Porcelain or composite veneer to repair bridge?

[SharonBW]

I have a 5 tooth bridge on the top front that is only 3 yrs old. It has had one of the Porcelain teeth just fall off. My regular dentist said the only option is to replace it but that is financially impossible as my insurance only covers once every 60 mo. He offered to put something on there temporarily (not sure what it was made out of) to see if I could get any more life out of it. It only lasted a week or two. In the meantime, he researched the problem and decided to do a porcelain veneer (his first one). Even though it was not covered by insurance and cost $1200, I consented because I was missing a front tooth! (It angers me that this type of "cosmetic" work isn't covered better by insurance since it's so traumatic and has a profound effect on people's lives.)

Turns out, this expensive bit of work didn't stay on either. So, having moved to another state almost immediately after the "repair" I tried a new dentist. He said, "oh I never would have done the Porcelain veneer and I'm not surprised it didn't stay on." He also told me he's seen better results with superglue. (I tried it - didn't work.) So, I went back and got a composite veneer (right word?) placed. It was much less expensive but now I'm terrified to eat anything. I'm chewing only on the back teeth on the opposite from the composite. I guess I can keep doing the indefinitely.

What are my chances that this is going to last at least the 2 years til I can get another bridge?
Is there anything else that can be done?
Did the first dentist do shoddy work or does this happen a lot?

Thanks!
Sharon

 

[Busybee]

I don't understand the terms of the dentist's practice but many dentists offer a five year guarantee for such work. The dentist who did it should be replacing or repairing it for free or compensating you. I reckon it's shoddy work by the technician if it falls apart as it has.

 

[MattKW]

Legally, we can't give guarantees, although there is usually a fair bit of good will extended in certain situations. It sounds like the lab may have used an inferior porcelain or non-precious metal substructure. If you approach the dentist nicely, he might agree to remake the bridge and the lab might do their part for free too. Otherwise you'd have to raise a consumer complaint. Neither is much use if you've moved a long way away.
You can't put porcelain on porcelain (except in a furnace), and composite doesn't usually last long, but 2 years would be acceptable.

 

[SharonBW]

Legally, we can't give guarantees, although there is usually a fair bit of good will extended in certain situations. It sounds like the lab may have used an inferior porcelain or non-precious metal substructure. If you approach the dentist nicely, he might agree to remake the bridge and the lab might do their part for free too. Otherwise you'd have to raise a consumer complaint. Neither is much use if you've moved a long way away.
You can't put porcelain on porcelain (except in a furnace), and composite doesn't usually last long, but 2 years would be acceptable.

Thanks for your reply! I was concerned that the problem might be the lab. It never occurred to me to ask the dentist to remake the bridge. He talked as if my only option was a new bridge. Once he decided he could try to repair it in my mouth (his first ever attempt) it involved bonding a porcelain veneer to metal as most of the existing porcelain was gone. The original didn't crack or break, it just came off the metal so most likely was poorly constructed. (Of note, the color matching was also poor - I wish I would've realized before he bonded it.)

The other question I had about the composite is whether it will stain easily. And, if it does, is it bleachable? My natural teeth are pretty stained as I'm a long time coffee drinker.

 

[Busybee]

It used to stain but the modern composites don't tend to stain much at all. It should look good for a couple of years.

I'm not sure of the law in your country but in the UK dental restorations are seen as "goods" and are covered by the Sale of Goods Act and if a dentist is unhelpful then redress can be claimed under that legislation. In such cases it's down to what is considered reasonable and the restoration must be "fit for purpose" which would include it being able to do the job for a reasonable amount of time. Private dental surgeries often offer guarantees as part of their contract with the patient and they will claim against their lab if something goes wrong. I'd assume the terms are in their lab contract. In the US they must have some kind of similar redress for consumers of shoddy goods.

One thing people often forget when they have any kind of treatment (not just dental) is to ask what happens if things go wrong. I'd avoid any provider that is not happy with such a question. Most dentists are accommodating, but it's best to ask next time you have a bridge done. Have you checked whether your insurance policy covers faulty work? It may be that there is a clause in there to pay for a replacement now.