Michael Nugent, D.D.S
Bad Dentistry Pasadena, Texas
It’s very unfortunate that the amount of dentistry I am doing in order to correct other dentist’s mistakes is growing. There is a huge difference between a private practice and a corporate chains, medicaid offices and in-network dental office. The private practice dentist is invested in the quality of their work as they are the owner and will be there long term. Corporate dental chain clinics and in-networks doctors in my opinion have a lower commitment to quality work as they know they have an endless supply of insurance patients and employee dentists. With the economy poor, benefits reduced and more people looking for lower cost care the quality of dentistry in the community is falling. Companies are reducing their benefits and offering lower tier insurance coverage.
A GE refrigerator model is the same at Home Depot, Lowe’s or Sears.
However, Dentistry is not a commodity. A filling, crown or ethics is not the same from dentist to dentist.
I take personal pride in my work. I am the owner and will be here in Pasadena until I retire.
Below I will chronicle some of the horrible dentistry I have had to correct.
This patient had gone to a “Cosmetic Dentist” for work on his front teeth. I was truly baffled when I saw the other dentist had made the patient look like a shark. There was a second row of teeth. It was the most bizarre thing I had seen in years.
With minimal work from a TRUE Cosmetic Dentist I was able to correct his smile with minimum work.
This makes me furious. I saw a new patient for a second opinion. She was at another local dentist for the first visit. The other dentist told her she needed a crown on this tooth. This tooth has a small conservative silver filling that is still functioning. There is no decay on the tooth and the remaining tooth structure is sound. The other dentist tried to hard sale the patient into doing a crown right then and there. Patient got a bad vibe and thankfully decided to not do the crown.
The patient looked at and read all our 5 star Google reviews and decided to try my office. I examined the tooth and it was fine and needed no work. It makes me so upset and disappointed that the dentist would suggest such a wrong treatment. I can only guess that money was the motivating factor for the dentist to suggest a crown. It saddens me that dentists recommend different treatment on their patients then they do on their family and loved one. There is no way that the other dentist would grind down a completely healthy tooth on a sibling or parent just to put a crown on a tooth. Therefore, it is greed that was responsible for the treatment recommendation.
Here is one of my patients that needed a crown. He had a LARGE silver filling and had fractured a quarter of his tooth.
Therefore, I recommended the patient get a crown to restore the form and function of the tooth. I recommend and do treatment on my parents, children, team members and my team member’s families. I practice dentistry the same way if you are family or a regular patient. There are multiple dentist in Pasadena that just see people as dollar signs. If you want a completely honest recommendation on your dental health I recommend you try my office.
I saw this patient several years ago when she came in as an emergency new patient visit. She had large decay into the nerve. I recommended a Root Canal and Crown. Fast forward a couple of years and now she is now back at my office. She is complaining of pain on her crowned tooth. I read my notes from several years ago and ask patient about what happened with her tooth. She told me she decided to go to an In Network Dentist because it was cheaper.
I tell her that there are a number of problems with the work. The crown margins (YELLOW) are very poorly adapted. The contours of the crown are not smooth and are contributing to gum disease. There is reinfection (GREEN) around both roots and there is root canal material pushed out of the root (BLUE) and into bone.
This patient had her work done at a in-network insurance clinic. She was experiencing pain and searched for the Best Pasadena, Texas Dentist. She chose to come see me to get her out of pain. There are so many problems with the two crowns the clinic did.
- Open crown margin
- Poorly condensed core build up
- Poorly shaping and cleaning of root canal space
- Root canal is short and not to apex
- Bulky and open crown margin
- Bulky and open crown margin
- Open contact between teeth
It is going to take a lot of time and effort to correct these numerous errors. When low price is the only decision in where you receive your dental care these are the results my office sees.
This patient received a crown and it was only six months old when it came off. Patient did not trust the local Pasadena, Dentist that did the work. When I examined the patient I noted the crown was loose. I was able to easily remove the crown and discovered a very poor crown preparation and decay. Now this crown was just done six months ago and it already has major problems. Furthermore, there was decay left underneath a filling. The crown preparation and attention to detail was very poor. The tooth was AGGRESSIVELY prepared and shaved down. Other problems with the tooth/crown included: the axial walls were 45 degrees and thus no retention, there was no clearly defined margin on the preparation, not enough clearance on the top of the tooth, the new crown did not fit the bite so the porcelain was ground down and destroyed the anatomy.
Six degrees of taper is ideal and what I was taught in school. This poor tooth was cut down so aggressive the angles ended up being 45 degrees. The RED lines represent the angles, the GREEN line is a reference for the angles and the YELLOW is decay.
This patient received fillings at a in-network dentist at a corporate dental office. This corporation has almost 20 offices in the Houston area. The dentist left decay and placed very poorly shaped and condensed fillings.
The red shows where the corporate left decay. This corporation advertises 59 Dollar Cleaning, Exam and X-rays. Well you get what you pay for. The quality of this work is an embarrassment to the dental profession.
This patient had been going to a “in-network” doctor for his two “free” cleanings a year. His gum tissue was hurting and he told the dentist. Nothing was done and the patient was told to brush and floss at home better. The patient went online and researched for a new better dentist. He decided to come see me.
