I know what you’re thinking, punk. You’re thinking “did he give me two carpules of anesthetic or only one?” Now to tell you the truth I forgot myself in all this excitement. But being this is a Kavo electric high speed, the most powerful high speed drill in the world and will blow your enamel clean off, you’ve gotta ask yourself a question: “Did I pick the right dentist?” Well, did ya, punk?
Nope… I didn’t go all “Dirty-Harry” on some sociopathic perp. My day just got made… as a dentist!
A few days ago, a 13 year old girl who was brought to my office after her mom searched the entire county for a dentist to re-do the cosmetic bonding on her teeth. The daughter had completed orthodontic treatment. She has congenitally missing laterals. The canines are now in the lateral position. She has one retained deciduous canine. The other has been replaced with a Maryland bridge for now.
Before (the previous dentist’s “after”).
She had gone to another dentist for some “cosmetic bonding” to make the canines look more like laterals. The young girl (we’ll call her “Mary”) and her mother were not happy with the result. Reportedly, the treating dentist dismissed their concerns with, “No. It’s good.” And, that was that. The daughter has been crying every day. Mom did a Google search and looked at dentists across the entire county. She picked my office because she liked the photos of cases I had posted.
Lingual view of how patient presented (before).
Mom brought Mary in for a consult. I asked Mary what she wanted changed. She felt the laterals were too short. We did a composite mock-up, and she loved it.
Composite mock-up. #7 is a bit long and needs contouring. But, this was enough for the patient to say, “That’s what I want!”
So, I suggested we make an appointment to do the bonding. In the process of just making conversation, I asked Mary if she had already done her class photos. She answered, “Tomorrow.” Aw, crap! I glanced at my schedule. She was the last patient of the day, but there was more dentistry than day left. You want to do it today? Right now? Her face lit up, “YES!” And, so we did… and stayed a little late.
After!
This was a tough case, as is every “lateralization of the canines” case. I flattened the facial contours before adding composite to the incisal areas. I faded the composite gingivally on the facial. It is FAR from “ideal.” They’re simply too wide, for one thing. But, it’s what we have to work with for now. In the future, when she gets implants, we can narrow the “laterals” to give a better “golden proportion.”
Today I got a thank you card from the girl with her inscription: “Thank you for everything. You are the reason for my beautiful smile!” – Mary
Enclosed with the card was a letter from her mom:
What a wonderful group of people you are. Words can’t describe the wonderful experience Mary and I had in your office. Jo-Ann is the warmest person I think I have ever had the pleasure of meeting. She is definitely the person you want greeting your patients when they walk through the door.
Dr. Mike, you are a true artist with the patience of a saint. Your superb bedside manner is the best I have ever seen. Mary has not stopped talking about how awesome her new dentist is. I have noticed a huge boost in her self-esteem since we left your office, and for that I am forever grateful. You have a wonderful philosophy and treat every patient as an individual with their own personal needs and wants. You really took the time to make Mary feel comfortable and important by asking her what SHE wanted and how SHE wanted her teeth to look. She never once felt scared or intimidated.
I can’t forget about Sandy! You are truly blessed to have such a wonderful woman working by your side. She has such a gentle way about her that makes you feel 100% at ease. She has an eye for perfection and does so without being overbearing. I can honestly say your office is one of a kind. I am grateful that my search led us to your practice. I will never forget what you have done for my daughter. I get to see her beautiful smile that she looks forward to showing off each and every day.
This is what it’s really all about, my fellow Dental Warriors! To be able to have such an impact on someone’s life through our work is pretty incredible.
Update: The Maryland bridge pictured above had to be replaced. Click on the link to see what we did: Changing Lives Again.
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Had a few of those. I love composite veneers. Great job Mike!
Thanks, Daniel. It isn’t a “Newton Fahl” level result that will impress dentists. But, I winged it at the end of the day on the last day of the week. Patient is beyond thrilled.
Awesome Job Mike. That is such an amazing feeling.
I left my practice yesterday on a high note too. Denture wearer for 30 years. Bone was horrible. My OS got some implants at the canine positions. I delivered her new locator dentures. It is such a joy for me to watch the patient struggle to get their implant dentures out for the first time. I like to watch them struggle. I giggle on the inside. Then I show them how to pull on the rear of the denture to help break the locator seal.
Yeah, that’s fun, Michael. It can sometimes be an issue for the old ladies with arthritis. Sometimes, depending on the number of Locator attachments, I’ll swap some out for non-retentive (black) processing males.
Great job Mike! Pt’s satisfied and sometimes that’s all matters.
As dentists we can keep picking on and on trying to get all to be just a bit more perfect. I am guilty of this too. But in the end, pts may or may not care for “dentist level perfect”, but care plenty if they felt “heard”. They are the ones who return and refer friends and family.
Good job again!
Excellent case. I don’t understand what you said about her getting implants at some point. If her canines were moved into the spaces where her laterals should have been, where will she get implants?
Hi Mark,
She’s got a retained deciduous canine on the right side and a Maryland bridge in the space where her left canine should be. She will eventually lose the deciduous canine. And, Maryland bridges are really temporaries. So, she’ll need something in both canine spaces in the future.
That’s a great case and a wonderful story, Mike. It’s always good to remind the dental world the profound impact you folks make on people’s lives, practically on a daily basis.
Also, as a Dirty Harry fan, you cracked me up with your hook!
Thanks, Fred! I had fun with the hook. 🙂
Love the post Dr. Mike – intro is great and the results are even better! Not many dentists would rearrange their schedule and fit her in like that
This is truly a heartwarming story to read and after seeing the before and after photos, I can see “Mary’s” concerns and you did a fantastic job with the cosmetic correction.