In the real world ( private practice ) doing dental procedures on a regular basis, being reimbursed a fair fee and expecting successful outcomes is a stressful and challenging goal.
A dentist must learn to be a businessman, psychologist and humanitarian along with an expert diagnostician and therapist.
These case studies are designed to present in an unedited manner the real world situations that are routinely encountered in private practice. Please realize that limited time documentation of a case may not be a fair appraisal of the long term success of certain procedures ( and guarantees of success in medical procedures are rarely given ).
Hopefully, by exposing and analyzing these cases the practitioner will be comforted in knowing that we are not infallible and as human beings, pursuing noble goals is a worthwhile endeavor.
This emergency patient arrived at my office in pain. He was on vacation from London. His dentist removed a portion of this lower left molar but was going to refer the patient to a specialist to complete the extraction. The … Continue reading
This 30 year old female presented to my office with signs and symptoms of nerve deterioration from the upper left lateral incisor. This tooth is sensitive to percussion and shows no response to an electric pulp test. There doesn’t appear … Continue reading
Local anesthesia is administered. Thanks to the potency of septicane it is not necessary to administer a mandibular block. The lesion is opened with a 556 cross cut fissure bur being careful to preserve as much natural tooth structure as … Continue reading
This attractive young lady appeared at my office with a broken filling. She recently had upper and lower porcelain veneers placed and I was very impressed with the result. However, when I requested a photo of the before shot I … Continue reading
The etiology in regards to dental decay is multifactorial, however in a simplified description, bacterial digestion of refined carbohydrates creates an acidic environment that “eats through” the enamel. Once the decay reaches the softer dentin, it can spread rapidly. Preventive … Continue reading
This gentleman appeared as an emergency patient (see report below). He was experiencing pain and swelling as a result of an abscess in the apical area of the upper left second bicuspid. The etiology seems to be the result of … Continue reading
There is a comfort zone that most general dentists have regarding their abilities. In order to expand those abilities it is necessary to study and educate themselves. Specialists are available for referral but this involves an inconvenience for the patient … Continue reading
This attractive young lady appeared at my office with severe pain. Her upper right central incisor was very sensitive to percussion. The radiograph showed no obvious peri-apical pathology but there was an indication of some internal resorption. Endodontic therapy was … Continue reading
A small radiolucency is apparent. Differentiating this from cervical burnout which is a radiographic artifact is important. Misdiagnosing would result in an iatrogenic procedure ( a mistake in therapy ). Utilizing high powered magnification conservative therapy ( excavation of decay … Continue reading
This 23-year-old woman who is 6 months pregnant presented for dental therapy. She has extensive decay along with areas of decalcification and generalized periodontal inflammation. Following an initial appointment for scaling/curettage of the upper anterior dentition the dacay was removed … Continue reading