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Ask Mark Bornfeld, DDS Your Own Question
Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5995
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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I have questions about a bridge and crown I'm in the process

Customer Question

I have questions about a bridge and crown I'm in the process of getting done - for the last 2 months now.
Submitted: 1 year ago.
Category: Dental
Expert:  Mark Bornfeld, DDS replied 1 year ago.

Sure-- shoot...

Customer: replied 1 year ago.
Ok. Thanks.Thanking you in advance for your expertise and advice. The background of my tooth situation is a little long, however, it is leading to my 3 questions at the end.6/18/15: Tooth ExtractionJuly 15, 2015: 9:00 am: I made my decision to go ahead and get the bridge on my lower left side. I was originally given a treatment plan for a 3 point bridge, however, at this appointment, Dr. Hedgepeth looked at the x-rays while I was sitting in the chair expecting to have a 3 point bridge done – he said it has to be a 5 point bridge, that he would have to file down a third tooth toward the front – my canine tooth, which was a perfectly healthy tooth with a very small filling in it. Dr. Hedgepeth said he learned in dental school that it would have to be a 5 point bridge because it has to support 2 false teeth (pontics) due to the wider space from when I also had a tooth pulled on that side when I had braces. I let him proceed with drilling down the teeth and the Dental Assistant, Ramona, took Impressions and made a temporary bridge.Bridge:
Crown – Porcelain fused Tooth #18
Pontic – Porcelain fused Tooth #19
Pontic – Porcelain fused Tooth #20
Crown – Porcelain fused Tooth #21
Crown – Porcelain fused Tooth #22As soon as the dental assistant placed the temporary bridge – I immediately felt pressure on my 2 front teeth that were connected together with the temporary bridge. The pressure felt like the pain I used to feel when they tightened my braces when I was younger. It felt like a vice was placed on my teeth. Dr. Hedgepeth said he wasn’t concerned with that, that the pain I’m feeling would go away – that I’ll get used to it.July 16, 2015: The next day, I called Dr. Hedgepeth’s office and asked to come in to have the 2 front teeth separated as my tooth was throbbing, and it kept me awake all night. Dr. Hedgepeth was not happy with my request. I advised him I cannot afford to be in pain as it affects me in my job where I need to be smiling and happy. I told him I prefer to forget about the bridge since it cannot be done correctly as a 5 point bridge, and to just replace it with 3 separate crowns.The Dental Assistant separated the 2 front teeth and made a temporary bridge for 2 teeth and a single temporary crown for the canine tooth. Dr. Hedgepeth called me the next morning to see how I was doing. I said better and requested again to have the 3 separate crowns versus the bridge. Dr. Hedgepeth informed me that he tries to listen to his patients, but that he’s a little bit of a hard head.He did tell me he can make it work with a 4 point bridge with adjustments versus the 3 separate crowns I was requesting. Dr. Hedgepeth also told me he would call the lab when he got off the phone with me to have the lab separate the canine tooth from the rest of the bridge.8/4/15: I want in for my appointment as the bridge was in. As soon as he placed the new bridge on my teeth, I immediately felt that pressure I felt last time he placed the temporary bridge on. I said: I thought you told the lab to separate the canine tooth from the rest of the bridge. Dr. Hedgepeth advised me that he was taught in dental school that it had to be the 5 point bridge due to the larger space from 2 missing teeth. Dr. Hedgepeth said I would get used to the pain – and that the pain would go away. Upon leaving, I told the Dental Receptionist that I was in a lot of pain and that if the pain is not gone by tomorrow morning – that I want this bridge removed! I was very upset that Dr. Hedgepeth had lied to me and did not fulfill my request to have the canine tooth separated from the rest of the bridge. Now I have to wait another two weeks.8/5/15: The next day, I was still in pain and called to come in to have the temporaries put back on. They placed the temporary bridge and temporary canine crown back on and said it would be another 2 weeks for the bridge to come back with the canine separated from the bridge. During this whole time – I was also having intermittent pain with the bridge part that was still connected. At each visit, I kept requesting 3 separate crowns versus going ahead with the bridge.Dr. Hedgepeth also made the following unprofessional comments to me over the last month: 1) I’m not worried about that (talking about the pressure/pain I’m feeling) 2) It’s all in my head 3) You’ll get used to it (the pressure I was feeling), , 4) He also said: I don’t like the way you said that. You’re going to ruin my reputation now, 5) You’re an unusual case. I’m going to submit your case to the dental board and put in the dental textbooks 7) He also said: You have issues, I have issues too – he said this at my next appointment while making adjustments on 8/20/15 8) he said he’s a perfectionist – a crazy dentist.8/20/15: Appointment for real bridge with canine crown separated this time. He placed the bridge and canine crown in my mouth and said to his dental assistant,
