Witness for the defense?


My dental practice in midtown seems to be located in the heart of the legal district. Seems like a lot of attorneys have practices located walking distance from Grand Central Station and I have more than my share of them as patients. For the most part they make wonderful patients but some of my explanations of my treatment plans and treatments seem a little like legal briefs followed by cross examination. They usually ask intelligent and somewhat pointed questions.

Why do I need a crown? What will happen if I don't get one? How long will it last? What kind of problems could I have afterwards? If I was a less confident dentist all these questions could make a fellow defensive. Not me, since I enjoy spirited conversation and frankly it doesn't take much for me handle the questions, since I know considerably more about dentistry than they do, at least most of the time. Most of the time they leave satisfied and happy!

Of course there is always the possibility of an exception to the rule. Two nights ago I had a retired lawyer call me up during my winter break ( the office is closed between Christmas  and New Years) . He is an exceptionally "sharp" retired attorney who coincidently has a family member who is a dental hygienist.  He seems to know more about dentistry than most. He confided in me that the new crown I placed on #18 was bothering him when chewing. He elaborated that his bite was OK when he closed but when he ate food it hurt. He also noticed that when he was supine (lying down)  the crown was hitting before the others. Although he knew the office was closed, he wondered whether I could see him sometime in the next week.

Now this really didn't seem to be the sort of problem that actually required me to open my office during the  holidays,  but after a little thought I  responded with "Of course!" I figured that his observations meant that when he was lying down the crown was hitting so the bite probably was high in centric relation since the jaw is moves slightly back when a person is lying down. Hopefully a little occlusal adjustment might just do the trick. Although the bite was probably the problem there always is the possibility that he actually might end up requiring a root canal  ( probably about 6 percent of crowned teeth do) and delaying treatment for this particularly knowledgable patient probably wasn't the best option.  I saw him the next morning, did my occlusal adjustment and my erudite patient left happy once again. Only time will tell whether his problem is solved, but I know I made my best effort and I made the trek back to my apartment in Queens to so that I could continue binge watching "The Good Doctor" on Hulu.




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/12/witness-for-defense.html - http://lspindelnycdds.blogspot.com/

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