Obsolete Dentistry

This year marks my 25th anniversary of graduating from UCLA Dental School. I’ve witnessed many changes in dentistry during that time. Recently, I began to look back on procedures that I used to perform and resources that I used to utilize much more frequently. Here is my list of things that I perform or see much less of now.



Gold Crowns
I used to do many more of these. Nowadays, I’ll place one or two a year. Don’t get me wrong: I love gold crowns. They are, ahem, the gold standard in restorative dentistry. However, patients want white teeth. There are so many esthetic crown choices today, in addition to PFMs.

Anterior Root Canals
I’m not saying I never see these. I just see a LOT less need for them. If someone needs RCT these days, it is likely a molar.

Amalgams
Like gold crowns, there are more esthetic alternatives. I have not placed an amalgam in several years. Again, patients want white teeth.

Ortho Extractions
I’ve witnessed the paradigm shift,from extracting four bicuspids to extracting none, due to orthodontic treatment. We’ve become much more conservative in this area.

Drug-seeking Patients
I used to have a LOT more people trying to score narcotic painkillers from me. But thanks to the Internet, they no longer need a middle man.

Professional Courtesy
Have you even heard of this? This is the practice of not charging other professionals. Lawyers, physicians, etc., and their families would be seen for free or at a discount. I have to admit that when I first started practicing, this courtesy was already dying off.

Immediate Dentures
Our patients are keeping more of their teeth. It is especially rare to have 20- or 30-year-olds come in for their “inevitable” full dentures. If you survey your older patients that have full upper and lower dentures, you’ll find that most become edentulous at a young age.

Premedication
Remember when we used to premedicate for every condition known to man? You may recall instructing your patients to take antibiotics one hour before their appointment. Yes, we still premed for some medical conditions. But do you remember instructing them to take antibiotics a day before their appointment, an hour before AND a day after their appointment? We used to hand out antibiotics like candy.

Recall Postcards
I haven’t sent postcards in the mail in years. These days, we text our reminders and get MUCH better results.

Appointment Books
Yes, when I began practicing the offices I worked in kept a paper appointment book. I haven’t seen one of those in quite some time. Although they are much more secure and not prone to viruses, most of us have moved over to computers.

I wonder which of the procedures we perform today will be obsolete in a few years.

Andy Alas, DDS