Nothing But The Tooth Dental Practice, DBA

I'd be happy to respond, but I have not received a written HIPPA release from the former patientWithout that I am not allowed to discuss this case with anyone but the patient or his designated representativeBut in a a broad manner, without identifying anyone, I will answer this complaint without getting into any detail that may violate HIPPA laws, penalties for which are substantial.DrS [redacted] (me) did not make this crown as this person allegesIt was made by an independent contractor who left the office in SeptI took over this caseFirst of all this person has severe bruxism (grinding teeth at nightMany people these days have that problem, and depending on the severity of their grinding or clenching, often break teeth, crowns, posts and even implants (titanium)The muscles of the human jaw are the strongest in the mouth.When I first saw this patient he had a TEMPORARY crown in his mouth that had come outThe reason it came out only a week or so after it was placed, is that the patient broke the post through his nightly grindingI had to make a new post and core (which I did at no charge to the patient), even though it was the patient's bruxism that caused this problem, not any defect in any work we didI also told the patient he must obtain and wear a night guard every night, and must wear a partial denture every day so he has some back teeth to chew withI subsequently inserted the permanent crown when it came back from the lab, and again told the patient he must obtain and wear his night guardA few months later the crown came out againI carefully checked the fit and margins and all were fine, so this time I bonded the crown in which is stronger than cementThe patient had not been wearing a night guard at this point, and I again stressed the need for oneI don't know if he ever got one or notThen a few years passed.During this time, this patient broke appointments with my officeIt is our written policy (signed by this patient) to ignore the first broken appointment (things do happen), charge a small fee for the 2nd broken appointment, and dismiss the patient from our practice after the third appointmentThat's hours of time I am just sitting around doing nothing while I could have filled that time slot had the patient had the decency to call me and let me know he wasn't comingI have patients waiting for months for an appointmentSo this patient was dismissed in accordance with our policyI am sorry his crown came out again, but after looking at the history, it is pretty certain that this crown came out due to the patient's bruxismAs far as "techs" recementing his crown, all I can say is that we have no techs in our officeOnly doctors can permanently cement crownsHygienists and assistants can only cement TEMPORARY crowns, with temporary cementAnd no one in my office ever told him that the margins of his crown were not goodI checked the margins myself before recementing it, and spoke to my assistant and both hygienists, all of whom denied saying anything about margins to any patientOnly a doctor can evaluate this, which I did.This is not an uncommon problemMore and more people today are under much stress, and bruxism is one way (unconscious and destructive) that crowns can literally be pushed out of the month by constant nightly grindingWe have had a number of patients break posts, break teeth, have crowns come out, and even break implants because of thisTo date, everyone I have treated who has this problem knows they have this problem and understands that when they grind their teeth they can break teeth, postscrowns, etcI firmly believe that this is what happened here.It's easy to say that we somehow made the crown wrong, but the lab that makes our crowns is known for their precise workWe make THOUSANDS of crowns every year, and any crown not meeting our standards gets sent back to the labThis is extremely rareAnd a post is a pre-made screw that is placed into the root for supportHe broke his post twice by grinding his teeth at night, causing the crown to come outThere is no way for us to make a poor post since they are made by large corporations, and we just cement them into the root of a tooth.To sum this up:1) The patient's temporary crown initially came out because he has bruxism and broke the post that retains the crown shortly after it was placed.2) I made the patient a new post and core at no charge, even though we were not at fault.3) This patient broke appointments with me, wasting hours of my time, denying that time to other patients who have been waiting for an appointment, and causing financial losses exceeding by far what we got paid for his crownHe was dismissed from our practice.4) I recemented his permanent crown twice, bonding it in the 2nd time.5) It is my opinion that the cause of this problem is the patients bruxism and not any defect or fault with the crownCrowns just don't come out without a reasonPosts don't just break for no reason.6) It is much easier (and cheaper) to blame DrM [redacted] and/or this practice for making him a bad crown than to accept that it came out due to his bruxism problemAs I have not seen this person since he was dismissed, I cannot evaluate the damage he may have done to himselfPerhaps he broke a third post and the crown came outI just don't know.7) After careful review of this patient's records, a second dentist not involved in this case independently came to the same conclusions I have stated above.8) While I understand this patient's unhappiness and frustration, I cannot find anything we did wrong.Respectfully,Steven S [redacted] DDSNothing But The Tooth Dental Practice

