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Where a patient has crowns and/or bridges placed, there are a number of ways in which negligent crown and bridgework may be provided. The fit of the crown or bridgework may be poor, and given that the purpose of such dental work is usually to improve the appearance of the teeth, if the outcome is cosmetically unpleasant, there may be a claim. In addition, the key purpose of this type of restorative dentistry is to maintain or improve the teeth’s function. If your function has been affected following the provision of crowns and/or bridges, then you may also have a claim.
Crowns and bridges are both examples of restorative dentistry.
A crown is a covering which sits over a tooth or an implant in order to make it functional. They should, according to dental experts, remain functional for approximately 15 years, but they can last considerably longer than that.
The lifespan of a crown will depend on a number of factors, including the health of the tooth, how well it is cared for, and whether it was properly fitted by the dentist in the first place.
Comparatively, a bridge is a fixed replacement for a missing tooth. There are three main types of bridges:
Bridges normally last for 5-15 years, but this too is dependent on oral hygiene levels and regular check-ups with your dental practitioner.
Samantha Swaby recovered £9,500 for a Claimant who suffered dental decay and had a substandard crown fitted.
The Defendant dentist fitted a crown to the Claimant’s lower right first molar (LR6) in October 2007. The dentist later placed a filling at the Claimant’s upper right first molar (UR6) in October 2010.
In October 2013, the Claimant attended with a different dentist. He was advised that his UR6 was decayed and required extraction, and that the crown at LR6 was ill-fitting which had allowed decay to form. It was likely that the LR6 would require extraction and replacement with an implant and implant retained crown.
The Claimant has experienced dental trauma to his upper right central and lateral incisors as a child (UR1 and UR2). In 2014, he underwent two procedure performed by the Defendant dentist to fit a post-crowns to both teeth. However, the post-crowns repeatedly fell off and required re-cementing.
The Claimant sought a second opinion from another dentist, who informed him that the prognosis for the UR1 and UR2 was hopeless.
Sophie Angwin recovered £1,500 for the Claimant on the basis that the post-crowns should have never been placed, and when they were placed they were done so negligently.
Sophie Angwin recovered £4,000 for damage sustained to a Claimant’s teeth following substandard bridgework.
In June 2014, the Claimant attended with the Defendant dentist as her Maryland bridge had fallen off. The Defendant decided that he would remake the bridge and cut retention grooves into the Claimant’s neighbouring teeth to facilitate this.
The bridge was fitted, but the Claimant was unhappy with the way it fitted. Two months later, the bridge had broken. The Claimant attended for a review with the Defendant and was advised that bits of excess cement had caused this. It was also found that the retention grooves had been cut deeply into the Claimant’s UR4 and UR6, which had exposed the dentine. The Claimant required veneers at both of these teeth to rectify this.
There are a number of issues that can arise when a crown or bridge is fitted negligently. Please click below if you are experiencing any of the following:
A crown doesn’t fit well. Is this negligent?
Whilst fitting a crown, a dentist should make sure that there is no gap between the crown and the gum-line (i.e. the crown is of a good marginal fit), and ensure that all visible cement is removed from the surface of the crown and gum. If a crown has a poor fit, it can lead to difficulties in cleaning the teeth, which in turn can lead to gum inflammation and bleeding. The fit of the crown should be adequate to allow you to clean around and between your teeth. If the dentist fails to do this, it may be negligent and could cause the tooth underneath the crown to decay.
Sometimes crowns can fall out if there is not enough tooth structure to hold the crown in place; generally when the original tooth was very weak or small.
If a dentist files down a tooth too much prior to fitting the crown (please see the below section on “over-preparation” on this point), then this can also cause a crown to fit poorly. This too may be negligent treatment.
In our experience, the dentistry behind the fitting of a crown is a huge contributing factor to the lifespan of a crown. Any dentist fitting a crown should have the relevant experience to carry out such treatment. If they do not, and a person suffers from having a poorly fitting crown, that may be negligent and give rise to a claim.
You’ve been told that there’s decay under a crown. How has this happened?
Decay under a crown can occur in two ways. If a crown is poorly fitting, this can allow decay to form under the crown, leading to the eventual loss of the tooth.
