When Young People Don't Know That They Don't Know

As you know, I have been a dentist for 40 years and enjoy a significant amount of respect among many of my colleagues, especially those that practice dentistry at a very high level. You also know that I firmly believe that dentists should not be cutting down teeth for crowns in patients that are 20,30 or 40  years old because those teeth will not survive to old age.  Why are so many crowns done? Because many dentists were taught that resins (bonded white fillings) do not last. And they are right when they are not done correctly which means using a rubber dam. There is an old saying: If it has been done before, it is probably possible.This is the exchange that I had with a well intentioned but uninformed dentist:

Kyle  Should have been crowned. A huge bonded restoration won't last. Zirconia and done for the next 30 years

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 · Reply · 1h

Gerald Benjamin Kyle, You have no idea what you are talking about. A huge bonded resin done correctly i.e. with rubber dam, caries removal, air abrasion of all surfaces, beveled cavo surface margins will last more than two decades. I do HUNDREDS of implant supported crowns in a year but only 1-2 on my long time patients of 25-38 years. WHY? Because I virtually never place a crown on a vital tooth for a 20,30 or 40 year old patient. If you crown a tooth at age 20 that tooth will not survive until 60. Implants are usually the result of dentistry's failures i.e. failed endo, recurrent caries under crowns. A crown totally destroys a tooth while a bonded resin conserves a tooth. Kyle, you can believe what you want but that does not mean that it is true.Manage

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 · Reply · 36m

Kyle Actually I do know what I am talking about because I see large restorations fail everyday and I crown them. If you want to believe your "magic" approach to filling teeth with huge fillings works more power to you. Zirconia is 20 times stronger than that huge thing in there and will outlast any composite restoration. The problem is you've been doing this so long its warped your perception of the reality of what happens everyday.

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 · Reply · 29m

Gerald Benjamin Kyle  No you just rarely have the opportunity to see fabulous restorative dentistry. The reality is that there is no defense for crappy  dentistry but you should learn to recognize excellence when you see it. The destruction of teeth for profit is unconscionable..and it is done everyday. You probably have not seen composites placed under a rubber dam since you left school.

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 · Reply · 26m

Gerald Benjamin I can show you cases all night long...And you can't show me ONE zirconia crown that has lasted even 20 years because it doesn't exist. I did one of the earliest zirconia crowns in the country when they first arrived...nothing special especially when compared with a bonded Emax restoration which never debond.Manage

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 · Reply · 22m

Kyle Good luck to you. Honestly I have better things to do than argue dentistry with someone who thinks he's right despite the way thousands of dentists do it everyday. But hey you are right and been right for 30 years. Congrats!

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 · Reply · 4m

The reality is that a dentist who lacks experience and knowledge is trying to convince a dentist who has been successfully placing posterior resins for a quarter of a century that what I am doing does not work.

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