Dental crowns are a common solution in restorative dentistry, serving as a cap to protect damaged teeth while also enhancing their appearance. But what happens if a crown doesn't hold up as expected?
Understanding who is accountable — and the right steps to take in the event of a crown failure — is important for ensuring your oral health is maintained without unnecessary stress. There is a tremendous amount of faulty information online about this topic, so if you want to minimize your expenses and frustration, keep reading!
Quick Answer: Is Dentist Responsible for a Failed Crown?
The success of a dental crown depends on numerous factors, from the strength of the underlying tooth, to the crown preparation procedure, to the quality of materials used, to the patient’s bite pattern, to diligent aftercare.
Issues like an improper fit or misaligned bite can lead to discomfort and the crown's premature failure, underscoring the dentist's role in precise fitting and assessment.
The choice of material can also affect a crown's endurance, with the dentist's guidance being crucial in selecting the best option for the patient's specific needs.
On the patient's side, regular oral hygiene, dental check-ups, and avoiding unnecessary trauma or destructive forces to the crown play a vital role in extending the crown's life.
In essence, both dentist and patient collaboration is key to the long-term success of a dental crown.
There is no hard-and-fast rule for crown failure and replacement fees.
Many insurances refuse to pay for a crown more than once in a 5 year period — for this reason some dental offices and patients treat 5 years as a warranty period or “magic number” for crown longevity.
While the 5 year mark is a simply a construct of insurance policies, rather than a dental standard, most dentists will agree that >5 year survival is a successful crown — and thus will not provide any discounts for crown failure after the 5 year mark.
Generally speaking, dentists will repair or replace crowns that fail within a year of placement.
Between the 1 year mark and 5 year mark, discounted or no-charge procedures are a bit more “iffy.” Some dentists will discount crown replacement during this time period, while others will not.
In the vast majority of instances, if a crown has failed as a result of something your dentist did, this failure will occur immediately (in the span of a few days or few weeks). So, expecting your dentist to no-charge a crown replacement that fails after a few years is, quite frankly, not fair or reasonable.
Common Reasons for Crown Failure
Several factors can contribute to a failed crown.
One common reason is poor oral hygiene. Inadequate brushing and flossing can lead to decay around the crown, compromising its stability and causing it to fail. It is crucial to maintain good oral hygiene practices to prevent bacterial buildup and decay that can affect the longevity of the crown.
Another reason for crown failure is the material used for the restoration. Some crowns may not be suitable for individuals with specific habits, such as teeth grinding or clenching. For instance, individuals with bruxism may require a custom-made crown that can withstand the excessive forces exerted during grinding.
Porcelain-fused-to-metal crowns, the “gold standard” for many decades, may chip or break with patients that have a traumatic bite or experience nighttime grinding.
Improper placement of the crown by the dentist is another factor that can lead to its failure. If the crown is not accurately fitted to the tooth or if there are issues with the cementation process, it can result in an ill-fitting restoration that is prone to complications. This problem will usually occur quickly, often within a few days or weeks, at which point your dentist will be able to repair or replace it.
Furthermore, underlying bite issues can also contribute to crown failure. Misaligned teeth or an improper bite can create uneven pressure on the crown, causing it to crack or become dislodged over time. It is essential for the dentist to assess the patient's bite and make any necessary adjustments before placing a crown to ensure its long-term success.
Last, and perhaps most importantly, the condition of the underlying tooth is a key determinant in a crown’s success. Simply put, if there isn’t much tooth remaining, it becomes increasingly hard to restore the tooth with a crown that will last for many years.
Factors That Can Impact Crown Success
Several factors can influence the long-term success of a dental crown. These include the patient's oral hygiene habits, the dentist's skill and experience, the quality of materials used for the crown, and the patient's overall oral health condition.
Patients are responsible for maintaining good oral hygiene practices, such as regular brushing, flossing, and dental check-ups. Dentists should provide proper placement and ensure the crown is of high quality. However, unforeseen circumstances and individual factors can still affect the success of a dental crown.
One crucial factor that can impact the success of a dental crown is the patient's bite alignment. If a patient has an uneven bite or teeth grinding habit (bruxism), it can put excessive pressure on the crown, leading to premature wear and potential damage. Dentists may recommend wearing a night guard to protect the crown and prevent further complications.
Another significant consideration is the location of the dental crown within the mouth. Crowns placed on molars, which endure the most chewing force, may have a higher risk of failure due to grinding compared to crowns on front teeth.
Additionally, the presence of gum disease or untreated cavities can compromise the longevity of a dental crown, as these conditions weaken the underlying structures of the tooth.
As mentioned previously, arguably the biggest determinant in crown success is the amount of healthy tooth structure underneath the crown.
For teeth that are relatively solid, but need a crown because a single cusp broke off, the outlook is quite favorable.
For teeth that are broken off entirely, near the gumline, the long-term outlook is much worse.
How to Determine Responsibility for a Failed Crown
Establishing responsibility for a failed crown requires a thorough evaluation of the circumstances surrounding the failure. It is important to consult with a qualified dentist or seek a second opinion to assess the situation.
A comprehensive examination may involve reviewing the patient's oral hygiene practices, examining the fit and placement of the crown, evaluating the materials used, and considering any underlying dental issues that may have contributed to the crown's failure.
