms of certain muscle groups resulting in the mandible being shifted
forward.

Equilibration does flatten back teeth. No arguing there. However, in the
absence of full orthodontics, it is "sometimes" needed. Personally, I never
to an equilibration without placing the patient in an NTI first.

To have a malpractice case, the OP would need to prove that the jaw was
different before the procedure (photos or models).

A poorly done equilibration will not create pain and symptoms of "TMD"
without some underlying muscle spasm. That muscle spasm is not initiated by
the equilibration. Odds are, the extra time of having the mouth open was
just the "straw that broke the camel's back". The next small filling, large
series of yawns, eating a jaw breaker, providing certain types of "personal
favors", etc., would probably have caused the same symptoms.

AC


"Steven Bornfeld" <dentaltwinmung(a)earthlink.net> wrote in message
news:J4Cdnb1ZQcsKuQjVnZ2dnUVZ_jednZ2d(a)earthlink.com...
> a_riot wrote:
>> Hi,
>> I am wondering if I might get some perspective from others on a dental
>> issue I am having.
>> I went to a few dentists to get quotes and treatment plans to have
>> some silver fillings replaced after moving to a new city. After
>> seeing 4-5 dentists I selected one and made the appropriate
>> appointments. The first appointment scheduled was for a complete
>> occlusal adjustment (I was unfamilar with this term).
>>
>> I had mentioned to the dentist on my consult appointment that I had no
>> TMJ symptoms at all, in fact I liked my bite, and only wanted the
>> fillings replaced. He told me the adjustment was so that the
>> restorations he was going to put in wouldn't get damaged and was just
>> a minor sanding down where there was some wear marks so I didn't think
>> much of it. After the appointment though, I realized to my horror
>> that he completely sanded down all the molars top and bottom. Now the
>> molars don't touch so I have no support for my jaw, my lower front
>> teeth keep hitting my upper front teeth causing a lot of pain, my
>> entire bite has been completely altered and my mouth is basically
>> dysfunctional now. I am now getting TMJ symptoms and apnea after
>> never having them before, and eating, talking, smiling, and just
>> resting my jaw causes pain and discomfort. He essentially changed my
>> head anatomy in one 30 minute procedure. This was all because I had a
>> supposed slide, which if true, was completely asymptomatic.
>>
>> I never consented to this radical procedure and have only found out
>> afterwards that the dentist unilaterly decided to change my bite to
>> what he thought would be an optimal "canine rise". I recall him
>> mentioning a "canine rise" to me at the consult but dismissed it as my
>> bite had no problems after 35 years of bite development, and I made
>> sure to mention this to him.
>>
>> I am furious that this was done to me without my premission and now
>> need to get my bite fixed along with the original dental filling
>> replacement. I am not a lawyer but it would appear to me to be a case
>> of dental malpractice, in that informed consent was not obtained, and
>> then the procedure was done so incompetently that it has resulted in
>> much pain and discomfort requiring a splint just to get my jaw into a
>> comfortable position.
>>
>> Any suggestions as to how to proceed with this? I have seen a TMJ
>> specialist and am continuing to interview dentists to find one that
>> can rebuild my bite and replace the fillings. Would it be worth
>> pursuing a claim against this dentist to pay for all this work now
>> that I am having to pay for? Every dentist I have spoken to just
>> shook their head in disgust when I tell them what happened so it would
>> seem to me that some restitution should be paid for this. Any one
>> have any suggestions as to how to proceed to get a successful outcome
>> in a situation like this?
>
>
>
> There is no way to say what appropriate action is. You may or may not
> have gotten informed consent. Of course if he was dishonest with his
> description of the procedure it could be said that he did not obtain
> informed consent. OTOH, how long were you sitting in that chair for him
> to grind down all your molars before you began to get the suspicion that
> something was amiss? Did he anesthetize all your teeth? Were you in
> pain?
> Where I'm going with this is that the question of whether you granted
> implied consent is very much up in the air.
> What is not in the air is the condition of your teeth. You say you have
> spoken to more than one dentist. Have they examined you? What do they
> suggest?
>
> Steve


From: Steven Bornfeld on 3 Aug 2008 20:45
Amatus Cremona wrote:
> I don't know. I read the OP and wonder.

Just speculating. OP states he has talked with other dentists, but has
not reported any findings.
Sure, extended opening could have set him up for muscle spasm.

