Responsibility in Dental Procedures: What Happens When Things Go Wrong?

Responsibility for the removal of the orthodontic brackets and the reinforcement pins during the braces removal process?

The front tooth (tooth 11) needs to undergo an implant surgery due to fracture.
The doctor strongly recommends a full porcelain crown for the anterior teeth (positions 13, 12, 11, 21, 22, 23) to enhance aesthetics.
However, I recall that the remaining tooth root from a previous cavity treatment was very small, and I am concerned that removing the crown might lead to complications, such as further fractures.
I asked the doctor if an unexpected fracture would make the situation worse, but he assured me that their equipment is very precise and that I shouldn't worry.
He also mentioned that removing the crown would allow for better adjustment and aesthetics for the future implant.
During the process, everything seemed fine, but while adjusting the temporary crown, a glass fiber post at position 22 was pulled out along with the temporary crown.
I was stunned as my fears had come true.
The doctor dismissed my concerns, suggesting that the glass fiber post was not securely bonded.
He then said he would reattach it with imported adhesive, assuring me that it would last for several more years.
He also mentioned that if I did not address the tooth root, it could potentially fracture at any time.
As a patient without a dental background, I would like to ask if this situation constitutes a mistake on the part of the doctor.
Can the post really be reattached and last for several years without concern? Additionally, since my other lateral incisor (tooth 23) also requires an implant due to the post coming out with the tooth, doesn't this logic imply that the tooth that was pulled out should also be considered for an implant rather than just reattaching and remaking the crown?
I have already paid a 60% deposit and am unsure about what to do next.
I would appreciate your guidance on how to proceed.
Thank you!

Mia, 30~39 year old female. Ask Date: 2016/12/02

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Mia,
Hello! As mentioned, the fiberglass-reinforced post was removed along with the temporary crown.
This is quite serious! Is it the case that the post was pulled out by the dentist, or was it the root that was too short? If it's the former, then the root may need to be replanted.
If it's the latter, then the post just needs to be re-bonded.
Please communicate more with your dentist!
Thank you! Wishing you well!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2016/12/02

More Info

When it comes to dental procedures, particularly those involving crowns, implants, and temporary dentures, complications can arise, leading to significant patient concerns. Your situation, where a fiber post was inadvertently removed along with a temporary crown, raises important questions about responsibility, the potential for further complications, and the best course of action moving forward.

First, it is essential to understand that dental procedures are complex and involve a degree of risk. Dentists are trained to handle these risks, but complications can still occur. In your case, the removal of the fiber post during the temporary crown adjustment is concerning. Fiber posts are often used to provide additional support to a tooth that has undergone root canal treatment, and their removal can compromise the integrity of the tooth.

Responsibility and Accountability
In terms of responsibility, if the removal of the fiber post was due to negligence or improper technique during the procedure, the dentist may bear some responsibility. However, if the post was already compromised or poorly bonded prior to the procedure, the dentist might argue that the outcome was not entirely within their control. This situation can be complex, and it often requires a thorough review of the clinical notes, the condition of the tooth before the procedure, and the specific actions taken during the treatment.

The Dentist's Assurance
Regarding the dentist's assurance that the post can be reattached and will last for several years, this can be a valid approach, but it is not without risks. The success of reattaching a fiber post largely depends on the condition of the remaining tooth structure and the quality of the adhesive used. While some dentists may successfully reattach posts, others may recommend extraction and replacement with an implant if the tooth's structural integrity is compromised. It is crucial to weigh the risks and benefits of both options.

Next Steps
1. Seek a Second Opinion: Given your concerns and the complications that have arisen, it may be beneficial to seek a second opinion from another dentist. They can assess the situation and provide you with an unbiased evaluation of the best course of action.

2. Discuss with Your Current Dentist: Have an open conversation with your current dentist about your concerns. Ask for clarification on why they believe reattaching the post is a viable option and what the long-term prognosis is for the tooth. Ensure you understand the risks involved.

3. Document Everything: Keep detailed records of all communications, treatments, and any complications that arise. This documentation can be crucial if you need to pursue any further action regarding the treatment.

4. Consider Financial Implications: Since you have already paid a deposit, discuss with your dentist the financial implications of any changes in your treatment plan. If you decide to seek treatment elsewhere, clarify how that will affect your current agreement.

5. Patient Rights: Familiarize yourself with your rights as a patient. If you feel that the treatment you received was substandard, you may have grounds for a complaint with the dental board or a legal consultation.

Conclusion
Dental procedures can be fraught with complications, and it is essential to advocate for your health and well-being. While your dentist may have the best intentions, it is crucial to ensure that you feel comfortable and confident in the treatment plan moving forward. Seeking a second opinion and maintaining open communication with your dental care providers will help you navigate this challenging situation. Remember, your oral health is paramount, and you deserve to have a treatment plan that aligns with your needs and concerns.

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