Agard & Lipker Dental Office

Review: Fours years ago I had a new Crown put in by Dr. [redacted] on my left lower jaw tooth which cost my insurance company nearly $1000 and myself approximately $100. I have crowns on my right lower jaw tooth (2 of them) that have been in place for over twenty years and are fine today. However the crown Dr. [redacted] put in broke off not on the top but on the side of my tooth. I am 55 years old and do not eat hard things because I know that breakage can happen with my own real teeth. The crown should never have broken in only four years (when my others have lasted over twenty). I do chew on both sides of my mouth not just the one. Since the first time the tooth broke it has broken off more and more with regular eating. I lost my insurance in my divorce. I am not on Obamacare. When I called Dr. [redacted]'s office I was told they don't take Obamacare and I'd have to pay for the Crown myself. I asked them to check for these extenuating circumstances. She came back to the phone and said He would see me but Obamacare does not pay for crowns. I told her that I'd talked to other dental offices and they DO pay for metal crowns but not the porcelain like the defective one in my mouth. Twice I would've been turned away had I not been persistent. I asked her to check on that and was redirected to I believe the office manager. Who told me they could have me in for an exam and take a new x-ray (billing Obamacare for it) and send in a preapproval to them to see if they will cover it. I would however be getting a metal tooth in my mouth not the more expensive porcelain one I currently have (so it will show when I laugh or sing, which I do very often. When I purchased it I was told it had a much longer life than just 4 years. I believe the integrity of the porcelain tooth was compromised from the beginning or else the installation of it was not adequate for the pressure. So I wanted to complain that they tried to dismiss me so easily and quickly. If I hadn't been insistent I wouldn't even have an appointment today for them to try to get Obamacare to pay for what I believe should be coming out of their pocket not taxpayers. They have not offered to do anything for me out of their profit not even upgrade me to a porcelain Crown instead of the metal one. Please I appreciate any help you can give me. Thank you for taking all the time to read this and try to work it out for me! Sincerely, [redacted]Desired Settlement: I'd like them to replace the old crown with a new crown at no charge to me.

Business

Response:

I am responding to a letter sent by a patient regarding a porcelain fused to metal crown in which some of the porcelain chipped off after 4 years of service. I would like to clarify a few details first.

She refers in the letter to billing Affordable Care Act (Obamacare) and how we don't take Obamacare. Obamacare is only for health insurance and has no dental component. She is actually on Medical Assistance for her dental care. Medical Assistance only covers basic dental needs, but not porcelain crowns. She mentioned that they cover metal crowns but those are actually stainless steel crowns that are not custom made and therefore don't fit the teeth well and can cause gum irritations and potential bone loss. Even though there are no warranties in dentistry, we do have a general rule that we replace work that failed within the first year. I know she would like this crown to last longer, but she did benefit from over 4 years of service from this crown before the porcelain chipped, and I don't have any control on what she eats or how she eats. You don't have to eat hard foods to cause teeth to break because it is the repetitiveness of chewing that causes stress to all your teeth. Because this tooth was the last tooth in the back of the mouth, it gets more stress than the ones in front of it, and you can't predict how much stress it will take before the porcelain will break. Fortunately, the porcelain that chipped off the crown does not expose the underlying tooth because it is still covered by a metal substructure. I know that she wants to have a porcelain crown put back on the tooth, but you run the same risk as before with the possibility of the porcelain chipping. If there was a flaw in the crown or on installation, it would have been apparent within the first few months because the pressure from chewing would have made that evident right away. Therefore, as a compromise, I will offer to replace the existing crown with a custom made metal crown, which I know won't chip, at no cost to her. I feel this is fair because she would get a new crown even after getting 4 years of service from the existing crown. I've always worked hard to make things fair for my patients and appreciate their loyalty to my practice. If there are any other questions, I would be more than happy to answer them.

Sincerely,