Everythings coming up Roses and daffodils?



 Even though I work hard to do excellent work and send my dental Labs clear impressions, not every lab fabricated restoration fits well in a patient's mouth. Yes, there are times when a restoration does seem to fit without any adjustments needed, but that is not what happens in most cases.

Part of a dentist job is to be methodical and check that each restoration is adequate and will actually help preserve a patient's tooth. Our patient may hope that their new crown or filling maybe perfect, but that is not always the case and while it may be true that 'perfection is the enemy of good' , we should not place inadequate restorations in our patients mouth, just because we are afraid to momentarily disappoint a patient or employer.

I take a bitewing radiograph when fitting a crown or after I place a new filling. Of course I have my fingers crossed that my new crown or filling fits perfectly, and often it is the case, but sometimes it is not. When this happens, I may try to adjust the crown, or reshape my filling and sometimes that is all that is needed. Sometimes no amount of adjustment will make a restoration perfect. Poorly fitting crowns, crowns with open contacts, or fillings with large voids should not be accepted and it is a dentist's job to figure out a next step that will create an acceptable restoration.

The solution may vary, but it is our job to recognize any problems and correct them. Sometimes a preparation needs to be refined further, and sometimes a new final impression needs to be done. Sometimes a new filling needs to be removed and redone. When any of these is the solution I take a deep breath and inform my patient of the need to 'try again'. If I have enough time I will do what is needed immediately or if not I will reschedule the patient.

Sometimes both my patient and myself are disappointed, but ultimately quality control is an important part of a dentists job. If we ignore this aspect of dentistry it can lead to a patients greater disappointment later and can definitely result in us experiencing guilt and regret at a later date. Often honesty is the best policy and long term it will help us enjoy our profession.



from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2025/06/everythings-coming-up-roses-and.html - http://lspindelnycdds.blogspot.com/

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