Crown This Lady “Worst Patient Of The Day”

I’m a dental assistant for a private practice. Most of our patients are wonderful people — friendly, happy to see us, respectful of our professional opinions and recommendations, etc. But today, I had the most entitled jerk in for what should have been a simple appointment.

When we do crowns — or caps, as some people know them as — we prep the tooth beforehand and take an impression. Then, that impression goes to a lab and the techs there make the crown. It takes two or three weeks for them to send the crown back.

When we deliver the crown to the patient, the doctor and I try the crown in first to see how it fits. It is VERY rare that it fits perfectly. We almost always have to make some adjustments — shaving down the crown here and there, checking the space between the teeth, checking the bite, etc. All of this is standard. The main thing we use is called “articulating paper”. When the patient bites down on it, we can see heavy blue markings where the bite needs adjusting. The more we adjust, the lighter those marks get, and it even stops marking altogether sometimes.

Most exchanges with the patient are like this.

Us: “How’s it feel?”

Patient: “It’s a little high.”

Us: “Okay, we’ll adjust that.”

We use the articulating paper and then grind the crown down a little.

Us: “How’s it feel now?”

Patient: “Oh, that feels much better.”

Us: “Okay, cool. Let’s cement it in.”

This takes maybe five minutes AT MOST. This lady we had tonight was having none of it.

Us: “How’s it feel?”

Lady: “Ugh, it’s way off.”

Us: “Okay, we’ll adjust it. How’s it feel now?”

Lady: “The same.”

Us: “Umm, really? No change?”

Lady: “The same.”

Us: “Okay, no biggie. Let’s adjust more.”

Over and over, she kept insisting that it was exactly the same, no change, even though the marks were gone at this point, meaning that her other teeth were no longer even touching the crown.

At this point, we had a couple of options that the doctor presented to her.

Doctor: “I can keep adjusting the crown. The only issue is that if I keep reducing the porcelain on top, the metal underneath might end up showing. Are you okay with that?”

Lady: “No.”

Doctor: “Okay. Well then, I need to make a small adjustment to the tooth above this one so that they don’t touch. It’s very superficial.”

Lady: “No! Don’t touch my other teeth!”

Doctor: “We do this all the time, ma’am. It doesn’t harm the teeth. We’re basically just polishing it.”

Lady: “No! That’s a lie! If you guys did it correctly the first time, you wouldn’t have to adjust it at all!”

Doctor: “Ma’am, we do this for everyone. The lab almost never makes them perfect. We either have to adjust the crown itself or the opposing teeth.”

Lady: “No, you screwed up.”

Doctor: “We have to adjust one or the other, so which would you prefer? Do you want metal showing?”

Lady: “No!”

Me: “So we can polish the opposing tooth?”

Lady: “No!”

Me: “It’ll literally take a few seconds.”

Lady: “No, you’re lying! It’s gonna harm my teeth!”

The doctor suggests getting our office manager to talk to the patient. Our office manager is an awesome lady. She’s old — two years away from retirement — and doesn’t give a f*** anymore. I tell her the situation and she laughs.

Office Manager: “Okay, let’s make her wait another month. I don’t give a s***.”

I laugh as she marches right in there.

Office Manager: “Okay, ma’am. Since you don’t want this crown, we’ll send it back to the lab and have them redo it.”

So, instead of just waiting the sixty seconds for us to adjust, she now had to wait three weeks to come in again. And that was just to RE-PREP the tooth. Then, she had to wait another three weeks for the crown to come back from the lab, again.

She had every right to request that the crown be redone. That’s not my issue. My issue is that she accused us of lying, screamed at us, wouldn’t tell us why it felt “exactly the same,” and didn’t want any solutions we offered.