When Your Dental Work Fails, What Happens Next

Patients arrive at a prosthodontic practice for a reason, and one of the most common is that something has already been tried and did not hold.

A crown that has come off three times. An implant that never felt right. Veneers that were the wrong shape from the day they were fitted. A bridge that broke within two years of a considerable amount of money.

This is not usually a story about a bad dentist

Complex reconstruction is genuinely difficult. That is precisely why it is a recognised specialty with three additional years of training attached to it.

Most failed work was done carefully by someone competent. What went wrong is more often a diagnosis that missed something, or a plan that treated the symptom.

The common reasons things fail

Decay at the margin. The junction where a crown meets the tooth is where crowns succeed or fail. A gap there collects plaque, and decay underneath a crown is hard to detect until it is advanced.

A fracture underneath. A tooth that has lost most of its structure flexes under load. Enough flexing splits it, and the crown is then sitting on a broken foundation.

The bite. If the way your jaws close concentrates force onto one or two restorations, those restorations will keep breaking no matter how well they are made. This is the failure most often missed, because the evidence is not on the tooth that broke.

The gum. Implants and crowns fail through the tissue around them. Untreated gum disease undermines good work steadily and quietly.

Design rather than execution. Sometimes the work was made well and was never going to look right, because proportion, edge position and tooth display were not decided deliberately before anything was prepared.

Why the first appointment should not be treatment

The useful first step is a diagnosis: an examination, x-rays or a scan where they are needed, and an assessment of the bite as a whole rather than the failing restoration on its own.

Sometimes the answer is small. A single crown remade properly on a sound tooth, and the problem is over.

Sometimes the answer is that the individual restoration was never the problem, and treating it again is what guarantees a fourth visit.

What you are entitled to expect

An explanation you understand of what went wrong. The options, including the cheaper one and what you give up by choosing it. A written plan with the sequence, the stages and the cost, before anything begins.

If you have had work that failed and nobody has told you why, that question is worth bringing to a consultation.