Decision day. I went in to have the filling removed to see what was left of the tooth. Even this standard procedure is one that separates excellent dentists from just okay dentists. Unfortunately, this dentist is "just okay."
After the decision was made, I learned that there were several things she might have been able to do to better stabilize this tooth. But none of these things were on the table.
Take another look at the X-ray. [And, by the way, take a look at the bitewing to note the occlusion.] Note that there is a good amount of natural tooth surrounding the filling. From her perspective, replacing the filling didn't seem like an option. There was some decay underneath; my fault for letting things slide so long.
Should she have more adeptly and promptly been able to assess the source of my pain? Should she have been able to see this decay before removing the filling? Should she have been more assertive with me when I deferred taking action by letting me know what I might be in for if I didn't address the problem right away? Did she know?
After she removed the filling and the decay, I asked: "Is there enough tooth structure for an adequate prep?"
THE moment of truth: "Oh yes, plenty," she said. I had to trust her assessment.
I told you at the outset that I made a poor decision; trusting her assessment was it. I could have, and certainly SHOULD have, asked her to a) take a photo of the prep so I could show it to Rob and b) asked her to give me a few days before moving forward with treatment so I could get a second opinion. Besides which, Rob pointed out to me after the fact, it would have been wise to wait so the traumatized tooth could settle down.
I didn't realize the ramifications I faced as a result of this one simple poor decision to trust. Instead, I compounded my error by choosing to be a guinea pig in the name of original—and personal—research for LMT.
As I said, I was greatly curious to know, first-hand, how a CEREC crown would compare in the hands of what I considered to be "your friendly neighborhood dentist."
Again, and this is so critical, I did not think about questioning her prep work. My jaw was numb from the drilling so I couldn't tell what the surface of the remaining tooth felt like.
I watched her work the CEREC software. "Hmm," I said, "that looks kind of bulky on the lingual side; can you make it thinner? Otherwise, I'll be running my tongue against it all the time." I watched her slice off some of the bulk on the monitor.
"Also, that anatomy looks very round; my teeth are pretty angular. Shouldn't it match the anatomy of my other teeth?"
"It's an anatomically correct tooth," she replied, and left it round.
After she did all this, she said it is possible there was more decay or damage to my tooth and it might very well need a root canal treatment in the near future. That appeased me regarding the round and quite unappealing tooth she designed. The reason for that appeasement is that I truly believed I'd have to have the crown removed for the endodontic procedure and then have the crown replaced anyway.
So I accepted the blob that looked like someone else's temp and left, glad that I would now be able to chew on both sides of my mouth.
And that was true. Until the night of June 6. (However, this is not the night the crown fell on the very, very old linoleum floor.)
That's in the next installment. Tune in August 16th.
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Curt Morgese, CDT · Owner/Ceramist at Oral Renaissance Dental Lab
Thank you Judy for being brave enough to bring this article to LMT. I also believe that you are a victim...See more of what Dan and I refer to as "The Dark Side." Unknowing patients are trusting their dentist a little too much. Just as in the new medical era where we as patients must do our homework before we place blind trust in our doctors. We need to SCREAM the same about our dentists and new procedures! An educated consumer is a good consumer does NOT only apply to clothing!