My caddie said to me: “Hey doc, what’s new in dentistry?” I thought for a moment and said: “not much”. Then I thought about it for a moment. We are in a new era of dental bonding and white fillings. It started about 10-15 years ago had not changed much. Yes, we can do beautiful white fillings that mimic nature and porcelain veneers that revitalize old smiles, but the underlying science responsible for “ esthetic or cosmetic dentistry” is now common place and not much technological changes have taken place in dentistry in years.
I realized how wrong I was when I sat down in my office Monday morning! My first patient required endodontics (root canal) on a lower right molar. I anesthetized my patient with a local anesthetic that only received FDA approval within the latter half of my almost 28 year career. It is faster acting and more profound. I then accomplished the entire root canal in an hour; a procedure that used to take two or three appointments of possibly an hour and a half each. Apex locators, rotary files, and ultrasonics make what was time consuming and sometimes painful stress free and easy for both the patient and the dentist.
On my next patient, we bonded two front crowns in place. They were replacement crowns for Porcelain Fused to Gold (PFMs) crowns done in her late teens due to facial trauma. The all ceramic crowns had no metal! The zirconia cores were milled by computer and life like porcelain covered them. No more metal color bleeding through, more room for pretty porcelain, and no more metal allergy concerns. My patient told me they looked better than her original teeth before her accident.
My first hygiene patient was an 18 year high school senior who didn’t have a single cavity or restoration in his mouth! We placed sealants, a bonded resin that “seals” all the deep pits and fissures on the biting surfaces of his molars, as they erupted, without any drilling or pain.
My “emergency” patient came next; she could not get the implant retained denture we finished last week out of her mouth. What a great problem to have! She was too proud to tell us how bad her arthritis was. We switched out the gaskets that snap the denture onto the implants with less retentive ones in about 2 minutes. We held our breath as she struggled to get the denture in and out of her mouth with the least retentive gaskets they make. She did it! She told us for the first time in her life, she was eating food with her lower denture. Denture patients used to haunt us with complaints of sore spots, complaints of looseness, and how denture adhesive makes their food taste funny. I used to think God made denture patients to keep us humble!!! Now I make my denture patients promise to come back for an annual exam or we would never see them again.
My next patient was the hardest but most rewarding. She was an elderly patient with failing health and brought by a nursing home attendant. We patched an old crown with a new hybrid material that has properties of a resin modified glass ionomer, composite, and release fluoride. It will more than likely last her remaining lifetime. Only a few years ago, our only choice would have been an extraction. Putting an elderly frail person through an extraction is the most devastating thing we once did. They take weeks to heal and their compromised dental health can quite literally alter the balance of nutrition, their other medications, and their overall health.
I was “cruising” and getting close to lunch time when we seated my last patient for a procedure I’d never done before – we made an impression of an implant healing cap that is coded and allows a computer to scan and set up the fabrication of the crown and abutment. No more messy impression copings and radiographs to communicate the three dimensional relationship of the implant to the lab!
Lunch was excellent and the tee time line opened for next week. I hope I can find my caddie of last week and tell him how wrong I was. Almost every procedure I did on Monday morning had not existed in its current state only a few years ago. Now if I could only not three putt next weekend……..
Paul W. Callahan, D.D.S.Callahan Dental
14 Pidgeon Hill Drive, Ste 200
Sterling, VA 20165