Only by considering all these factors can a fair assessment of responsibility be determined.
There is an internet myth that suggests that you should start by contacting an attorney or filing a complaint with the state dental board — this is flawed advice!
Considering the fact that a crown generally costs <$2,000, attorneys won’t want to get involved. If you wish to spend thousands of dollars in legal fees to attempt to get a “free” crown replacement, you can surely find an attorney that will comply.
Contacting the state dental board may yield results, but it puts undue stress and time commitment on both yourself and your dentist. Before contacting the dental board, you should contact your dentist and give him/her every chance to rectify the situation. When in doubt, get a second opinion, and feel free to discuss the second opinion with your original dentist.
Understanding Responsibilities for a Failed Crown
When a dental crown fails, it's natural to question what went wrong.
However, in the vast majority of cases, the path forward doesn't involve legal action but rather a conversation with your dentist. Dentists are committed to your oral health and will want to understand any issues with treatments they've provided.
Steps to Take with Your Dentist
If you're facing issues with a failed crown, the first step is to discuss the matter openly with your dentist. Many dentists will offer to examine the problem and may provide solutions, including adjusting or replacing the crown, often at a reduced cost or, in some cases, free of charge if within the warranty period.
If you're unsure about the proposed solution, seeking a second opinion from another dentist can offer further clarity and peace of mind. A second opinion can provide clarity and outline necessary steps to take moving forward.
Minimizing Risks of Crown Failure
Crown failures are rare and often due to factors beyond anyone's direct control. However, both dentists and patients can take steps to minimize risks:
Practice diligent oral hygiene with regular brushing and flossing.
Ensure all dental health issues are fully treated before crown placement.
Discuss crown material options with your dentist to select the best for your needs.
Be mindful of habits like teeth grinding, which can affect the longevity of your crown.
If Issues Arise With a Crown
While the thought of pursuing compensation for a failed crown might cross your mind, consider that dental professionals are motivated to ensure your satisfaction and health.
Communication is key. Speak with your dentist about any concerns, and they will likely work with you to find a satisfactory resolution. Legal routes are typically not necessary and should be considered only in exceptionally rare cases where communication has not resolved the issue.
Final Thoughts
While dentists strive to provide the best care possible, the responsibility for a failed crown is not absolute. Determining who is responsible requires careful evaluation of the circumstances and considering various factors that may have contributed to the failure.
Preventive measures and open communication between patients and dentists can help minimize the risk of crown failures. In case of a failed crown, seeking a second opinion from another qualified dentist can help explore possible remedies.
Remember, taking proactive steps towards maintaining good oral health and addressing any issues promptly can increase the odds of a successful dental crown.
FAQs
Will a dentist warranty a crown?
Many dentists offer a warranty of some kind on dental crowns, typically ranging from 1 to 5 years, covering defects in materials or workmanship. The specifics can vary based on the dental practice and the materials used for the crown. Feel free to discuss warranty details with your dentist before the procedure, but generally any discounts or warranties will apply on a case-by-case basis related to the cause of failure and the amount of time that the crown survived.
What happens if a dental crown fails?
If a dental crown fails, it might become loose, fall off, or show signs of wear, such as cracks. A failed crown needs to be evaluated by a dentist to determine the cause of failure and the best course of action, which may include repairing, re-cementing, or replacing the crown.
What percentage of crowns fail?
The failure rate of dental crowns is relatively low, with studies suggesting a survival rate of approximately 90-95% over ten years. Factors affecting longevity include the material of the crown, the health of the underlying tooth, and the patient's oral hygiene habits.
How long are crowns under warranty?
The warranty period for dental crowns can vary, usually ranging from 1 to 5 years, depending on the dental practice's policy and the type of crown material used. Feel free to clarify the warranty terms with your dentist, since there is no universal policy for this topic.
What if my crown fell off after a month?
If your crown falls off after a short period, contact your dentist immediately. A crown that falls off soon after placement may indicate an issue with the fit, the cement, or the underlying tooth. Your dentist will need to assess the situation and may reattach or replace the crown.
Why are crowns not covered by insurance?
Dental crowns are typically covered by dental insurance, but coverage can vary depending on the policy and the reason for the crown. Some policies may have restrictions on coverage for cosmetic reasons or if the crown is replacing an existing crown that has not reached the end of its expected lifespan. Some insurances also have waiting periods or pre-existing conditions clauses, or will refuse to pay for a crown if an insurance representative feels that it is not functionally necessary.
Why did my crown only last 2 years?
A crown lasting only two years can result from several factors, including improper fit, poor dental hygiene, dental trauma, or issues with the underlying tooth. It's crucial to follow up with your dentist to identify the specific cause and prevent future failures.
What is the most common cause of crown failure?
The most common causes of crown failure include decay or breakage of the underlying tooth, wear and tear leading to cracks or chips, and issues with the crown's fit or the bonding process. Maintaining good oral hygiene and regular dental check-ups can help detect and prevent potential problems early.
* Though the author of this post is a licensed dentist in the state of Kansas, this information is provided for informational and educational purposes only. Please use your best judgment and contact emergency medical services in the event of an emergency.