I paid for an expensive treatment and I still have the same problem. What now?

The honest answer is: before deciding what to do, you have to separate three things that tend to be tangled together, and it can almost always be done in one afternoon with the paperwork in front of you.

The three are: what you were promised, what was done, and what is still the same.

When someone spends several thousand dollars and walks out feeling they are in the same place, what comes first is a mix of anger and embarrassment that makes it very hard to think. That is completely normal. But decisions made from there are poor ones, and some of these decisions cost money again.

This article does not judge your treatment. We did not see it, we did not examine you and we do not know what happened. What we can give you is a way to understand it yourself.

First of all: this happens in every country

Colombia included. It is not a matter of one country, one clinic or one type of practice.

And it does not always mean someone did something wrong. There are three different situations that look very much alike from the outside:

• An expected complication that was within what was foreseen and that nobody explained to you beforehand
• An expectation that was never put in writing, so each side understood something different
• Something that genuinely did not go as it should, which also happens

All three feel equally bad. They are resolved in very different ways. That is why the first step is not deciding, it is working out which one you are in.

Step 1 · Gather the paperwork before doing anything

This is pure administrative work and it is what changes the conversation the most.

• The treatment plan you were given, if you were given one. It is different from the quote: the quote says how much, the plan says what and in what order
• The signed quote, with the lines you accepted
• The receipts for what you paid and on what dates
• X-rays or CBCT scans from before, and from after if there are any
• Photos of yourself from before, if you have them, even phone pictures
• The messages where the treatment was discussed

In the United States your clinical record and your images are yours and you have the right to request them, even if the relationship with the practice is tense. You ask in writing, without giving explanations and without announcing what you intend to do with them.

Step 2 · Write down what you expected, and where that expectation came from

On a sheet of paper, two columns.

On the left, what you expected: to chew on that side, for it not to move, for it not to show, to stop being in pain.

On the right, where you were told that: it is in the written plan, the dentist said it at the appointment, I understood it from the advertising, I assumed it.

That second column is uncomfortable and it is the most useful one. What is in writing can be claimed. What was said out loud can be discussed. What you assumed matters too, because it points to something that was not explained, but it gets raised differently.

Step 3 · The first conversation is with whoever treated you

Even if you do not feel like it. Even if you no longer trust them.

There are three reasons, and none of them is politeness:

• They have your complete information. They saw your case, they know what they found and why they did what they did
• Plenty of things get resolved right there, with an adjustment, a follow-up or an explanation that was missing
• If you later want to make a claim, the first question you will be asked is whether you gave them the chance to fix it. Any professional, any insurer and any authority starts there

Ask for a follow-up appointment and bring your three things in order. The conversation changes completely when you arrive with documents instead of a feeling.

What to ask at that appointment

• Is what I am feeling within what is expected at this stage?
• What exactly was done and what was still pending?
• What can be done now to resolve it?
• If something more needs doing, is there a cost to me? Why or why not?
• Can you give me in writing what you have just explained?

That last one is the most important of the five. A written explanation is what later lets you get a real second opinion, instead of someone giving an opinion on your memory of a conversation.

Step 4 · Only then, an outside look

Once you have the paperwork and you have spoken to whoever treated you, it makes sense for someone outside to look at the whole picture.

Not to tell you that something was done wrong. To help you understand what everything you gathered says, which questions went unanswered, and what options usually exist in cases similar to yours.

If you are going to do it, go with what you already gathered. An outside opinion without X-rays, without a plan and without receipts is an opinion about what you remember, and that is no use to anyone.

Two articles help at this point: when a second opinion is worth asking for and, if what does not add up is that the plan did not address your problem, I understand the quote, but not whether this will fix my problem.

What is worth not doing

• Do not stop going to your follow-ups. Even if you are upset. A half-finished treatment gets more complicated than a finished one
• Do not start another treatment somewhere else without closing the first one. It is the fastest way for nobody to take responsibility for anything afterwards
• Do not sign a satisfaction document or accept a refund without reading what you are giving up. Sometimes accepting is right, but it is worth knowing what for
• Do not delete messages or photos, even ones that seem irrelevant
• Do not post the case on social media before talking to the practice. It closes doors that are still useful

About the word almost nobody says

There is a difference between a treatment that did not turn out as you expected and one that was done badly. From the chair they feel the same, and deciding which one yours is requires examining the person, not reading a quote.

We do not make that determination, and be wary of anyone who makes it by message, without seeing you and without your images. What can be done without examining you is helping you organize the information so that whoever does examine you can answer you properly.

If you want the clinical side

This article is about organizing your situation, not about the treatments. If what you are looking for is what can be done clinically, Dr. Carolina Macareno explains it on her practice's site:

• My implant failed. What now?
• How implant healing works, step by step
• How long do dental implants last
• Warranty and follow-up for international patients

Frequently asked questions

Can I ask for my money back?

Sometimes yes and sometimes no, and it depends on what was done, what had been agreed in writing and where the treatment stands. Before asking, it is worth being clear about what you would be accepting in exchange, because a refund usually comes with a closing document.

Is there any point going back to the same dentist if I have lost trust?

It helps with at least two things: getting an explanation in writing, and formally giving them the chance to resolve it. Both serve you afterwards, whatever you decide.

I am in the United States and I was treated here. Can you give an opinion on that?

We can help you understand the documents you have, what they mean and what to ask. We do not diagnose and we do not say whether the treatment was right or wrong: that requires examining the person.

How long do I have to make a claim?

It depends on the state and the type of claim, and time limits do exist. That is one reason to get the paperwork in order soon, even if you have not decided anything yet.

If I end up treated somewhere else, do I need to bring anything?

Yes, and this gets forgotten often: the plan you signed, your X-rays, and above all the brand and reference of the materials or components that were placed. Without that detail, whoever receives you is working blind, and sometimes things have to be removed that could have been kept.

If you want us to look at it with you

In a Second Look we explain, in Spanish, in 30 minutes, what the documents you gathered say, what each line means and what to ask your treating dentist. You also get it in writing within 48 hours.

And if you do not know whether your case needs it, send us what you have and within 24 to 48 hours we will tell you whether it is one where it changes something, or whether you do not need it. If you do not need it, we say so and that is that.