Dental malpractice prepping teeth for crowns or not?

My lower left 2nd molar was prepped for a crown. The sides of the molar are not parallel and the top of the molar is not straight across. Rather it was tapered like a teepee-the top of the molar slants diagonally toward the inner gumline at a steep angle. Therefore, my crown keeps falling off. It has not stayed glued on to this day. I am at risk for losing the molar from decay or fracture since the crown doesn't stay glued on. I am left with a little stump. Could there have been a logical reason why my dentist tapered the molar in this way? Was it tapered this way because of my bite? Is it common for dentists to taper molars for crowns in different shapes depending on the bite? Or does this sound like malpractice?

Dental malpractice prepping teeth for crowns or not?
I cannot answer your question directly, but I can give you some advice based on my experience with some poor dental work I received once.





First off, your crown doesn't stay on. This is clearly a problem, regardless of specifics like the shape of the crown. I would go (or call) your dentist and explain that you need a solution to this problem. Is s/he charging you for each visit? If so, I think you need to ask for some sort of refund for your repeated visits.





After your conversation, I would write the dentist a letter, registered, return receipt requested (in the U.S.), outlining your problem, your conversation and your expectations for a proper resolution.





Meanwhile, if you have dental insurance, I would contact the insurance company, and speak to somebody about your problem, and tell them that you need to see another dentist to have this problem resolved, and obtain authorization to do so. Discuss with the insurance company the possibility of their withholding payment to the dentist for this substandard work. A good way to begin this process is merely to call the insurance company, tell them your problem, and ask them what you should do.





At this point, you can either (a) trust the old dentist to get things right, or (b) you can go to another dentist and get another opinion about the work, and hopefully, a good fix. In my opinion, I would go with option (b) if you have been to the 1st dentist 2 or more times to get this fixed (in other words, 2 or more visits since the final crown was inserted).





Be sure to tell the new dentist you want an opinion of the quality and appropriateness of the previous crown work. Also, get copies of the charts from this new dentist. For that matter, if it's not too late now, request copies of the charts from the old dentist. If they won't give them to you, have the new dentist, or the insurance company request them.





I would not make any threats of malpractice or anything else until you've exhausted all your options. If you do have to go to another dentist to get this fixed properly, and your insurance won't pay for it, you should write another letter to your 1st dentist, requesting that s/he reimburse you for the new work. If that is not forthcoming, you should send a 2nd letter, saying that if you aren't paid, you will seek "other solutions." If that doesn't accomplish anything, I would then file a formal complaint with your local dental board, and perhaps file a small claims lawsuit to obtain your money.





In my case, a dentist installed a filling that caused me no end of problems (bleeding mostly). I went back twice, and the dentist said "nothing was wrong," and did nothing. However, she did charge my insurance each time. Finally I went to another dentist, and they found rough edges around the filling that were causing the bleeding, and they removed them, ending the problem.





At this point, I contacted the insurance company and told them what had happened. They withheld payments to the old dentist and demanded a refund for the old work. The old dentist was very angry at me and sent me a nasty letter. Why? Because an unfortunate characteristic of U.S. medical professionals anyway is that they frequently behave in an exalted manner, and never admit mistakes. Also, they don't think they should ever have to take direct financial responsibility for their mistakes or poor quality work.





However, I would never challenge doctors'/dentists' bloated egos directly, because you will get attacked ferociously. It is important for you to behave in a neutral, professional manner at all times with everybody. Just keep your eyes open, collect records if you can, get professional opinions, contact the insurance company and a new dentist, and get your tooth fixed. I know how unpleasant it is to have these sorts of open-ended problems, and I wish you all the best with your solution.
Reply:That's the way they do it. Are you talking about your temp crown or our real one? Temp ones come off regularly.





They have to make the tooth that way to keep the nerve intact. Or else the tooth will die
Reply:The taper is so the tooth doesn't get broken from side forces. The cone or pyramid shape gives more surface for the cement to hold. I have known several people that had crowns done like that. Maybe you are doing something that puts too much force on that tooth, especially if the nerve has been removed and you don't realize how hard you are biting. Maybe you didn't let the cement set up before you used it. Give the dentist a chance to re glue it or see another dentist. This one may be missing something. With all mechanics, some are better than others.