{1 - 24} GreyGrey
{25 - 49} GreenGreen
{50 - 499} BlueBlue
{500 - 4999} OrangeOrange
{5000 - 24999} RedRed
{25000+} BlackBlack

Please confirm that you would like to report this for an admin to review.


Is it possible that just a scaler instrument can yank out a crown or filling just by a cleaning?

Just wondering but is it possible or a really slim chance that just a scaler instrument can yank a crown, filling, or an older gold onlay just by a cleaning. The patient i had today refuses xrays and says he only takes them if with something’s wrong. I always explain to patients thats its easier to detect them early with xrays. He was all upset when his onlay popped out when i was cleaning. He was loud and arrogant anyways but these people can really hurt u with their attitudes. All we do is try to help. I hope this has happened to a lot more than I. It aggravating and rude when ure patients try to tell you what to do like how to do our job. Thanks just just wanting to vent and advice lol



Confirm that you would like to Remove Email Alerts for your question. You cant undo this and you will not be able to re-subscribe.


13 Answers

Yes, it is totally possible for restorations to come out during a cleaning. Normally, it’s not from anything you really did by scaling, it’s that the crown/amalgam/etc. was about to go anyway! I explain that exact thing to the patient and tell them it was perfect timing for “it” to fall out because otherwise they could have swallowed it while eating later that night or aspirated it (which could have led to an ER visit and possible surgery). Also, ask the patient how old the restoration is. It’s a chance to remind them that how long a restoration lasts depends on many factors (occlusion, homecare, etc.); some last 2 weeks, some last 20 years. I say this because not a lot of dentists still do onlays so I’m guessing this was an older restoration that came off. You are saying the correct thing to patients about radiographs; many patients are uneducated on how little radiation dental radiographs actually are and how important they are in a correct diagnosis!

 

As far as mean patients, you are not alone there! Unfortunately there are people out there who allow negativity to consume them and they then pass on that negativity to others. I have a tough time not taking things personally as well, but it is important to remember that when people are being mean it is because of their own issues that they are projecting on to you. It’s also important to remember that a lot of people are nervous coming in and their stress is what leads to a bad attitude. Stay pleasant and do a good job. Even if you can’t change your patient’s negativity, don’t give them the power to transfer their negative energy to you. I have to remind myself of this a lot! Do know that you take things personally because you truly care which is admirable!

 

I hope this helps!

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I second what Kara said. It’s much easier to turn a positive negative then it is for to turn a negative positive! Also I have found that many people come across mean due to anxiety/fear of the dentist.
I too have ‘scaled’ out restorations and crowns over my many years. However, in mist cases it was due to recurrent decay or it had already been loose!

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I have popped out old amalgams with recurrent decay underneath and composites that didn’t bond correctly. I haven’t popped out any crowns yet *fingers crossed* It is totally possible to do without any fault of your own. Now if a patient just had a new crown cemented and then saw you for a cleaning right after and you went to town with your scaler then it could be seen as a mistake on your part but this is rare. Usually the hygienist is doing her job properly and the restoration was likely to come out soon anyway. I have had patients be thankful that it happened in office where it can be fixed right away and not while at home on a weekend.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I have removed amalgams, composites, and crowns during or after a prophy. If this happens it is because the restoration was failing due to decay or cement washing out. It is natural to feel badly about it particularly as the patient may not have noticed there was a problem with it prior to the appointment.
I agree that patients often have anxiety and fear that gets directed towards those trying to help them. I think dealing with these patients gets easier with experience. Remember not to take it personally it is really themselves that they are angry with for their circumstance.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


Yes it is possible. If you can pull out a rest

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


Yes but as the others have said it is because the crown, amalgam or sealant was already compromised. If it was secure and intact it would not occur. Patients will like to blame us, but we know better and have to try and explain it to them

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I have done so and I agree that it only happens with a faulty or restoration.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


You are not alone. I’ve pulled out some old fillings/crowns. I feel bad when it happens but know it’s not because if what I’ve done but because the restoration needed to be replaced. As far as the patient only wanting X-rays if something is wrong I would explain that’s why we need the X-rays to make sure there is nothing wrong. Always speak with confidence and authority – it goes a long way with getting patients to accept treatment. This is also where you doctor should step in and support what you’ve told the patient. Without X-rays he’s opening you both up to liability issues.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I explain to the patient that its a good thing that it happened because it means there was a problem with the filling/crown and by it coming off/out we are now able to fix the problem. Had this not happened bacteria could have been getting in and around the restoration and causing a bigger issue that might not have been picked up until it became unrestorable. Patients tend to be more at ease about it after Ive explained it to them that Im not just yanking things out!

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


Yes to all of the above….of course explaining that if it came out it was leaking doesn’t go over well either lol…we gotta just suck this moment out, tell them its leaking or decayed and needs fixing to avoid losing the tooth to decay…they simmah down 😉

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I have scaled out restorations and crowns. I have even flossed off a crown or 2. The patients usually understand but Murphy’s Law says it will happen to the grumpy one. I had a patient recently that is scared to death of xrays of course something was missed or cone cut on the first film so needed to take a second angle. She was belligerent and degrading to me. You just need to stand tall and brush it off.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


Your dentist should back you up. I’ve been told that I’m scaling the enamel off their teeth because it was taking do long. I’ve pulled off sealants, crowns and fillings too. Some get mad and some act like nothing happened. I tell them…if I pull it out it is because it was already loose and they are lucky it happened at the dental office.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


I accident scaled off an DIL on #9 the other day I didn’t even realize I did it because I guess the composite flew off either when I scaled or when I polished and I didn’t see it. Pt noticed that her tooth felt different immediaty so I pulled up her photos she was right #9 definitely lost the composite. I explained to her that front teeth just don’t seem to hold fillings as well due to the fact that they aren’t as bulky teeth and we use them constantly initially bite into things. She seemed to be understanding of the what happened after explaining this to her thankfully. I’ve also scaled off a huge over hang on a composite as well.

Confirm that you would like to select this answer as the "Best Answer" to your question. This will bring this answer to to top and be highlighted as "Best Answer". You can always change this if a better answer is given.


You must be Logged In to Answer this Question

Already a Member, Log In
Not a member yet? Sign Up