Alternatively, prior to fitting a crown, a dentist should remove any decay present in the tooth, x-ray the area to ensure it is suitable for a crown and also make sure that there is no existing infection or gum disease that may require treatment.
If a dentist fails to take x-rays to check for infection or gum disease, decay could develop which can also lead to the eventual loss of the tooth. Both are negligent, so if you have experienced this you should contact us as soon as possible.
You’re left really unhappy with the aesthetics of a crown or bridge. Have you been subject to substandard treatment?
Given that the purpose of a crown or bridge is usually to improve the appearance of your teeth, if the outcome is cosmetically unpleasant, there may be a claim.
If you are unhappy with the aesthetics of your crown or bridge, you should consider seeking a second opinion from a different dentist and contact us to discuss this further.
You’ve been left very unhappy with the lifespan of a crown or bridge. Has something gone wrong with the treatment?
As stated above, the average lifespan of a crown is approximately 15 years, and a bridge 5-15 years.
If your crown or bridge doesn’t last this long, it may well be that something has gone wrong with your treatment. This can be particularly frustrating as dental treatment is often expensive.
If this applies to you, we would encourage you to contact us in order to discuss this further.
You have been told that your teeth were over-prepared for a crown or bridge. Have you been subject to substandard treatment?
Yes, if a dentist has over-prepared your teeth prior to placing a crown or bridge, you may have been subject to dental negligence.
The main symptom of over-prepared teeth is sensitivity, so if you are concerned about this we would encourage you to see your dentist.
Unfortunately, over-preparation of a tooth can have serious consequences, even leading to the loss of a tooth, so if you have suffered from this you may have been subject to negligence.
Your bridge sometimes falls out. Is this as a result of negligence?
Prior to fitting a bridge, a dentist must take impressions to ensure that the bite of the bridge will mirror the patient’s original teeth. If this stage is substandard, a patient may experience prolonged issues with their bite, causing them to feel as though their teeth do not meet together. This can also cause a bridge to feel as though it is “rocking”, or about to fall out.
If your dentist fails to rectify this or you experience persistent issues with your bridge, this may indicate negligent treatment.
Bridgework is a complicated area of dentistry, which means that bridges can fail for a variety of reasons. If your bridge has fallen out, you may have an issue with the abutment teeth (the teeth supporting the bridge), including fractures, decay or leakage.
In some circumstances, decay may not have been diagnosed and treated and this can cause the bridge to fail within a matter of months or a few years of being placed.
Sometimes, when a bridge fails it is possible to treat the teeth and the teeth may still be suitable for new bridgework. However, in some cases, the bridgework has failed to such a degree that the abutment teeth are compromised and dental implants may be the next suitable option to restore the missing tooth/teeth.
If you have experienced issues with your bridge falling out, please contact us to discuss a potential claim.
As a general rule, cases concerning substandard crown or bridgework should come to a conclusion between 18-24 months after the first time you contact us. However, each case is different and this may vary dependent on the facts.
Any compensation you receive will vary depending on what injury you sustain. For example, if you require an extraction of one of your teeth resulting from substandard crown or bridgework, you will receive more compensation than if you suffer a period of pain as a result of negligence.
Compensation received following a successful claim for dental negligence will be comprised of:
You can sue a retired dentist, as long as your claim is not statute barred.
By law, all dentists must be registered with the General Dental Council (GDC), and must have appropriate indemnity and insurance arrangements in place; this allows patients to seek any compensation they may be entitled to.
Therefore, even after a dentist retires they will still be responsible for the treatment which was carried out when they were practising as a dentist.
You have three years to bring a claim of dental negligence, from the date of negligence or knowledge of it, under the laws concerning ‘limitation’ in England and Wales. These laws state that a Claimant must issue court proceedings within this time period, or else their claim would be statute barred.
Generally, we would advise you to contact us at least 6 months before the limitation period in your case is due to end. However, this can be reviewed on a case by case basis; if you believe that your limitation period may expire soon, we encourage you to contact us as soon as possible.
“I was told I’d developed severe gum disease due to years of dental neglect. I had no idea as nothing was visible and was horrified that my previous dentist had not picked this up.” Victoria underwent a year of treatment, …