I saw him as a new patient exam. When I started to perio probe (measure the space between the tooth and the gum tissue) the patient asked what I was doing. I asked “did the other dental office never do this?”. Patient replied “No.”
This is absolutely crazy. THE ONLY WAY to determine if a patient has gum disease is to measure the gum pockets. Patient had visible calculus above and below the gum tissue. His gum tissue probing showed massive periodontal disease.
GREEN = where the bone levels should be
RED = where the bone is now because of the infection
Purple = Calculus and tartar attached to the teeth
It is a shame the patient was going to the dentist and received such poor attention and quality. It is neglect that the other dental office never measured the gum tissue. The patient received his “free cleanings” from the in-network dentist. Do you think going to the cheapest dentist or an in-network insurance clinic will result in the best dental care? I don’t.
This patient was seen as a second opinion. He went in and saw a local dentist for a tooth ache. The other dentist pulled two front teeth. The other dentist wanted to immediately do a bridge to replace the missing tooth and it was a pressure sale. The patient did not feel comfortable with the hard sales tactics. Patient researched and choose me. The problem was that the patient had periodontal disease. In GREEN is where the bone should be and in RED is where the bone is. The other dentist did not even tell the patient about his gum tissue status. The anchor teeth for the bridge were mobile. It is bad dentistry to put large bridges on teeth that have a compromised support. Plus, bridges are old fashioned dentistry. The other dentist did not give the patient any other options besides a bridge. I talked with the patient about getting the gum tissue healthy and then gave the patient my preference in treatments: dental implants or a partial denture. I do not think a bridge is appropriate as the long term prognosis of a bridge on this patient would be very poor.
Patient had extensive implant dentistry done by a Corporate In-Network Dental Office. The level of incompetence on this case is borderline criminal. The implant placement is horrible and is the cause of these implants failing.
Problems with the implant on the right:
- It is to far back from the natural teeth.
- The implant is way to small for the tooth the implant is replacing.
- The Corporate dentist put two crowns on a undersized implant.
- There is way to much force being placed on the implant.
- Poor angulation on placement.
- The implant is failing as there is over 70% bone loss around the implant.
Problems with the two centered implants:
- Poor angulation on placement.
- The implants are two close together.
- When dealing with multiple implants the surgeon must allow for 3 mm in between the implants. The space is needed to allow sufficient blood supply to the bone between them.
- Caused massive bone loss.
None of the implants placed at the Corporate In-Network Dental Office should have been allowed to stay. During implant surgery one is supposed to take periodic x-rays to verify proper angulation and placement. If a problem is noticed and can not be corrected it is best to abort the implant surgery, place a bone graft and try again in a couple of months. The other dentist placed horrible dental implants and then they restored the doomed dental implants with a 5 unit bridge and 2 crowns. All of the dentistry done by the In-Network has failed. Furthermore, the poorly placed implants have actually caused massive bone loss and the patient is going to lose the tooth next to the two dental implants.
I get an email from a neighborhood friend. Her brother Robert went to a high end dentist in Bellaire. The dental office said the patient had Periodontal Disease. The dental office wanted to do scaling and root planing and ozone therapy (this snake-oil treatment does nothing but come with a big price tag) on the patient. Plus, the office said Robert needed to buy nutritional supplements and of course the office was selling the supplements. It was all high pressure sales. Robert declined treatment at the aggressive Cosmetic Office.
I told my friend it was OK to give her brother my cell phone and for him to contact me so we could talk about his dental concerns. Roberts explains that he moved to Houston and was trying to find a dentist. He has gone twice a year his entire life and has never had a cavity. Robert describes the dental office he went to and I knew exactly the type of office he was describing. Robert went to a frilly and posh dental office. Robert told me the dentist’s name and I knew who she was. This particular dentist has branded herself as a Cosmetic Dentist and has an over the top office. She markets and spends tons on money on TV, Print, Radio and Internet marketing. Well all that marketing comes with a hefty price tag. The office needs to generate enormous profits from every patient to pay for the overhead.
The “Cosmetic Dental Office” wanted to do over two thousands dollars worth of treatment on Robert. Because Robert has never had any dental problems he was very suspicious. Based on our phone conversation, Robert decided to make the short drive to Pasadena for a new patient exam. Robert had spectacular teeth and absolutely no signs of gum disease.
In-network dental corporation offices are all over. They take every insurance and therefore work at extremely discounted prices. Therefore, they need to see a much higher volume of patients daily. Quality care is often sacrificed in my opinion.
Proper cleaning of the teeth is vital. If plaque and bacteria harden they form calculus (tartar). Calculus is a cement like materiel that cannot be removed with a toothbrush. The calculus starts a bacterial infection that destroys gum tissue and bone.
This patient was being seen at a insurance factory dental office on Spencer. He got “regular cleanings” every six months. I had to be the one to tell him that he had periodontal disease. He was shocked and confused because he had been going to the dentist. I asked him how long his cleaning appointments were and he said thirty minutes. I then asked if he ever had his gum tissue pocket numbers recorded and he said no.
The RED line shows where normal healthy bone should be. The BLUE line shows where the current bone level is. The YELLOW blobs indicate the calculus.
This patient has severe Periodontal Disease. This is also referred to as Gum Disease. The bacterial infection is destroying the gum tissue and bone levels. If the infection is left unchecked complete loss of teeth will occur.