What's the problem with waiting?


I have written often about the importance of staging dental treatment. Some dental treatment, especially multidisciplinary treatment plans  that involves multiple procedures with more than one dentist  can require a number of steps and be quite expensive.  Part case acceptance is the patient being made aware of the timing of the steps involved. I always try and make my patients aware of how  much time can be allowed to overlap before their next visit.

This is especially important for implant driven cases and teeth that need to have a periodontist, endodontist, oral surgeon or orthodontist involved. Patients are usually made aware that the visits should be performed on a certain time table. For some the timing is not critical but for others it can make the difference between a good and bad outcome.

That being said , people generally can get busy with their lives and not start their next stage in the time recommended. I have just been going over a case that I just finished for a very nice patient who came in three years ago with a broken central incisor that needed a new post and crown and also a crown lengthening procedure in order to assure that her final restoration would have sufficient tooth structure to hold up for the long term. I cemented in her gold post and made a temporary and asked her to seem my periodontist to have the crown lengthening procedure as soon as possible. The crown lengthening was needed to expose additional sound tooth structure to support her final restoration and make a tooth fracture less likely. 

My patient was dealing with some difficult personal problems that made it difficult both to afford the time and money needed for further visits and I was not able to persuade her to see the periodontist as we requested.  She returned six months later with the same tooth fractured again, but this time there wasn't sufficient tooth left on the facial surface for the tooth to be restorable. She now needed to have the tooth removed instead.

When given this news, she started crying. I made her an essex retainer to immediately replace her "missing tooth and started formulating a Plan B. Eventually she decided to redo the restorations on her  adjacent teeth as  well and now two years later she has finally completed treatment and is very happy. Even though her story has a happy ending, it does show why delaying treatment can cause problems and end up costing a patient  more time and money in the long run.




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/02/whats-problem-with-waiting.html - http://lspindelnycdds.blogspot.com/

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