First of all I must apologize for the delay in responding to youI did, however, leave you two voicemailmessages a week ago, as well as two on Friday, asking you to call me, but have not heard back from you.We have experienced an unprecedented series of"disasters" at this office from March 1, until thisweekWithout going into detail, these various serious physical ailments and sudden loss of personnelhave left us severely shorthanded, to the point where I'm writing this letter myselfWe are behind onvirtually everything, and are only now hiring and training new staff to replace those lostAside frommajor staff problems, I refractured my spine on May 1, and have been in the office only as much as thedoctors will let me, and Dr [redacted] broke his arm weeks later and was out of the office for weeks.Neither of us is operating at full potential at this pointIt's not your problem, but it is an explanation.I was upset to hear that you had left our practice, especially without speaking to me about any problemsyou were havingI have always considered you a friend as well as a patientBut I respect your decisionto do what you believe is in your best interest.To answer your questions about any funds we may owe you:I performed a procedure on you that I learned from a teacher many years agoThere is no code for it inthe CDT manual, so it cannot be billed to insurance companiesI explained to you that I could repairthe root decay you had under your bridge, and that the cost would be $600.00, and that the only otheralternative was to remake your bridge, which would have cost far moreI would estimate that the vastmajority of other dentists would have just told you to have the bridge replaced, since this "open flapsubcrestal root repair" is not taught in any dental schoolLike many other procedures, I learned itduring my hospital residencyl also explained that we would attempt to bill your insurance companyfor whatever services they cover out of this procedureBut they only covered some of the proceduresthat are involved in what I didThey did not cover the entire $procedure I perfomed on you.We are not holding your $"for ransom"Whatever fees we received from your insurancecompany for portions of this procedure are refundable to youYour insurance company paid us $389.00towards parts of the $procedureThis $should be refunded to youHowever, yourinsurance company did not pay for a number of other services we provided to you on different dates (xrays,exam) for a total of $You are responsible for that $in unpaid insurance fees, per theagreement that you and all other patients have signedThis brings the total we owe you down to$Normally we would issue you a check for $300, and we would both be even.However, your son [redacted] has broken a number of appointments, each over an hour longAgain, perour written agreement, we assess a fee of $for a half hour appointment and $for appointments ofan hour or longer [redacted] accrued $in No-Show fees before we dismissed him from our practice.These "No Show" fees don't come close to our hourly production, and don't come close tocompensating us for the time and income lost when someone just doesn't show upWe have dozens ofpatients waiting for those time slots, as you can personally attestWhile [redacted] is over 18, you arelisted as his guarantor, which unfortunately means that you are responsible for paying his No-Showfees.As his fees total $300.00, and we owe you $300.00, the balance to be refunded to you is $0.00.Again, my apologies for this late reply, but I wanted to assure myself that all your credits and debitswere calculated accurately, so I reviewed your chart, ledger, and your son's chart and ledger myselfbefore responding in writing.I hope this letter addresses your issues as outlined in your letters dated 07/07/and 07/25/2017.Feel free to contact me with any questions or commentsI wish you well, and am always here if youneed meWe will send a copy of this letter to the Revdex.com in response to their letter.Sincerely,Steven [redacted] DDSNothing But The Tooth Dental Practice

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below Hi [redacted] ,I am not satisfied with the response from DrS [redacted] I received an evaluation from another dentist who said the crown should not have failed so soon, that there is not enough tooth left to even re-cement the crown and that the root canal was not even done to completion so I am getting an implant It is easy for DrS [redacted] to blame teeth grinding on this problem as he stated many people these days have this problem I see it as a way for him to deny any responsibility for the success of the crowns he cements The average life span of a crown is years, this one didn't even last and fell out after a few weeks I have other crowns that have not been compromised from the so called teeth grinding I also wear a mouth guard at night There are many reasons a crown may fail teeth grinding is just an excuse for DrS [redacted] As I see he takes no responsibility for his work, I am not pursing a refund since I am now under the care of a reputable and caring dentist DrS [redacted] did not cement the crown the 2nd time, it was a different Drso his records are false He also cancelled many appointments on me causing much confusion and frustration It is no wonder I missed appointments it is impossible to keep up with their reschedulingAs I stated before I received a bill from Nothing but the Tooth after I filed this complaint for $with no explanation for what it is for I believe this bill is in retaliation to my complaint as I had not received a bill from them and was told at my last appointment that I did not owe any money, and as DrS [redacted] stated in his response to the Revdex.com he re-cemented the crown at no charge I am requesting this bill be removed as I feel it is and made up after the fact Once this bill is removed I will consider this matter resolved and would like to sever all contact with Nothing but the Tooth[redacted] ***

I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. Regards, *** *** It
would be helpful to have an itemized bill showing dates of any missed
appointments by my son that totaled $300, rather than saying “numerous”
timesI would like to have it in print like most businesses do. When
I returned your phone call recently it was while I was working and I
could only stay on hold for so longI’ve been trying to resolve this
for months, so to make it sound like I ignored your attempt at
communicating is ridiculousPlease
send me an itemized bill with the missed appointments so I can verify it
with my son that it in fact happened, and if it did like you say, then
we can resolve thisI wish I would have known that missed appointments were accruing, but it’s impossible to know when you get no bills in the mailSincerely, *** ***

