Doctor, Don’t Be Afraid!

Dental offices find themselves doing everything they can to help the patient feel more comfortable and calmer. There are billboards, television commercials, and even name changes that ensure the patient has nothing to be afraid of.

Now, perhaps this will help those reluctant Doctors to feel more comfortable when it comes to large cases. These longer-span bridges and even “all on four” type cases can be started with confidence.

Occasionally the crown and bridge lab will get the short end of the stick. I sometimes wonder if the doctor has more confidence in me than I deserve. Impressions and scans come in with multiple units to be made with the instructions to go to finish. Although technicians love big cases, they often scramble, looking for a place to start. So many times, full arch and even double roundhouses are not given the respect that a denture case might get.

With a denture case, I will get a bite rim with various landmarks indicating vital specifics. If it is done correctly, I will at least see a midline, smileline, labial incline, and vertical dimension. With crown and bridge, it can be a real puzzle. A blank canvas doesn’t have any boundary lines and lips are so important. When a patient decides they want smaller teeth, it isn’t as easy as taking the teeth out of the pink wax and replacing them.

I know part of the fear is that the doctor does not want it to look like the provisional. They love their labs’ discretion and assume they will get a better result than what they or the patient can imagine. Whenever I get a big case, I ask for anything to help me. pre-op impressions, measurements, a bite stick for lip line and cant levels, or pictures of teeth the patient may have had or seen.

Ask your lab to make you a temporary, and you will see the direction they are planning. Even impressions of the provisional will give your lab an idea of the functional issues you have already taken time to solve. Good technicians love information. They are well able to consider all your suggestions while creating their masterpiece. When a good foundation is laid, work can begin with confidence for all parties involved.

Ned LaMarti CDT