Friday, August 17, 2012

Nagging Injuries

Happy Friday to you.

I haven't talked much about TV lately because, other than the Olympics, I haven't been watching much. But there are a couple of shows that I have really gotten into. My favorite TV show right now is Suits on TNT. It has good story lines, conflict, and good character development. I looking forward to Thursday nights even though we never watch it on Thursday because we DVR it (it is just nice to know it is there when we sit down). My wife likes White Collar and I have always liked The Closer (even though it is over). You guys watching anything good? Let me know.

Today's topic is that tooth. You know that tooth. The one you worked on 10 years ago. The one that looked good when you did it but maybe on the x-ray it looks like it might be failing.

Look at this photo. I finished this root canal 10 years ago. He is totally asymptomatic. Is the palatal root failing? I don't know. Is it going to blow up on him over the weekend? I don't know. Should I tell him what I see and worry him? don't know. It should be fine… right?

When I think about it, I have a bunch of these things floating around my practice. Maybe on a posterior composite restoration that I did and there is a little radiolucency at the bottom of a box. Is it decay? Is it air? Is it a radiolucent material bonding agent that got a little thick? I just don't know.

How about a crown with an overhang? How about a submarginated filling? (I have seen these things last forever with no issues.) What if you did a veneer 6 years ago and the margin is starting to discolor? Maybe the cement is wearing out or there is a microscopic opening.

I can't just go around redoing every little thing that might have something going on, can I? You know the thing that drives me is the fear that this patient with this "maybe" thing going on in their mouth would move away. What if they go to another dentist and that guy asks who their last dentist was with a sound look on his face? (You know you do that. I do that. I don't mean to, it just comes out.)

Of course, I want the best for my patients. I want to give them the best dentistry out there and I want my stuff to last. Is doing the best dentistry going in and redoing something that might be wrong? I don't think so. What are your thoughts? Do you have a bunch of "maybes" out there? What do you do if you do?

Short and sweet today. Have a great weekend. Thanks for listening.


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