Dr*** contacted the Revdex.com to advise us he sent the copy of the missed appointments to the consumer and he accepted that information

[redacted],The charges have been written off for the patient named above and he now has a clear balance.Thank you,Mechelle H[redacted]Office Manager###-###-#### Ext [redacted]Nothing But The Tooth117 Fairview Avenue Hudson, NY 12534

I'd be happy to respond, but I have not received a written HIPPA release from the former patient. Without that I am not allowed to discuss this case with anyone but the patient or his designated representative. But in a a broad manner, without identifying anyone, I will answer this complaint without...

getting into any detail that may violate HIPPA laws, penalties for which are substantial.Dr. S[redacted] (me) did not make this crown as this person alleges. It was made by an independent contractor who left the office in Sept. 2013. I took over this case. First of all this person has severe bruxism (grinding teeth at night. Many people these days have that problem, and depending on the severity of their grinding or clenching, often break teeth, crowns, posts and even implants (titanium). The muscles of the human jaw are the strongest in the mouth.When I first saw this patient he had a TEMPORARY crown in his mouth that had come out. The reason it came out only a week or so after it was placed, is that the patient broke the post through his nightly grinding. I had to make a new post and core (which I did at no charge to the patient), even though it was the patient's bruxism that caused this problem, not any defect in any work we did. I also told the patient he must obtain and wear a night guard every night, and must wear a partial denture every day so he has some back teeth to chew with. I subsequently inserted the permanent crown when it came back from the lab, and again told the patient he must obtain and wear his night guard. A few months later the crown came out again. I carefully checked the fit and margins and all were fine, so this time I bonded the crown in which is stronger than cement. The patient had not been wearing a night guard at this point, and I again stressed the need for one. I don't know if he ever got one or not. Then a few years passed.During this time, this patient broke 3 appointments with my office. It is our written policy (signed by this patient) to ignore the first broken appointment (things do happen), charge a small fee for the 2nd broken appointment, and dismiss the patient from our practice after the third appointment. That's 3 hours of time I am just sitting around doing nothing while I could have filled that time slot had the patient had the decency to call me and let me know he wasn't coming. I have patients waiting for months for an appointment. So this patient was dismissed in accordance with our policy. I am sorry his crown came out again, but after looking at the history, it is pretty certain that this crown came out due to the patient's bruxism. As far as "techs" recementing his crown, all I can say is that we have no techs in our office. Only doctors can permanently cement crowns. Hygienists and assistants can only cement TEMPORARY crowns, with temporary cement. And no one in my office ever told him that the margins of his crown were not good. I checked the margins myself before recementing it, and spoke to my assistant and both hygienists, all of whom denied saying anything about margins to any patient. Only a doctor can evaluate this, which I did.This is not an uncommon problem. More and more people today are under much stress, and bruxism is one way (unconscious and destructive) that crowns can literally be pushed out of the month by constant nightly grinding. We have had a number of patients break posts, break teeth, have crowns come out, and even break implants because of this. To date, everyone I have treated who has this problem knows they have this problem and understands that when they grind their teeth they can break teeth, posts. crowns, etc. I firmly believe that this is what happened here.It's easy to say that we somehow made the crown wrong, but the lab that makes our crowns is known for their precise work. We make THOUSANDS of crowns every year, and any crown not meeting our standards gets sent back to the lab. This is extremely rare. And a post is a pre-made screw that is placed into the root for support. He broke his post twice by grinding his teeth at night, causing the crown to come out. There is no way for us to make a poor post since they are made by large corporations, and we just cement them into the root of a tooth.To sum this up:1) The patient's temporary crown initially came out because he has bruxism and broke the post that retains the crown shortly after it was placed.2) I made the patient a new post and core at no charge, even though we were not at fault.3) This patient broke 3 appointments with me, wasting 3 hours of my time, denying that time to other patients who have been waiting for an appointment, and causing financial losses exceeding by far what we got paid for his crown. He was dismissed from our practice.4) I recemented his permanent crown twice, bonding it in the 2nd time.5) It is my opinion that the cause of this problem is the patients bruxism and not any defect or fault with the crown. Crowns just don't come out without a reason. Posts don't just break for no reason.6) It is much easier (and cheaper) to blame Dr. M[redacted] and/or this practice for making him a bad crown than to accept that it came out due to his bruxism problem. As I have not seen this person since he was dismissed, I cannot evaluate the damage he may have done to himself. Perhaps he broke a third post and the crown came out. I just don't know.7) After careful review of this patient's records, a second dentist not involved in this case independently came to the same conclusions I have stated above.8) While I understand this patient's unhappiness and frustration, I cannot find anything we did wrong.Respectfully,Steven S[redacted] DDSNothing But The Tooth Dental Practice

