Dentaltown March 2013 - (Page 41)

endodontics message board The Patient Blames Me for Cracking His Tooth » Dentaltown.com > Message Boards > Endodontics > Endodontics – The ENDO Files > The Patient Blames Me for Cracking His Tooth A family friend, 25-year-old, moving permanently to Israel soon, switched dentists to become a patient of my wife and I in mid-November. During initial exam I find small IP lesions on 18 and 19. Combined with clinical evaluation I feel 18 warrants an MO composite and I place a watch on 19 DO. He schedules with my wife and she does the MO. Patient comes back a week or so later with mild to moderate pain, primarily to biting. We adjust the bite. He returns another week later with similar symptoms. He says he consulted with another dentist who told him the composite was not properly cured and the filling should be replaced. I tell him to give it a little more time and if the symptoms don’t disappear we will replace the composite. One week later: replace composite. Symptoms go away. One week later he calls me and wants his X-rays. Says tooth hurts again. I give him Xrays and advise him to see an endodontist. He gladly takes the referral and goes. Two days later he sees endodontist. Endodontist initiates RCT. Endodontist finds vertical root fracture. Says tooth is NR. Later that day patient was referred to OMFS and tooth is extracted. Now he blames my wife and I for cracking his tooth. This patient is highly intelligent, ivy-league-educated with a master’s and a bit on the paranoid side. Had it not been for him moving to Israel permanently this coming week I would have probably continued to manage his pain as post-op sensitivity from the filling for a while longer. He rated his pain as varying from three to six on a 10 scale, and only from time to time. Given that he was moving to Israel I decided to hurry up and refer him. This diagnosis and sequence of events came as an utter shock to me. Since then the patient wrote us a scathing e-mail and blames us for cracking the root of his tooth. How do I respond? n t This Townie’s family friend accuses him of cracking his tooth. How would you respond? acaroll Member Since: 03/05/09 Post: 1 of 45 JAN 5 2013 We cannot know what is the cause of his crack. We just know that the endodontist first saw it. We can suppose that a crack was pre-existent to the filling, and the filling and especially RCT helped the crack to propagate. You probably did not see the crack before filling the tooth. You did not crack the tooth. You just did not diagnosticate or better prognosticate it would happen. “Tell before” means to inform; “tell after” means to forgive. Diagnosis is the key. We need to see. Magnification and good illumination is the first step. n pasqualevenuti Member Since: 09/01/03 Post: 2 of 45 JAN 5 2013 Personally, I wouldn’t respond. No amount of explanation at this point will change his mind. He’s moving… problem solved. n Pat patrick4 Member Since: 08/28/03 Post: 3 of 45 JAN 5 2013 There are many good points made in the responses here. Since he is a family friend, I would probably go through the effort to say there was really gregholm Member Since: 04/28/01 Posts: 5 & 6 of 45 continued on page 42 dentaltown.com « MARCH 2013 41 http://www.Dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown March 2013

Dentaltown.com Highlights
Howard Speaks: Dentistry Could Come Back with a Vengeance
Professional Courtesy: I’m No Anti-Dentite
Continuing Education Update
Second Opinion: Should Endodontists Place Implants?
Needle Stick Question
Am I the Only One Who Didn’t Know How to Use My Loupes?
The Patient Blames Me for Cracking His Tooth
Corporate Profile: {KöR}
CAD/CAM Materials
Dentaltown Research: Cosmetic Dentistry
Do-it-Yourself Finance, Part IV: Savings and Investing
Product Profile: Centrix
Keep Them Coming Back
You Should Know: Likeable Dentists
Multimodality Endodontics
Endodontics for the Recent Graduate: Instrumentation
Continuing Education Porcelain Veneers: From Case Selection to Cementation
8½ Tips for Dental Safety Checklists
How Prepared Are You For a Medical Emergency?
Dental Stem Cell Preservation and the Dawning of Regenerative Oral Medicine
Product Profile: Ivoclar EvoCerem
Narrow Diameter Implant Overdentures with Locator Attachments
In This Issue: Zeroing in on Xerostomia
Perio Reports
Ad Index
Profile in Oral Health: Substances for Targeting Xerostomia
Dentally Incorrect

Dentaltown March 2013