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I have been treating a patient for 7 or 8 years and she recently remarried. Her new husband was told that he needed 4 or 5 crowns and his wife told him that perhaps it was time to visit her dentist in Saratoga.
As is usual, I disagreed with my colleagues about when it is NECESSARY to place a crown on a tooth. Prior to 1992, a back tooth with a large mercury filling or a large new cavity was deemed to be a weak tooth and required either a crown or an onlay. I observed these rules for the first 15 years of my career. In 1992, we learned how to bond to the inside layer of a tooth, dentin, and that meant that we no longer had weakened teeth that required protection of a crown. I was not the smartest guy in the my dental school class but I clearly recognized that dentinal bonding was a game changer and would save many teeth from being destroyed for crown placement.
That was a QUARTER CENTURY ago and I have been proven correct. My patients have fewer crowns placed on their teeth than any dental office that I know.
When my patient's husband presented to my office, I did agree that his 25-35 year old mercury fillings did, indeed, require replacement but my recommendation was to restore the teeth with a direct resin restoration (a white filling) placed under a rubber dam. My new patient accepted my recommendation and last week I completed the replacement of his old mercury fillings. When my patient got up from my chair, he told me how grateful he was to be my patient and that "the best thing that ever happened was when he lost his dental insurance because he would have stayed with his old dentist."
I am always honored when a (new) patient recognizes that our reason for being is to take care of you and that we will always place your best care above our own (financial) well being.
