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.
Treatment planning is based on multiple factors; expense, time and technical considerations. Here is an asymptomatic upper left second molar with no opposing dentition. The tooth has lost a lingual amalgam and has extensive mesial-buccal subgingival decay. The patient cannot … Continue reading
This emergency patient came to my office with a chief complaint that a portion of a crown had fractured off. Clinical exam showed no fractured crowns. There was a small white material that seemed to be excess resin cement. It … Continue reading
The upper left first bicuspid has had endodontic therapy. The radiograph shows a questionable obturation and an apical area with a slightly different bone density. This is a rather typical scenario and in an ideal world, prior to … Continue reading
This patient arrived in my office on a Friday afternoon referred from a Miami Beach 5-star hotel. Her New York Manhattan aesthetic dentist had recently replaced the two central incisors with feldspathic porcelain bonded new crowns. This was performed due … Continue reading
This patient came to my office having lost her lower bridge. Clinical and radiographic exam shows generalized recurrent decay, inflamed gingival tissues and other pathologies. I was surprised that she was in the process of implant therapy in her native … Continue reading
When most patients present for therapy they are concerned with two things… fixing what’s wrong and the cost. This presents a dilemma for most dentists who are taught to fix things only the right way. There are creative ways to … Continue reading
This emergency patient presented with a fractured amalgam restoration. The tooth was asymptomatic and a radiograph showed no obvious pathology. The following therapy was performed. Local anesthesia was administered (topical plus septicaine). Removal of the amalgam and soft tooth structure … Continue reading
There is a concept in dental radiology called cervical burnout. It presents at what appears to be decay around “the neck” ( cementoenamel junction of the tooth ) when in reality it is an artifact. This patient presented to my office for … Continue reading
The following is the initial report sent to this emergency patient: Monday, June 17, 2013. This patient called this office yesterday with a chief complaint of swollen gums. He was prescribed an antibiotic (amoxicillin, 500 mg. # 20 tabs ) … Continue reading
This patient’s chief complaint was the unesthetic two front crowns. They obviously needed to be replaced. She told me that she was seeing a periodontist and that she was scheduled to have periodontal surgery the next day. When I examined … Continue reading