Why does my tooth need a crown?

Dentists crown teeth for a number of reasons including; to protect weakened tooth structure, esthetics and also to open bites. The first reason is by far the most frequent. Teeth that are weakened by removal of significant tooth structure are more prone to fracture. When restoring a weakened tooth dentists often recommend either a crown or onlay, since these are better at distributing vertical forces on these teeth.

Often patients will ask their dentist to place a large filling rather than a crown because they feel this will be a more conservative and a more affordable restoration. Unfortunately large multisurface fillings are hard to place and probably need to be replaced more often than smaller more conservative fillings. Also since large fillings allow greater cuspal flexture they can make it more likely for teeth to develop cracks that can compromise the life expectancy of a tooth.

Am I the worst patient you ever had?

This is a question that I am asked at least once a month by a patient. Usually they are seeking a reassurance that they are not badly behaved. Often dental procedures can be difficult for patients to sit through, especially if their mouths are small and the procedures are lengthily.

Often a dentist will have to remind the patient to keep their mouth open widely to fit the tools in "or ask them not to move while they are being worked on. This certainly doesn't make them a bad patient!

Although there are patients whome are more difficult to treat than others, it certainly doesn't make them bad patients. Sometimes they do require a dentist to schedule more time or more visits in order to treat their problems and often dentists may not feel they are being as well compensated financially when treating these patients.

Sometimes dentists can become resentful of patients that routinely require more patience and time to complete dental procedures. It adds to the stress of a day since it can cause a dentist to run behind schedule or even make it more difficult to achieve what the dentist feels is an acceptable result.

If I do have a patient in my New York dental practice, who I routinely have difficulty completing procedures in my normally allotted time slots, I will schedule them for longer appointments and sometimes I am forced to alter my fees for their treatment to allow for the extra time needed to complete their treatment.

What happens to patients who put off their recall appointments?

For what ever reason, I have noticed an increasing number of patients who have put off going to the dentist for their regualarly scheduled cleanings and check ups. I am not sure why this has happened but increased anxiety about t jobs and finances may have something to do with this trend.

Although some appear to have suffered no apparent consequences others do present with problems more severe than I am used to seeing in their mouths such as a reoccurance of gum disease, moderate to large carious lesions, and teeth that needed root canals or extractions.

Since I "preach" preventive dentistry this both reefirms my commitmnent to prevention and I have started emphasizing the need for pre-appointing my patients recall appointments before they leave the office. They will get a notification of their upcoming check up and cleaning appointment and the onus will be on them to cancel or reappoint this visit.

Any apparent savings on their cleaning visit will surely be wiped out by any significant dental expendature involved with and extraction, root canal or an implant restoration that may result due to putting off their check up and 'waiting' until something is bothering them.