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Editor's Corner Nov 2009
Published: Nov 1, 2009

We Have All Been There

 
I recently received an e-mail from a colleague entitled, “Ever Have a Day Like This?”  There were about thirty names of local dentists that this went to. I thought it might be one of those jokes where some guy got his head stuck in the fence and a rottweiler was licking his face, but there was no attachment and the only thing in the body of the e-mail was, “Today is one of those days? Hope yours is better!”  
 
After thinking about this for a while, I became concerned so I sent a reply asking if everything was ok. The response I received explained everything! It turns out that the porcelain broke off of a six-month-old 8-unit bridge on number 8. Yikes, that is not a good day!  
 
Certainly, we have all had those days in this amazing profession of ours. This incident brings several things to mind.
 
First of all, this fine practitioner now has the arduous task of cutting the bridge off, impressing, making a provisional bridge, another lab fee, and delivering the new bridge. The chair time alone is very expensive. We dentists tend to stand behind our work and treat patients, as we would want to be treated if the shoe were on the other foot. We’ve all been there and it is no fun. It is even worse if the patient thinks the failure was somehow your fault. If this were a heart surgery that required a second surgery later, I doubt that there would be any freebies on that.  
 
Secondly, we as a profession should realize that the larger and more complicated a restoration is, there is more chance for failure. I’m sure I’ve done large bridges that have more opportunity for flexing and other things that make a long-term prognosis difficult to predict but failed to explain this to a patient before the treatment was performed and for the most part been lucky. A patient who knows this can happen is less likely to be upset if they knew there was a possibility of failure. Not to say that patient dissatisfaction was a factor in this case, but depending upon the patient, it easily could be a problem. We as dentists have the tools, procedures, and skill to do a very good job of restoring esthetics and function in even the most compromised mouths. I can think of no other body part that can be replaced where function and appearance is so lifelike. We need to make sure that we take the time to explain to patients that just as their natural dentition can fail, so can any restoration, no matter how well it is planned and fabricated.  
 
Lastly, I see this e-mail from the colleague as reaching out to the only group that can possibly understand the frustrations and complexities of what we do as dentists. Dentists all have these issues at one time or another. Discussing problems, concerns, frustrations, and even successes with our fellow dentists is healthy and reassuring. I feel for those of us who isolate ourselves in our own practices and totally internalize the myriad of issues that we face on a daily basis. Reach out and communicate!
   
 
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