Steve
>
> The description of the change is not consistent with an equilibration. It
> is consistent with joint inflammation pushing the posterior teeth apart, or
> spasms of certain muscle groups resulting in the mandible being shifted
> forward.
>
> Equilibration does flatten back teeth. No arguing there. However, in the
> absence of full orthodontics, it is "sometimes" needed. Personally, I never
> to an equilibration without placing the patient in an NTI first.
>
> To have a malpractice case, the OP would need to prove that the jaw was
> different before the procedure (photos or models).
>
> A poorly done equilibration will not create pain and symptoms of "TMD"
> without some underlying muscle spasm. That muscle spasm is not initiated by
> the equilibration. Odds are, the extra time of having the mouth open was
> just the "straw that broke the camel's back". The next small filling, large
> series of yawns, eating a jaw breaker, providing certain types of "personal
> favors", etc., would probably have caused the same symptoms.
>
> AC
>
>
> "Steven Bornfeld" <dentaltwinmung(a)earthlink.net> wrote in message
> news:J4Cdnb1ZQcsKuQjVnZ2dnUVZ_jednZ2d(a)earthlink.com...
>> a_riot wrote:
>>> Hi,
>>> I am wondering if I might get some perspective from others on a dental
>>> issue I am having.
>>> I went to a few dentists to get quotes and treatment plans to have
>>> some silver fillings replaced after moving to a new city. After
>>> seeing 4-5 dentists I selected one and made the appropriate
>>> appointments. The first appointment scheduled was for a complete
>>> occlusal adjustment (I was unfamilar with this term).
>>>
>>> I had mentioned to the dentist on my consult appointment that I had no
>>> TMJ symptoms at all, in fact I liked my bite, and only wanted the
>>> fillings replaced. He told me the adjustment was so that the
>>> restorations he was going to put in wouldn't get damaged and was just
>>> a minor sanding down where there was some wear marks so I didn't think
>>> much of it. After the appointment though, I realized to my horror
>>> that he completely sanded down all the molars top and bottom. Now the
>>> molars don't touch so I have no support for my jaw, my lower front
>>> teeth keep hitting my upper front teeth causing a lot of pain, my
>>> entire bite has been completely altered and my mouth is basically
>>> dysfunctional now. I am now getting TMJ symptoms and apnea after
>>> never having them before, and eating, talking, smiling, and just
>>> resting my jaw causes pain and discomfort. He essentially changed my
>>> head anatomy in one 30 minute procedure. This was all because I had a
>>> supposed slide, which if true, was completely asymptomatic.
>>>
>>> I never consented to this radical procedure and have only found out
>>> afterwards that the dentist unilaterly decided to change my bite to
>>> what he thought would be an optimal "canine rise". I recall him
>>> mentioning a "canine rise" to me at the consult but dismissed it as my
>>> bite had no problems after 35 years of bite development, and I made
>>> sure to mention this to him.
>>>
>>> I am furious that this was done to me without my premission and now
>>> need to get my bite fixed along with the original dental filling
>>> replacement. I am not a lawyer but it would appear to me to be a case
>>> of dental malpractice, in that informed consent was not obtained, and
>>> then the procedure was done so incompetently that it has resulted in
>>> much pain and discomfort requiring a splint just to get my jaw into a
>>> comfortable position.
>>>
>>> Any suggestions as to how to proceed with this? I have seen a TMJ
>>> specialist and am continuing to interview dentists to find one that
>>> can rebuild my bite and replace the fillings. Would it be worth
>>> pursuing a claim against this dentist to pay for all this work now
>>> that I am having to pay for? Every dentist I have spoken to just
>>> shook their head in disgust when I tell them what happened so it would
>>> seem to me that some restitution should be paid for this. Any one
>>> have any suggestions as to how to proceed to get a successful outcome
>>> in a situation like this?
>>
>>
>> There is no way to say what appropriate action is. You may or may not
>> have gotten informed consent. Of course if he was dishonest with his
>> description of the procedure it could be said that he did not obtain
>> informed consent. OTOH, how long were you sitting in that chair for him
>> to grind down all your molars before you began to get the suspicion that
>> something was amiss? Did he anesthetize all your teeth? Were you in
>> pain?
>> Where I'm going with this is that the question of whether you granted
>> implied consent is very much up in the air.
>> What is not in the air is the condition of your teeth. You say you have
>> spoken to more than one dentist. Have they examined you? What do they
>> suggest?
>>
>> Steve
>
>
 |  Next  |  Last
Pages: 1 2
Prev: Wholeflaffers = Dr Richard X. Frager, Verdict: LIAR!
Next: science-med-dentistry---