 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Dentistry / November 2008Rough and Rushed Dentistry
My dentist seems rushed and rough. What can go wrong with a crown,the usual things? > My dentist seems rushed and rough. What can go wrong with a crown,the usual > things? The more rushed and rough, the greater the chance something will go wrong. There are no "usual things" that go wrong with crowns. Steve > My dentist seems rushed and rough. What can go wrong with a crown,the usual > things? A crown is a crown. A rushed crown preparation *may* not look the ideal crown prep as shown in a fixed pros textbook. ( with experience, a rushed crown prep wouldn't appear different from crown prep done at leisurely pace ) Then again, once the final crown is cemented and the patient feels comfortable, the rushed drilling becomes a moot point. I don't know what you mean by 'rushed and rough.' But from my earnest standpoint, a dentist who can't cut a crown in 15 minutes really needs to work on his/her speed. >> My dentist seems rushed and rough. What can go wrong with a crown,the usual >> things? [quoted text clipped - 8 lines] > standpoint, a dentist who can't cut a crown in 15 minutes really needs > to work on his/her speed. Maybe semantic difference. Rushed to me means insufficient time spent, not "fast" or quick". Fast can be careful and well-done. Rushed to me implies sloppy. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Sorry if I was not clear in my words. Since I cannot see the dentist working on me, I cannot say exactly what I mean by "rushed" other than he was very quick and seemed aggressive in the drilling. When I was a kid, my dad used to take me to a brake shop. They did nothing but brakes and they were FAST, but very good. They looked as if they could do this in their sleep. So I guess fast or rushed does not necessarily mean incompetence. That is why I asked what could go wrong with a crown, or what USUALLY goes wrong with them. >>> My dentist seems rushed and rough. What can go wrong with a >>> crown,the usual things? [quoted text clipped - 15 lines] > > Steve With mechanical devices, it's okay to slap things around and use a bigger hammer when needed. Speed in a dental office (as has been stated) is not necessarily 'bad'. However, 'rough' is. Fast is fine as long as the quality of work is good and it is *smooth*. Don't jerk cheeks, jab instruments, etc. JMO, D > Sorry if I was not clear in my words. Since I cannot see the dentist > working on me, I cannot say exactly what I mean by "rushed" other than [quoted text clipped - 4 lines] > incompetence. That is why I asked what could go wrong with a crown, or > what USUALLY goes wrong with them. > > My dentist seems rushed and rough. What can go wrong with a crown,the usual > > things? [quoted text clipped - 8 lines] > standpoint, a dentist who can't cut a crown in 15 minutes really needs > to work on his/her speed. I respectfully disagree. There are too many factors which influence the preparation of a tooth for a crown. Accessibility and angulation factors may increase the difficulty and the time for a crown prep. Also, I have to consider the possibility today that many of the teeth being prepared for crowns may not even need a crown -- it's easier and faster to make an ideal prep on an ideal tooth -- but if the tooth is ideal, why is a crown being made? In many cases also, existing restorations may require complete removal and careful buildup of a tooth for crown prep. That takes additional time and effort. I have received many phone calls over the years from patients whom I have never seen before, asking if they can come in to "put a crown back on" because their "crown fell off." This always puzzles me. Crowns are designed not to "fall off." In those cases where the crown loss was not related to trauma or caries, I invariably see a tooth which has been aggressively prepped with inadequate parallelism or insufficient prep height, or both. I always wonder how much of a factor the "speed" was in the dentist's priorities for that patient. A little extra effort expended on buildups and parallelism is not too much to expect. - dentaldoc > I respectfully disagree. > > There are too many factors which influence the preparation of a tooth > for a crown. Accessibility and angulation factors may increase the > difficulty and the time for a crown prep. That's true, too. But they become less of an issue as you become more experienced. Really, how many times must you keep drilling to get a 1 mm shoulder/bevel? And believe me, no one enjoys going to the dentist, let alone having to open their mouth for long time. Also, I have to consider the > possibility today that many of the teeth being prepared for crowns may > not even need a crown -- it's easier and faster to make an ideal prep > on an ideal tooth -- but if the tooth is ideal, why is a crown being > made? Most dentists prep for