Posts Tagged ‘checkup’
Frequent Failures: Diagnosis and Treatment Planning
Friday, July 10th, 2009
The dental experience is very often and hopefully a routine visit involving your periodic cleaning, some x-rays, a checkup, and maybe a minor correction, such as a filling. However, about every three to five years it is recommended by the American Dental Association that you have a full mouth evaluation with x-rays of all the roots. It’s very tempting to put that off, but I can attest to the fact that this is where we find most of the serious problems. Nobody likes to go looking for trouble, but it will surely gather some buddies and come looking for you otherwise.
It’s good to have an edge, so I thought it might be helpful to be armed with the knowledge of some common pitfalls when faced with the possibility of more involved treatment. These are the most frequent causes of failures based on my experience and a report by a very popular and wise prosthodontist, Dr. Gordon Christensen. This will be a six-part series that we hope might help you avoid any failures.
The first consideration is, of course, the first step in your journey: the exam. Be sure to be very thorough in your approach to making decisions that could mean the difference between a happy or sad outcome. Have your dentist take full mouth x-rays, pictures, study models, periodontal charts, and a current health history. It shouldn’t be too expensive, because most of this work can be done by the assistants, and when the dentist does the exam and makes recommendations, he will be dealing from a full deck. Ask questions, find out about alternatives, and request additional educational materials to familiarize yourself with the situation.
Take an active role in planning your treatment, and when you and your dentist make your plans, remember these hints: Use specialists for the more complicated root canals, extractions, gum surgery, and so forth. Don’t get too heroic in trying to save problem teeth, such as trying to save just one of the roots, or redoing root canals that have failed once or twice. Use posts liberally to strengthen the teeth that have had root canals – especially in areas of stress, such as bridge supports. If you are trying to improve the appearance of teeth with fluoride staining (flourosis) or very dark or striped teeth, you will get a far more aesthetic result with opaque porcelain crowns rather than bleaching or veneers. That will also give you a better success rate because of other factors in badly stained teeth such as bonding problems and weakness from cracking. Speaking of weakness, if you’re planning a filling that is too wide, it would be a much wiser choice to do a crown or an onlay, but not a fired ceramic inlay that has become so popular recently. They break too easily. Use cast porcelain. Finally, if you’re using any metals, stay away from the most allergenic metals, such as nickel, chromium, copper, palladium, and mercury, which by some strange coincidence happen to be the most commonly used metals in dentistry.
Dr. Moulton’s article was published in the Desert Valley Times, March 2007
Tags: ADA, allergenic metals, checkup, chromium, copper, Dr. Gordon Christensen, exam, filling, full mouth x-rays, gum surgergery, mercury, nickel, palladium, periodic cleaning, root canals, routine visit
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