Remember the days when “herodontics” was all the rage? Hmmmm… maybe you don’t. Now, if there’s even a question about a tooth’s restorability, it’s reflexively diagnosed as acute titanium deficiency syndrome. When in doubt, take it out (and replace it with an implant).
Let’s face it. It’s often much easier, and it’s always more profitable. Oh, sure… you’ll argue that it’s more “predictable.” And, you may be right. Or not.
I’m still willing to try to restore teeth that may be more likely dismissed by today’s “standards.” My guiding principle is still, “What would I do if this was my mom?”
Such a case came through my office recently. It wasn’t MY mom, but she’s somebody’s mom. Her nephew, a periodontist up north, referred her to me. The 76 y.o. female’s chief complaint was a loose crown (#6). Tooth #6 had an existing crown and post / core.
It was readily apparent that the post / core was loose and still attached to the crown. I tried to gently remove it. No go. I used the “crown tapper,” again gently. No go. I didn’t want to risk fracturing the root (if it wasn’t already).
I sat the patient up, and we had a discussion. She was already familiar with implants, as she had several. We discussed extracting the tooth vs trying to save it. I explained that I could remove the crown by cutting it off and then seeing what we had to work with afterwards. I may or may not be able to restore the tooth. Continue reading
Many times, I’ve been asked why I refuse to comply with the new rules or indulge the “new ABnormal.” I’ve been called every name “in the book.” Someone told me she hopes I get sick and “a tube is jammed down my sorry throat.” Others have wished me dead.