Hello everyone from Ann Arbor, Michigan, home of the #1-ranked Michigan Wolverines! Wow, I’ve waiting a long time to say that—literally my whole life.
If yours is anything like mine, life has been pretty crazy lately. I hope you are managing to keep up and enjoy it a bit. I have had the pleasure of following John’s adventures over that last few years, and I hope you will also enjoy reading about mine. In his farewell post, John talked about the importance of being vulnerable and writing about things that do not go so well. In his honor I am going to talk about failures today.
It is always nerve-racking to head home at the end of the semester knowing there is nothing I can do for my patients for at least two weeks. I know that when I enter private practice, I will be able juggle my personal schedule and see a patient if I truly need to. But here at the dental school, my hands are tied. With a patient list of 55, one might think emergency calls wouldn’t be all that common. But somehow I can count on at least one patient leaving me a message saying he lost a filling, cracked a tooth, or is in pain.
I see a lot of failures in the dental school clinic. Most of them are lost or fractured restorations and crowns. Right now I am redoing a maxillary denture from my patient’s previous student that “never looked or felt quite right.” (Could you live with a denture that was 8mm too open for your bite?) Regardless, I simply cannot believe that failures are this common in private practice.
Longevity data leads me to believe that there is something going wrong in this setting. Is our problem the poor isolation of not having an assistant keeping things dry and being too busy (ok, lazy) to place a rubber dam? Are we not prepping enough retention or using subpar materials? Maybe we are trying to cure composite layers that are too thick. Or are we all too often dooming ourselves to failure by trying to make direct restorations work when crowns are indicated, simply because our patients cannot afford them?
Do you see fewer failures now? I really hope you do. How do you keep your failures minimal?
Have a great rest of the week,