Question on liability when a hygienist chips a crown.

[PurplePeopleEater1]

If a hygienist chips a 20 year old #8 porcelain only crown during a cleaning, verified with before & after x-rays, is that office liable for repair/replacement? Even if they were not the ones to do the original work? Chip would be at the gum line where it was previously filled due to gum recession, again, not by this office, and approx 15+ years ago (for filling).

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[ysrebob]

I would replace the fill at no charge, as a good will thing since it happened in the office. Really, though, the bond for the old Class V fill was probably getting pretty weak after 15 years... dentin bonding isn’t good forever.

 

[siliso]

If you fender-bended an 87 Chevy I suppose you’d still need to replace that decrepit fender. You probably can’t total a tooth so not a perfect comparison.

 

[PurplePeopleEater1]

I would replace the fill at no charge, as a good will thing since it happened in the office. Really, though, the bond for the old Class V fill was probably getting pretty weak after 15 years... dentin bonding isn’t good forever.

They say they can't fill a porcelain crown. Which I know is BS because it's been done before. And insist on the purchase of a new one, at our expense. To me, this is unethical.

 

[ysrebob]

Oh, I didn't realize you are asking as a patient vs as a dentist. You really should seek a 2d opinion locally rather than post on a national student forum. Close thread?

But for the record: patching the margin of a crown is often done but is "less than ideal" dentistry, so it's not surprising that the old patch eventually failed. Porcelain can be bonded (for a patch) but the bond is weak. If the chip runs obliquely further across the face of the crown than before, patching it again may not be a realistic option. It's worth noting again that the crown/old patch were likely already well along the road to failing, and your cleaning just happened to be the last straw. I do understand your frustration but IMO there's been no mistreatment and no true liability on their part -- it would however be a nice gesture if they would redo the patch for free for you if it's technically possible. It doesn't seem fair to expect them to remake the crown at no charge. Making a new crown 15 years ago (vs patching) would have been ideal treatment.

 

[Endeross]

If a hygienist chips a 20 year old #8 porcelain only crown during a cleaning, verified with before & after x-rays, is that office liable for repair/replacement? Even if they were not the ones to do the original work? Chip would be at the gum line where it was previously filled due to gum recession, again, not by this office, and approx 15+ years ago (for filling).

Id prob fix a small chip (if possible) at cost or free depending on how it was pre-cleaning. If it needs a new crown due to various things and cant/shouldnt be booboo fixed any more with a small fill Id charge. Sounds like the structure was weakened or compromised already so without seeing it in person and before treatment id side with them over you and say the dentist is prob in the right on this and has the right to charge for it. Just because 15 years ago it was ok, doesnt mean nothing changed, or perhaps the dentist doesnt want to do sub par treatment. Fillings with composite often need refilling after 15 years anyway. The car analogy kind of works but id rather compare it to chipping paint, its oxidized and peeling off and you want the auto carwash joint to repaint your car cuz some came off while a squeegee was running over it? lots of unknowns from this story.

 

[DrJeff]

Question #1.... Do you want to retain the patient or not??? If the answer is yes, then you take care of it. Whether that means replacing the filling at no charge or say making a new crown for the patient at say half price, that's what I'd do if I wanted to keep that patient.. If the answer is no, then tell the patient that they're going to be responsible for the full fee of a new crown, plus the fee of their cleaning and your exam. Chances are they'll be leaving your practice real soon, as well as bad mouthing you to their friends..... Regardless of the fact that the honest reality is that restoration was failing before the hygienist touched it, and in reality since it was failing the hygienist likely did the patient a service is getting that failing area addressed before more harm to any surrounding currently healthy tooth structure could happen.... It doesn't matter to the patient that you didn't place that restoration, in their eyes, you, or in this case a person you're responsible for, "broke" that filling....

Question #2.... Do you want to retain the patient or not????

 

[lemoncurry]

one of the problems of bonding to porcelain is the use of HF acid etch, which can be dangerous if not handled properly. I know of plenty of general dentists who refuse to use that product and thus would not do any porcelain bonding procedures.

 

[PurplePeopleEater1]

one of the problems of bonding to porcelain is the use of HF acid etch, which can be dangerous if not handled properly. I know of plenty of general dentists who refuse to use that product and thus would not do any porcelain bonding procedures.

Then that may be the case here. The original work was done by a dentist in CA that specialised in cosmetic dentistry. I have reservations about this dentist doing a new crown. We plan on getting a 2nd opinion, but I have to wait for insurance. Can only go every 6 months.

 

[schmoob]

SDN is not for medical advice. Please see your dentist for appropriate diagnosis and treatment.
Closing thread.