Customer: replied 1 year ago.
8/20/15: Appointment for real bridge with canine crown separated this time. He placed the bridge and canine crown in my mouth and said to his dental assistant, Ramona, that the bridge isn’t right. He said he doesn’t like the looks of it, that it’s not right (How come it was right 2 weeks ago when it came in not separated – no adjustments had to be made then) He said it came from the lab with instructions to make adjustments. He proceeded to file down 2 of my perfectly fine upper teeth. I was hesitant to let him do it. He said it would just be a couple millimeters and that it was needed to fix the bridge. This is when he made the above-mentioned comment that I have issues, well, he has issues to. He said he was a perfectionist – a crazy dentist – he called himself. So now they placed the temporaries back on.9/10/15: Had real bridge and separated canine crown placed on my teeth, and Dr. Hedgepeth made some adjustments on the actual bridge and canine crown. Dr. Hedgepeth then left the room, and the Dental Assistant, Ramona, used the temporary cement at my request to place the bridge and canine crown on my teeth. I was in pain again – I felt the pressure (tightness) with the temporary cement and bridge and canine crown. Ramona walked me out to the Reception area telling me the pain and pressure will go away. This was approximately 9:15 am, and I was still feeling the pressure and pain later that afternoon. Ramona had said she would try to call me to see how I was feeling later and she never did. I then called and left a message at Coast Dental for them to call me, and they never called me back.9/11/15: I went to another Dentist for a second opinion on my bridge/crown process I’ve been going through. I was willing to pay him $65 cash for his advice. He said he didn’t know what Dr. Hedgepeth was thinking when he went ahead with the 4 point crown. He also stated he didn’t like the way the canine crown was. He also mentioned that he does things differently and that he uses different labs. He came highly recommend by my friend as well as a lot of excellent online reviews. He recommended I go back to my dentist and have him have the lab cut the bridge into the three separate crowns for me and see how I feel. He had tapped on my teeth and discovered nerve pain on my back molar. He stated when I get the bridge removed and have the 3 separate crowns – if I then feel better, it was the bridge causing the pain. If I still have pain – then it is nerve pain from the back molar, and I may need a root canal if it gets worse.9/14/15: It is now 3:44 am on Monday, 9/14/15, and I am typing this bridge process I’m going through now because I can’t sleep again due to the throbbing pain and overall dull ache. Tonight is the worst.I will not go back to Dr. Hedgepeth. I enrolled in a new insurance plan which starts October 1st, and I want to go to a new dentist to get the 3 separate crowns and see how I feel. I am willing to pay cash now at a new dentist for relief.I have 3 questions:1) What is the best way to proceed to replace this bridge and canine crown? The second opinion dentist didn’t like the way the canine crown is made, and I noticed that the lower canine now scrapes against my upper tooth when I am waking up in the mornings. I also see that the canine crown looks like it is overlapping part of the front tooth next to it.2) Do they remove the bridge and canine crown and then take impressions (a mold) to make the temporary crowns, or do they take impressions with the bridge and incorrect canine crown in place? The bridge and canine crown are cemented with Temporary Cement.3) Is it best to have them send the already-made bridge and canine crown back to the labs to have 3 separate crowns made out of them or have 3 new crowns made? I’m concerned that this canine crown is not done correctly either.
Customer: replied 1 year ago.
I look forward to your reply.
Expert:  Mark Bornfeld, DDS replied 1 year ago.

I regret that I cannot provide answers to the questions you pose, because rational and accurate answers require access to your diagnostic record, which is unavailable in this forum. I suspect that your initial premise-- that pressure from the connection between the abutment crowns is to blame for your tooth pain-- is not quite accurate. Your comparison to the tightening of an orthodontic appliance is apt: although pressure can induce short-term pain, any pain from pressure on the teeth due to change in lateral forces resolves within a few days, and would not account for the persistence of your pain. In short, there is/are other factors involved-- either periodontal, endodontic (i.e., in the pulp of one or more of the prepared teeth), or occlusal (due to issues with the bite. The source of the problem must be identified before further action is taken, because the nature of the appropriate action depends entirely upon that diagnosis. I would encourage you to seek consultation with a specialist-- preferably one recommended by the dentist who fabricated the bridge, because it is unlikely that other dentists will assume liability for issues created by a bridge made by another dentist.

Good luck!

Customer: replied 1 year ago.
Ok Thanks for your time.