Unacceptable or inappropriate crowns and bridges

Our experienced dental negligence lawyers understand the anxieties, concerns and frustration that may be caused by negligent dental care and treatment. We also fully understand the practical problems and social embarrassments that may be caused by unwanted or unexpected changes in appearance or the ability to eat in comfort.

At DNC we are sympathetic and knowledgeable about the situation you may find yourself in. We have helped many people make successful dental negligence claims and receive compensation for their injuries as well as for any corrective treatment that may be required.

Dental claims and dental negligence law is a very specialist area. We are true professionals with both legal and dental knowledge and expertise to help you through this difficult time.

Please note that the information here is only applicable for adult, permanent teeth. Deciduous (baby) teeth have different treatment needs and procedures.

What is a crown?

A crown is an artificial tooth – it is sometimes called a ’cap’. A crown is made of porcelain and/or metal and fits over the visible part of the tooth in the mouth.

A crown is usually required to either hold a damaged tooth together/improve its strength or make it look better. The tooth requires cutting down to create space for the artificial crown to be permanently cemented over it.

If a tooth is very broken down, a ‘post-crown’ is an alternative treatment option to trying to rebuild the tooth in order to put a crown over it. Quite literally, a post is fixed into the root canal space and acts as the ‘core’ of the tooth after it has been cut down to make space for a crown. The post in the root canal helps to retain the tooth core and this may be a better option than trying to rebuild the tooth structure in other ways. Usually these teeth have already had a root canal treatment, although an x-ray should always be taken to check that this has been successful.

Incidentally, a ‘crown’ is also the term given to the part of a natural tooth, which is covered in enamel and seen in the mouth.

What is a bridge?

A bridge is a fixed, permanent replacement for a missing tooth. It is a false (usually porcelain) tooth, which is attached to one or more adjacent teeth. These adjacent teeth are called ‘abutments’ and support the false tooth, which is called the ‘pontic’.

A bridge is permanently cemented or bonded to the adjacent tooth/teeth.

A bonded bridge means that the abutment teeth do not have to be cut down – the bridge is attached and supported by a metallic ‘arm’, which is made to fit around the supporting tooth rather than fit over it. A bonded bridge is more appropriate if the supporting tooth is healthy as it means that there is no need to cut down a healthy tooth.

A bridge usually replaces one missing tooth, but may replace more.

Problems with crowns and bridges

When crowns and/or bridges fail – for whatever reason, the treatment options may be very limited. For example, if the tooth supporting the crown or bridge abutment fractures, the remaining root may have to be extracted – in the case of a bridge, this can be a devastating and costly loss of much more than just one single tooth.

Dental negligence claims arising from crowns and bridges

Before placing a crown or bridge, it is important to assess the health of the tooth to ensure that there is no decay, risk of needing root canal treatment or gum disease around the tooth. If any of these are present, they should be diagnosed and treated before a crown or bridge is placed.

Similarly, it is important to check that a crown or bridge fits well around the margins with the natural tooth as this will reduce the risk of tooth decay occurring and spreading under the crown or bridge abutment.

Before placing a crown or bridge, it is also important to assess the occlusion (the ‘bite’) and how this may affect it. If the biting force is not level on the crown or bridge it will repeatedly knock against it and this will eventually break the cement or bond that holds the crown or bridge in place.

Alternatively, if the tooth is affected by gum disease, a crown or bridge placed without any assessment of the occlusion on that tooth, may reduce the stability of the tooth and so put it at greater risk of the entire tooth and root becoming mobile (’wobbly’) and needing to be extracted.

It is also important when cutting down a tooth to make room for a crown/abutment, to ensure that the shape is not too conical as this will reduce the retention of the crown/bridge and make it more likely to fall out.

The most common claims involving crowns and bridges include the following:

  • Poor fit (with poor appearance around the gum line)
  • Poor fit (with repeated need for recementing or rebonding)
  • Poor fit (with tooth decay affecting the supporting tooth)
  • Uncomfortable or strange sense of bite on the crown or bridge
  • Fracture of the supporting tooth/abutment (with loss of the crown or bridge)
  • New toothache symptoms in a supporting tooth and the need for root canal treatment
  • Increased mobility of the supporting tooth (especially if already affected by gum disease)
  • Wrong shade
    Wrong shape/contours feeling bulky

If you are not sure whether you like how the crown or bridge looks (the colour or shape), it may be possible for you to ask the dentist to use temporary cement when initially fitting the crown or bridge. Your dentist can discuss this further with you.

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