First of all I must apologize for the delay in responding to you. I did, however, leave you two voicemailmessages a week ago, as well as two on Friday, asking you to call me, but have not heard back from you.We have experienced an unprecedented series of"disasters" at this office from March 1, 2017...

until thisweek. Without going into detail, these various serious physical ailments and sudden loss of personnelhave left us severely shorthanded, to the point where I'm writing this letter myself. We are behind onvirtually everything, and are only now hiring and training new staff to replace those lost. Aside frommajor staff problems, I refractured my spine on May 1, and have been in the office only as much as thedoctors will let me, and Dr. [redacted] broke his arm 2 weeks later and was out of the office for 8 weeks.Neither of us is operating at full potential at this point. It's not your problem, but it is an explanation.I was upset to hear that you had left our practice, especially without speaking to me about any problemsyou were having. I have always considered you a friend as well as a patient. But I respect your decisionto do what you believe is in your best interest.To answer your questions about any funds we may owe you:I performed a procedure on you that I learned from a teacher many years ago. There is no code for it inthe CDT manual, so it cannot be billed to insurance companies. I explained to you that I could repairthe root decay you had under your bridge, and that the cost would be $600.00, and that the only otheralternative was to remake your bridge, which would have cost far more. I would estimate that the vastmajority of other dentists would have just told you to have the bridge replaced, since this "open flapsubcrestal root repair" is not taught in any dental school. Like many other procedures, I learned itduring my hospital residency. l also explained that we would attempt to bill your insurance companyfor whatever services they cover out of this procedure. But they only covered some of the proceduresthat are involved in what I did. They did not cover the entire $600.00 procedure I perfomed on you.We are not holding your $600.00 "for ransom". Whatever fees we received from your insurancecompany for portions of this procedure are refundable to you. Your insurance company paid us $389.00towards parts of the $600.00 procedure. This $389.00 should be refunded to you. However, yourinsurance company did not pay for a number of other services we provided to you on different dates (xrays,exam) for a total of $89.00. You are responsible for that $89.00 in unpaid insurance fees, per theagreement that you and all other patients have signed. This brings the total we owe you down to$300.00. Normally we would issue you a check for $300, and we would both be even.However, your son [redacted] has broken a number of appointments, each over an hour long. Again, perour written agreement, we assess a fee of $50 for a half hour appointment and $100 for appointments ofan hour or longer. [redacted] accrued $300 in No-Show fees before we dismissed him from our practice.These "No Show" fees don't come close to our hourly production, and don't come close tocompensating us for the time and income lost when someone just doesn't show up. We have dozens ofpatients waiting for those time slots, as you can personally attest. While [redacted] is over 18, you arelisted as his guarantor, which unfortunately means that you are responsible for paying his No-Showfees.As his fees total $300.00, and we owe you $300.00, the balance to be refunded to you is $0.00.Again, my apologies for this late reply, but I wanted to assure myself that all your credits and debitswere calculated accurately, so I reviewed your chart, ledger, and your son's chart and ledger myselfbefore responding in writing.I hope this letter addresses your issues as outlined in your letters dated 07/07/2017 and 07/25/2017.Feel free to contact me with any questions or comments. I wish you well, and am always here if youneed me. We will send a copy of this letter to the Revdex.com in response to their letter.Sincerely,Steven [redacted] DDSNothing But The Tooth Dental Practice

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
Hi [redacted],I am not satisfied with the response from Dr. S[redacted].  I received an evaluation from another dentist who said the crown should  not have failed so soon, that there is not enough tooth left to even re-cement the crown and that the root canal was not even done to completion so I am getting an implant.  It is easy for Dr. S[redacted] to blame teeth grinding on this problem as he stated many people these days have this problem I see it as a way for him to deny any responsibility for the success of the crowns he cements.  The average life span of a crown is 15 years, this one didn't even last 3 and fell out after a few weeks.  I have other crowns that have not been compromised from the so called teeth grinding.  I also wear a mouth guard at night.  There are many reasons a crown may fail teeth grinding is just an excuse for Dr. S[redacted].  As I see he takes no responsibility for his work, I am not pursing a refund since I am now under the care of a reputable and caring dentist.  Dr. S[redacted] did not cement the crown the 2nd time, it was a different Dr. so his records are false.  He also cancelled many appointments on me causing much confusion and frustration.  It is no wonder I missed appointments it is impossible to keep up with their rescheduling. As I stated before I received a bill from Nothing but the Tooth after I filed this complaint for $100 with no explanation for what it is for.  I believe this bill is in retaliation to my complaint as I had not received a bill from them and was told at my last appointment that I did not owe any money, and as Dr. S[redacted] stated in his response to the Revdex.com he re-cemented the crown at no charge.  I am requesting this bill be removed as I feel it is false and made up after the fact.  Once this bill is removed I will consider this matter resolved and would like to sever all contact with Nothing but the Tooth.[redacted]