Cerec??? crown problem

[labdude]

Made in office 1st molar crown lower left. Incorrect anatomy on lingual. Has an indentation on lingual. Doctor made this crown in office using Cerec.
There have been other issues with other teeth while using this doctor.
Any suggestions or advice guys???
Mike.

[TheLabGuy]

Any advice about what? Cerec is a in-house cad/cam crown. As with anything in life, it's only good as the operator, i've seen horrible ones and i've seen some really nice ones, really depends on the Doctor/assistant doing them, somewhat of a learning curve.

[labdude]

It's my fedex driver . She asks me about that crown and 2 others. She feels that maybe she should find another dentist. DUH.
He has placed another crown on a different tooth with her, that he did a root canal on. That tooth developed decay underneath the crown due to leakage, and had to be redone. She has a 3rd tooth worked on by same doctor, cerec also. It now needs to be replaced. Which he said he would do under "warranty".
Makes me crazy. She has 80 20 dental coverage. It just seems highly incorrect (maybe screwed) this guy bills insurance for 80% and gets another 20% from the patient. No quality lab work involved. True lab work bypassed at the expence of the patient in both cost and quality.
True, he may be charging overall less than if using a lab. The patient is still the loser as the work is substandard. Needing repair on every case.
She is only aware that she needs to find another dentist. She is interested in finding someone capable. We did refer her to the Dr we use. Informed her that cost would be higher, but, as we know, you get what you pay for.
Educating the general public in the matters of their own health care is tough. They have no idea what is going on when they visit their Dentist or Dr.
Some over "educate" themselves by reading a few books, then go to the Dr and really make his day.
I just don't know what to do about this kind of thing in general I guess.
I want to help out, but, you have to start so basic, the people lose interest. Then they go on to falling for the same ploy with another situation.
Thanks Rob for the Cerec info. It explains alot quite simply. Good as the operator.
I have a crown, porcelain to metal lower 1st molar. Great crown. But, my dentist is edgey working on me. I never put forth my job, he asked. I never try to "guide him" in his work on me. He does enjoy the level of communication he gets. Being able to describe things in technical terms, and be answered in kind. It is really ideal to be able to undersatnd and talk about what needs to be done and how without having to wonder about the things not realy understood by some.
Education, on all levels in so many areas, how do we do it???
And, some people don't want to learn till the bus runs them over, that a bus just might hurt you.
Now....I'm going to my observatory, open the roof, let things cool down, then let the universe take my mind from what I see here. Deliver my thoughts from what I see here, to what is out there.
Mike.

[Travis]

Your talking one patient getting some bad work done probably by a good doctor who made a bad decision by useing the cerec. Maybe saved some money doing it himself, probley not if he spent the time staining and glazing it.

Imagine all the other people that think there getting care when the doctor gets a restoration make for 40.00-100.00 saving him money. Patient pays 800.00 for a crown, insurance pays x amount doctor makes 760.00. Why dont the insurance pay the labs fees?

[TheLabGuy]

Travis-You don't want the insurance company paying the lab fees, that would be like our Imperial federal government telling us what we can and can't do (charge). Dentists' have a nightmare of a time getting their money from the insurance companies as it is, now just imagine all the labs on top of that. Their would be some postal laboratory owners out there in no time flat.

Mike-That's touchy ground that I deal with everyday. Fixed and some Removable has to deal with patients coming to the lab for custom shades (average about 3 a day), custom stains (average 1 a day), and to drop off partials/dentures. You gotta be real careful what you say to patients. For instance, I'll share a nightmare on elm street with you all. I got a Dentist sued by his patient because of what I said to the patient during a custom stain (I know, I know, not one of my smoothest moves). The patient came in to have some flourosis added to the incisal of her bridge (easy enough I said to myself). While chitter chatting with the patient, she was rambling on about how she couldn't understand why the Dentist cut her two good teeth down adjacent where she had a space (pontic from a previous extraction). Not paying attention to her or getting side tracked at what I was doing I non-chalantly said if it was my mouth I would of I got an implant. Then we checked the stained bridge and I didn't give it a second thought about what I had said and she didn't question me about it, she was happy with the color and out the door, enough said. Little did I know, she went home and jumped on the internet and looked up what a "implant" was and the next morning called her Lawyer, by afternoon the Dentist was getting a summons for court. I talk to patients like they're rats, will rat you out to the first trial lawyer around, it's sad I know, but after that nightmare, I don't take the chances. However, if one of them asks who is a good Dentist, I don't mind telling them who I go see to have work done, or my family for that matter.

P.S. The Dentist still sends all his work to me and patients. Doctor was surprised that I had the cohano's (integrity) to admit to him that I said that to a patient and after apologizing up and down for such a amateurish mistake, he forgave me as well.

[labdude]

Yup Travis, one person, one doctor. Just surprising how little people know or understand what is happening to them and how. I don't want to bad mouth a doctor, or Cerec either. Seems to me thoguht that the 2 things together aren't such a good idea.
There is a dentist in town I refuse to work for, for simple reasons.$ There was an ortho office sharing the same floor in the building. Ortho office moved across town. Gp starts doing ortho work. Again, on another Fedex person that comes to the lab. The Gp apparently has no one to refer ortho to, so he does it himself. Not a legal problem, just tweaks the ortho docs. Ortho docs generally have smoe sort of relationship with a GP or10, they refer back and forth. Without referals, a given practice experiences slower business. The result is "branching" out to other areas to stimulate income. Small town here, not a good idea to paint yourself in a corner by being "disagreeable" with your cohorts. Fickle business stuff. I try (successfully) to stay out of the good ol buddy network with anyone, anywhere. Rob's right about insurance, don't take it even if it comes with sand.

Rob,
Your right on. That is the creepy part, dealing with the public. I don't envy you that. So easy for a person out there to take what you say lightly, and start a large fire for you. I trip over my **** on regular basis, keeps me honest I suppose. If your really good at what you do, and you are Rob, it all works out. With those guys that it doesn't work out with, they're probably not worth working with. But there is always someone who will work with them, nice to have a choice ain't it??? I suppose Travis is o.k. too.
Your both a couple of gaming pussies.
Thanks guys,
Mike.