crowns when there's an MOD decay, a coronal fracture, and/or a large old filling that is marginally failing. Of course, you can still do the tradtional composite restoration on them but haven't we all learned of how large fillings will break or fail? I don't want to put up with tightwad patients who talk of how it was ME who put in the filling that broke. You also can't reproduce the original tooth anatomy anyway. > In many cases also, existing restorations may require complete removal > and careful buildup of a tooth for crown prep. That takes additional > time and effort. When I come across those, and if they have a pre-existing deep filling, I also suggest to the patient a prophylactic root canal. Will it cost a bit more to the patient? Yes but I'd rather charge the patient more and get the job nailed completely rather than risk a nasty phone call in the future explaining to me how the crown is starting to hurt like hell and that I am responsible for it. It's not like the past. People are no longer as naive and you have to protect yourself. Saving tooth enamel doesn't bear much meaning to the average patient. They only know what looks good, how good it feels, and if it'll last. > I have received many phone calls over the years from patients whom I > have never seen before, asking if they can come in to "put a crown [quoted text clipped - 6 lines] > wonder how much of a factor the "speed" was in the dentist's > priorities for that patient. Actually, I sometimes end up over-prepping and result in a teepee crown prep because I was spending too much time on one tooth. And, even with the best of intentions, it's not uncommon to accidentally overreduce for occlusal clearance when trying to drill just a tiny bit for that perfect 1.5 -2.0 mm space. For anything you do, I won't argue that rushing through a procedure is likely to create mistakes. But I wouldn't establish causation between time spent and a poorly done crown. There's not enough evidence. Machine milled onlays Signature/ Amatus / On Nov 19, 2:49 pm, Bill <dental...@hotmail.com> wrote: > I respectfully disagree. > > There are too many factors which influence the preparation of a tooth > for a crown. Accessibility and angulation factors may increase the > difficulty and the time for a crown prep. That's true, too. But they become less of an issue as you become more experienced. Really, how many times must you keep drilling to get a 1 mm shoulder/bevel? And believe me, no one enjoys going to the dentist, let alone having to open their mouth for long time. Also, I have to consider the > possibility today that many of the teeth being prepared for crowns may > not even need a crown -- it's easier and faster to make an ideal prep > on an ideal tooth -- but if the tooth is ideal, why is a crown being > made? Most dentists prep for crowns when there's an MOD decay, a coronal fracture, and/or a large old filling that is marginally failing. Of course, you can still do the tradtional composite restoration on them but haven't we all learned of how large fillings will break or fail? I don't want to put up with tightwad patients who talk of how it was ME who put in the filling that broke. You also can't reproduce the original tooth anatomy anyway. > In many cases also, existing restorations may require complete removal > and careful buildup of a tooth for crown prep. That takes additional > time and effort. When I come across those, and if they have a pre-existing deep filling, I also suggest to the patient a prophylactic root canal. Will it cost a bit more to the patient? Yes but I'd rather charge the patient more and get the job nailed completely rather than risk a nasty phone call in the future explaining to me how the crown is starting to hurt like hell and that I am responsible for it. It's not like the past. People are no longer as naive and you have to protect yourself. Saving tooth enamel doesn't bear much meaning to the average patient. They only know what looks good, how good it feels, and if it'll last. > I have received many phone calls over the years from patients whom I > have never seen before, asking if they can come in to "put a crown [quoted text clipped - 6 lines] > wonder how much of a factor the "speed" was in the dentist's > priorities for that patient. Actually, I sometimes end up over-prepping and result in a teepee crown prep because I was spending too much time on one tooth. And, even with the best of intentions, it's not uncommon to accidentally overreduce for occlusal clearance when trying to drill just a tiny bit for that perfect 1.5 -2.0 mm space. For anything you do, I won't argue that rushing through a procedure is likely to create mistakes. But I wouldn't establish causation between time spent and a poorly done crown. There's not enough evidence. |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2009 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.