Broken implant screw caused by too-tight biteguard?

by Diana
(North Palm Beach, FL )

I had a bridge placed over a lower molar & bi-cuspid with an abutment tooth in the middle, appprox 10 yrs ago. I went to a new dentist to get a new niteguard, as I grind, but he made it for the lower arch, and it was hard to snap in & out,so I questioned him why he didn't make it for the top, as I've always had them done. He said it was better on the bottom, so I could talk with it in...( in my sleep???) .

About three weeks later, I snapped the niteguard off, and the bridge felt like it was being pulled, and come to find, the molar implant screw broke. When I went back to the original dentist who did the implants & bridge, he cut the bridge off so as to leave the bi-cuspid as a separate crown, (he had taken the bridge off & into the lab to cut it) Then I was informed I would have to get a new bridge made, and have the implant dug out, and I would have to pay for all of it again.

He did not torque the remaining crown properly, & as soon as I left, it started spinning around, cutting my gums, and I also discovered a strange lump on top of the gum, where the abutment tooth had been. I was billed nearly $400. for that appointment, which I'm making payments on.
Then, I bumped into the dentist who made the lower niteguard, & explained what happened, as politely as I could, & he got very defensive, & told me it wasn't his fault, or the niteguard. Period. (I had paid $500. for the niteguard, and it broke in half when it snapped the implant off)...which I'm also making payments on....

The niteguard dentist then ran off a list of his latest medical problems, telling me he "almost died" and (it seemed) tried to make me feel guilty for even slightly assuming the screw broke because of something he did.
Might I also add, I went to dental assisting school years ago, & even though I am no longer in that field, I know plenty about it.

so, now I have $800. of bills, have been making small payments, the niteguard dentist put me into collection after a month, and the remaining crown and screw has come off, so I have no teeth on that side, as well as no money to pay for all this as well as having to pay for a new bridge. I'm not sure what to do now, except to try to find a lawyer, and let the two dentists fight it out.

I also believe the bridge did not have to be destroyed by cutting it off, leaving me to spend more money to replace it, because the dentist was in a hurry and didn't think it out. There was nothing wrong with the actual bridge.

I'm now trying to find a dental school, or lower cost way to fix this.

Any advice would be very much appreciated.

Comments for Broken implant screw caused by too-tight biteguard?

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that's pretty sad. NEW
by: Anonymous

I thought implants were guaranteed for life?

Broken Screw NEW
by: Sharon B., RDH

Hi Diana,

I suspect that the bridge dentist cut it because there was no way you could be functional with that bridge as the implant was broken..so he thought cutting it down (which you're familiar with, I am sure, since you were once an Assistant) would at least allow you to protect the other abutment tooth without buying a new crown.

It definitely sounds like the guard fit had something to do with it, but I am not sure I would completely place the blame on just that. If your teeth had shifted any at *all* between wearing the guard (if you did not wear it every single day), which is very, very common, it may have been too tight if you forced it in, and caught on the bridge when you were taking it out.

While it's not uncommon, lower guards are performed less often than upper ones. Theoretically they are both equally functional and it is is preference or based on anatomy (maybe you have some tori on the upper, making it more difficult for an exact fit?)

If it were me and I suspected it definitely was the fit, I would be asking the guard dentist to make you a new guard as well as have the other dentist write a letter stating that he believed it was the guard's fault that the bridge broke...getting an outside opinion, then asking the guard dentist to foot the bill for the new bridge/crown/implant/whatever. It is definitely a mess.

Don't take this the wrong way...but I also think that since you are shopping around and seeing various dentists for dental care, that is part of the problem. If you are unhappy with one dentist then you should move to another, but I would highly recommend all dental care be performed at the same office, so that the practitioners there know exactly what is going on with your teeth at all times, and can address those in a comprehensive manner. Moving here to there between treatment can unfortunately, encourage things like this to happen.

Sharon




P.S. To "Anonymous": no dental treatment is ever guaranteed for life. New tires are not guaranteed for life as they wear out and eventually need replacing...same with dental work.

broken implant screw NEW
by: Diana

Hi Sharon,
thanks for the feedback. As far as asking one dentist to write a letter saying the biteguard was at fault, well, we all know that dentists will not pass an opinion, much less blame another dentist. The biteguard was extremely tight when it was delivered, and I did wear it every night, as I have all upper veneers, & try hard to avoid chipping them.
I know that since you are in the dental field, you are also aware that most dentists specialize in different procedures, hence, my going to another dentist for the biteguard. I don't jump around from one dentist to another, & certainly don't think a 10 year span between the two would be called dentist shopping.
One thing I should have mentioned, is that the implant on the posterior molar was apparently a short one, which was never conveyed to me, and if it had been, I would never have allowed the biteguard to be made on the lower. I guess I just assumed, since the biteguard dentist took bitewings, that he would have seen there were implants on the lower quadrant, and could have seen how short the implant was.
Well, as you say, it's a mess, and, had I been asked about what I wanted to do about the loose bridge, I most certainly would have tried to save the bridge, and have a temp placed over the one implant, until I could get in to have the screw removed.
I guess I need to find another dentist who wants their patients to be involved in their treatment plans....

Guard and Implant NEW
by: Sharon B., RDH

I did not realize it had been 10 years. It sounded as if it had been a period of months. In this case yes, it is up to whoever performed the most recent treatment to be responsible for what changed. If the x-rays were taken immediately before the guard was made (within the past month) then it should have been noted as to what type of bridge you had and if there was recurrent decay or infection around something that needed to be corrected first.

However, since the bridge was 10 years old, this is now around the average time that you would probably need to have the crown replaced anyway, and it could have simply worn out and had a small amount of recurrent decay somewhere that caused it to just go ahead and come right off the moment it had any type of over-appliance (bite guard) on it. So most likely you will just need to pay for a new bridge to be placed in, and it was not the guards fault at all...it just happened to cause it to go ahead and come out even though it was going to eventually anyway. This is my opinion.

I think I made it confusing..... NEW
by: diana

Hi again, I guess I'm a bit long winded, when it comes to explaining something.....and, that very thing is what confuses the story. I don't blame you for not understanding my writing. The bridge was made over two implants, w/ a fake tooth in the middle. There were no natural teeth of mine under the bridge, hence, no possibility of any decay. The three teeth had been removed a long time ago. The back molar implant screw is what broke off, leaving the bridge wobbly., and, the implants are both still in place., the bicuspid implant is exposed, & the molar implant is underneath the gum. Hope that clarifies it. Thanks again forfor taking the time to write. Makes me feel that there are people who do care. Diana

I think I made it confusing..... NEW
by: diana

Hi again, I guess I'm a bit long winded, when it comes to explaining something.....and, that very thing is what confuses the story. I don't blame you for not understanding my writing. The bridge was made over two implants, w/ a fake tooth in the middle. There were no natural teeth of mine under the bridge, hence, no possibility of any decay. The three teeth had been removed a long time ago. The back molar implant screw is what broke off, leaving the bridge wobbly., and, the implants are both still in place., the bicuspid implant is exposed, & the molar implant is underneath the gum. Hope that clarifies it. Thanks again forfor taking the time to write. Makes me feel that there are people who do care. Diana

Implant NEW
by: Sharon B., RDH

I'm sorry for the misunderstanding. With it still being several years since it was placed I suspect that it has simply given out and will need to be replaced entirely, and would have happened whether or not you had the guard over it. This is my gut instinct.

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