No excuse for poor dental work
Life with an ill-fitting bridge, cap or denture can be a never-ending floss-filled misery. There’s no quicker way to ruin a nice salmon supper than having small pieces of the main course get trapped under a cap, nagging at you for the rest of the evening. Worse still, if you’ve parted with several thousand dollars for the dental work, you’ll not only hate and rue its existence but it may leave you longing for your old gapped-tooth grin.
So who’s to blame for shoddy dental workmanship? It could be the inept technician who uses cheap materials or the dentist who doesn’t take great moulds and cuts corners to make a few extra bucks.
No excuse for discomfort
No doubt, creating bridges, dentures, crowns, inlays, implants and other specialties is a skilled and difficult process. But as Dan Huber, a dental laboratory technologist and partner with Toronto-based Lindberg and Homburger, one of Canada’s most prominent dental labs, says: “There’s absolutely no excuse for uncomfortable dental work.”
The keys to comfy chewing, Huber and other experts agree, include:
• Accurate mould-making.
• Choosing reliable dental health-care expes.
• Maintaining open and clear lines of communication among the dentist, the lab and yourself.
Most important, says Emily Cheung, registrar of the College of Dental Technologists of Ontario, patients should definitely become more involved in how their dental prostheses are produced. “You have the right to ask your dentist for information, and you should,” she says.
Think of dental technicians as pharmacists and the dentists as prescribing doctors. So ask your dentist exactly the same questions you would ask a doctor who has prescribed medication for you. Ask what kind of materials he’ll be ordering and if there are alternatives. Some caps, for instance, are completely ceramic but if it’s in the rear of your mouth, you may prefer a less expensive ceramic veneer.
Before you commit to any expensive dental work, survey friends who have had similar work and ask if they’re happy with the results. If they are, you’re in luck. Carmen Foglia, an executive with Ultra Lab Group of Canada dental laboratory companies, says even registered technicians vary in their levels of experience, so you can contact your friend’s dentist and find out which lab he or she uses. Then you can recommend that lab to your own dentist.
In Ontario, British Columbia and Quebec, lab technicians should be certified by a professional college – but they don’t have to be. If they’re not certified, their work may not meet the highest standards. Cheung recommends you ask your dentist whether the lab he or she uses is supervised by a qualified dental technologist. “At least that way, the practice standard is set by the regulator,” she says. Otherwise, you don’t know what you’re going to get.
Consider like hospital surgery
Bernie Teitlebaum, executive director of the Dental Industry Association of Canada, laments the lack of standards, but he says the government has not made dental technology a priority. “Sad but true. It’s probably going to take a serious problem to crop up before this gets changed,” he says.
He also says that most people use the same amount of care with their teeth as they do with their fingernails, and he advises patients to re-frame their dental work as medical surgery and to take the same care and concern into the dentist office that they would take to hospital surgery.
Conversely, says Huber, if you need work done but you don’t have confidence in your dentist, there’s nothing stopping you from contacting dental labs for referrals. “The technicians know which dentists do the best work,” he said.
Dentists can have bridges and appliances manufactured outside Canada at far lower prices but you can’t guarantee the quality of the materials or workmanship. “We can’t compete on price with those places,” says Huber. “But we can ensure high quality.”
If you don’t feel completely comfortable with the appliance when the dental work is done, speak up. Don’t walk away, hoping you’ll get accustomed to it. “If over a period of time, the patient doesn’t adjust to the appliance, they should seek a second opinion,” Huber says. “But you should be comfortable.”
Alterations for free
When the dentist inserts the finished product, describe any strange sensations or peculiar bite sensations. The dentist won’t know unless you tell him or her. The bill will not go up for alterations.
In fact, Cheung says patients can ask to see the lab bill that the dentist receives. The law prohibits dentists from charging extra for the actual dental cost of the appliance. However, the dentist has the right to charge for his time and for fitting and adjusting the appliance.
In the end, Teitlebaum says the greatest safeguard against cost and discomfort is to avoid unnecessary dental work. He’s referring to cosmetic procedures such as whitening procedures. “They’re using bleaching agents on your teeth,” he says. “Bleach is corrosive, the work is invasive and we shouldn’t be that anxious to have white teeth anyway. When dentists use those little shade tabs to match the colour of our teeth for crowns and bridges, they use a number system for a reason. Natural teeth are never white, but experience has taught dentists never to say that within striking distance.”