Tag Archives: dentist

Commandment #4–Do it Once; Do it the Right Way–the First Time.

measure_twice_cut_once_mugIn carpentry, the first rule every beginner is taught is:  MEASURE TWICE, CUT ONCE! Similarly, dentistry requires the same attention to detail. If one follows my preceding three dental “Commandments“, the prognosis for their teeth can be pretty solid long-term.

For most dental patients, I recommend that they have needed dental work accomplished in as few steps as possible–Do it once; do it the right way the first time in order to avoid multiple procedures. For example, if a tooth needs a crown (Commandment #3), then I may be able to patch it with a filling, but will have to treat the tooth again in the future to protect it with a crown. Treating a tooth twice means twice the risk of injury to the nerve in the root canal of the tooth–since every time a tooth is damaged, infected or restored (“filled”), the nerve inside the tooth is injured/inflamed and must heal. That can happen only so many times before the tooth is irreparably damaged and gives up the ghost–leading to extraction.

 

Restorative Patch Therapy

Fig. 1 Check out the “new” roof. Sometimes the patch doesn’t “quite” match the original.

I advise my patients that the amount of dental care they need will be directly proportional to the amount of dental work they needed (or should have had…) while in their teenage years. Every 20 years or so, they will need to have the dental work updated or replaced–just like those “20-year” shingles on a roof. Now, I can hear all the nay-sayers out there saying, “Ha! Well my dentist did a great job–my fillings have been there for almost 30 years.” To that, I say, “Please refer back to previously discussed  Commandment #1 and Commandment #2, because nothing lasts forever and to maximize long-term predictability of dental care, one must be preemptive in its maintenance.

Figure 2--Preliminary photos (2006)

Figure 2–Before photos (2006)

 

Though the patched roof in Fig. 1 may not match or look as good as the original (it may be part of a long-term replacement plan by the owner), it should function well until the rest of the project can be completed.  For the patient in Fig. 2 and 3, I created a phased treatment plan so that all the procedures needed for his extreme dental makeover (and thus the expenses!) were accomplished over a 7 year period to permit numerous travel opportunities for him and his wife and necessary delays to allow for orthodontic therapy, sinus augmentation and implant healing time. The important part was that he completed his goals on HIS time schedule; got the cosmetic and functional result he desired and each tooth was only restored once!

Fig. 3 Smile complete (2012)

Fig. 3 Smile complete (2012)

 

The only time that a “phased” approach to care doesn’t make sense is when one or more teeth must be touched multiple times unnecessarily. It’s not a mandate, but merely advice to avoid increasing the risk of complications. Remember: Commandment #4 really means that the more times a tooth is touched, the more likely one is to lose the tooth! So, if you are in need of extensive dental care, ask your dentist if the option of a phased approach to care would be best for you. If your dentist cannot answer that question to your satisfaction, give my office a call and schedule a consultation appointment to discuss your needs–I’ll do  my best to provide sound advice.

Either way:  Do it once; do it the right way–the first time.

Until next time–Keep Smiling! Please check in again, or visit my website at:

Dr. Bobbitt’s Website

P.S. Don’t forget to “LIKE” us on Facebook—tell a friend, spread the word:

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Next time: Commandment #5–The “Apartment Building Theory”

 

Commandment #2–Nothing lasts forever

Nothing lasts forever

The band, KANSAS, crooned: “Nothing lasts forever but the Earth and Sky.” As much as my patients wish otherwise, everything in dentistry (except extractions, of course!) has a finite lifespan, too. One can assume that the useful life of a typical filling will average somewhere between 10 – 15 years; it’s a “Bell Curve” like we all remember from the test grades in high school. Some may not make the average; some may stay in the tooth longer, but all will eventually develop recurrent decay due to leakage and/or break the tooth under the forces of clenching/chewing combined with the oxidation (“rust”) of the material. Materials that do not corrode will always last longest. The smaller the filling, the longer it lasts–and vice-versa.

Preemptive dentistry

Fig. 1. But the shingles are still there!

My patients know that I L-O-V-E! analogies. I seem to have one for almost every condition that presents in my office. Material breakdown/failure is a favorite topic. Everyone has seen an old barn like the one in Fig. 1 at some time in their lives. The shingles are still there, but the barn is destroyed underneath it–the shingles quit doing their job many years earlier!

Dental work is no different.

Small, painless holes in teeth can lead to big problems.

Fig. 2. This is NOT going to end well! Better to have patched that “little” hole before the structure is destroyed.

The dentist can identify and repair/restore small issues before they become big ones (see Fig. 2). Most patients don’t realize that the fillings that your parents had your dentist place for you as a teen (or you had done in your early adult years) were not meant to last forever, but rather, to “get you through” until the teeth are lost to gum disease, fracture, or extensive decay, or until you can afford to upgrade them to more permanent restorations that Mom and Dad won’t have to pay for…

Beautiful and well-maintained.

Fig. 3: Attention and meticulous maintenance will result in long-lasting health, function and beauty in dentistry, too!

With a little luck and good health, you WILL outlive your dental work. So, to make the most of it, one must do the things that we consistently NAG our patients about: Floss and brush the teeth every night; cut out the excess sugar and acidic food and drink in the diet; see the dentist twice a year and abide by the 5 Commandments of Dentistry that are being discussed in my blog!

 

Until next time–Keep Smiling! Please check in again, or visit my website at:

Dr. Bobbitt’s Website

P.S. Don’t forget to “LIKE” us on Facebook—tell a friend, spread the word:

Dr. Bobbitt’s Facebook Page.

Next time: Commandment #3