Second Opinion Roundup

Here are some pictures of “second opinions” I have given and what my thoughts were.

When patients tell me that I am “more expensive” then another dentist in town, I can not help but imagine what type of dentistry this patient really want in their mouth. My answer, always, is to have the patient compare apples to apples, and oranges to oranges.

If you are looking for high quality dentistry that looks beautiful, is made by a top laboratory technician, and is designed and maintained to last (experience matters, but a lot of bad experience does not count!), then I am the dentist for you.  On the other hand, if you want the cheapest and are not really worried about what is put into your mouth/body, how it fits or functions, or how long it will last, then I most certainly am not.

I follow the golden rule – “Treat others the way you want to be treated”.  I would never put something into one of my patients mouths that I would not put into my families mouth, period.  After all, all you really own in this world is your body, right?! 

I am getting carried away, sorry.  I just wish people knew what I know about dentistry, how it affects everything about you from soul to function.  That would keep the following examples from ever happening.

Local “cosmetic” dentistry.  Upon closer examination (besides the fact that the veneers are not good looking), the “real” problem this lady had was ignored.  Below is the picture of the lower teeth.

Note all the gum tissue is pulling away from the teeth!  That is a great way to loose teeth rather quickly.  This person need to see a gum specialist as soon as possible, plus determine why the “recession” is happening.

Needless to say, this is not very good “cosmetic” dentistry.  The “black triangle”  is a result of tissue loss and is very difficult to remove.

This may be hard to see at first, but I will explain.  The above patient has 2 premolars, or the 2 teeth to the right of the turned tooth, that are bigger than the molars, or the far right teeth.  These are really big and bulky crowns!  The tissue cant breathe, so it gets inflamed, bleeds easily and gum disease is the result.

When tissue bleeds, bacteria seep into the bloodstream and attack your system from the inside.  This is an all too common “one size fits all” dental lab.  The good news you ask?  This patient saved a few bucks by going to a lower priced dentist!  (Except of course now it has to be redone).  This dentist did not make less money then a high quality dentist would, he/she just charged less and hired a cheap lab (possibly in China) to make the new crown.  Who suffered in the end?

This picture is from the same patient above, only it is his other side.  Note how “small” his own two premolars are!  Don’t let that other dentist get a hold of those perfect little teeth, all they need is to have the silver mercury removed, minimally, and the tooth can be restored without cutting it down to a little stump.

This patient, I call him patch, has been to the same dentist for many years.  He came to me after a recent filling “just fell out”.  Well, almost every single tooth has a bunch of plastic patches on it, most surrounded by decay.  A “new” bridge was placed on the lower right side of the above picture (the patients lower left).  Everything else was “ok”.  Really?!  Well, I hate to be the messenger sometimes, but there is a significant amount of decay that should have been treated a long time ago.  Of course the patient is shocked, but I need to tell the truth about what I see.  Now we are “fixing” the mouth, not patching.

This is a great example of “if it does not fit into the mouth, grind a little more!”.  The black spot on the big tooth is where the porcelain has been ground off to make the crown fit into the space.  And even worse, the tooth to the right of the big crown has a monster patch that is fractured.  That little tooth needs a crown, a buildup, and possibly a root canal.  Maybe the tooth is even fractured itself and then it can not be saved.  Was it worth placing a super large plastic filling where they really don’t work?  And that crown, if you look closely, you will see that where the top touches the tissue the tissue is red and swollen.  That is a portal for bacteria into your system, and it bleeds if you touch it.  Not a very healthy situation.

Now, here is the next level of “if it does not fit, grind a little more”.  The gold/black spots on the teeth above are where the porcelain crowns were ground through to the underlying metal to make them fit in the mouth.  Just because the patient can’t see these areas does not mean they don’t exist!  This weakens the crowns, and is just not acceptable.

Here is another final example of a mega tooth.  This white blob is significantly larger than the original tooth, inhibiting everything from the flow of food to tissue health.  There is just so much wrong with this tooth that I don’t know where to begin.

Moral of the story, you own your mouth/your body, nothing else.  Take good care of it and it will take good care of you.

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4 comments on “Second Opinion Roundup

I LOVE this blog!!! I am a dental assistant and from reading your blogs I can tell how thorough you are with your exams and procedures! I wish there were more Dentists out there like you! Keep up the great work. It is appreciated!! Your patients are lucky to have you!

Thank you Ginger, I do really appreciate it. Nothing is more important than the exam and consultation. You must have a detailed roadmap of where you want to go and how you are going to get there if you want to succeed. As with any large endeavor in life: 99% preparation, 1% execution!

I just recieved a call from my dentist stating that my dentures could NOT be made dued to the fact that my bite was crooket i was very upset this will be the 3rd BITE impression that im being ask to make and they are saying its my fault. I had brain
surgery in 2004 and was having a problem closing my mouth correctly on my left side I asked my doctor why I was told that they had fracture my jaw to get to the two aneurysm in my brain which they were able to clip thank God I also had plastic surgery on my left side laugh line I need HELP please give me your opinion do you need pictures they also did exrays of the top and bottom but didnt notice anything i guess I refering to my upper gum

Dear Patricia,

I am not able to help with this case as there is just too much going on and a quick comment would not do justice to your situation…You need to trust your dentist and if you cannot then you need to find someone you can trust.
I am glad you are doing better.

Dr. Chris

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