Sixth Sense
Yeah we all agree that most of this banter is a bit
annoying. However, truth be told ...
1. Amalgam is not poisonous.
2. Root c{*filter*}therapy is effective and it saves teeth.
3. Orthodontists are really not out to harm anybody!
4. The movie, "Sixth Sense" with Bruce Willis is
pretty much fiction.
Truth really be told, this newsgroup is little more
than the playground for a bunch of overly-antsy
patients who cannot complain in person, so they use the
internet to trash their dentists! Yeowwwww!
**
Now changing the topic a bit, there is a good article
in the August 2000 issue of Dentistry Today, by Dr.
Peter Kurer. He writes,
"The fear that cylindrical threaded posts would cause
fracture, due to the fact that they are threaded and
not of similar shape to the root, has been shown to be
groundless by both published research and clinical
experience."
(References are included).
Anyone for discussion?
Cheers,
Joel M. Eichen, D.D.S.
***
[post from last summer ...]
Sixth Sense, starring Bruce Willis
**
"Can I tell you something?
I am ready to tell you my secret now."
"What is it?"
"I see dead teeth."
"You mean that you see dead teeth in your dreams?"
"No, I see dead teeth while I am awake. I see them
chewing around, just like regular teeth. But they
don't know that they are already dead."
"What do you think they want?"
"They want my help."
**
A tooth is either normal, or it develops a pulpitis.
Pulpitis means, "inflammation of the pulp." This is
dentalspeak for "pulp" plus the suffix, "itis." This
last term means some inflammation is present. This is
the "Yeowwww!" that you get when you eat ice cream,
right after a nice deep filling. It can result from a
deep filling or from a deep cavity.
The tooth either recovers or the tooth itself becomes
dead. Whenever these dead teeth start getting angsty,
you see the temperature in the room drop and the people
sitting around start to breathe out some icy cold air.
This tells the audience that something weird is about
to happen. This is because you will no longer have a
"Yeowwww!" You will just have a chronic, dull, hurtin',
sometimes throbbing ache. If you touch your tongue to
it, Aggghhhhh.
If you put ice cold Pepsi or Breyer's Natural Vanilla
on it, the pain goes away pronto. This is diagnostic
for an abscess. It is also diagnostic for a $300
million dollar film in the US alone. World-wide, the
total is up to around $600 million.
**
Now Bruce Springs{*filter*} has a classic class III cross-
bite. However, please note that the music still comes
out pretty darned good. There is no need for "the
Boss" to get jaw surgery any time soon.
If you find yourself sitting around the Stone Pony over
in Asbury Park, NJ, and suddenly everybody around you
is whispering and turning around, chances are that the
Boss is sitting at a table in the back. Perhaps he and
the E Street Band will sit in a bit later for a couple
of sets.
Nobody says, "I'm leaving because the dude has a
crossbite."
Sometimes you are over at Blockbuster Video in Rumson,
and an aging station wagon pulls up into the parking
lot. Out pops "the Boss," who is just over here to rent
a couple of movies, order a pizza or two, and then head
right back home, just like the rest of us are doing on
a Saturday night. It is refreshing to see such a
really down-to-earth superstar.
Contrast that with some of our dental superstar
colleagues.
Lifted from the internet!
posted April 03, 2000 09:21 PM
"I charge $185, $255, $295, and $350 for 1,2,3,and 4
surface composites, and the insurance companies give me
real grief! But heck, I feel that I STILL lose money
with these fees."
"We tell the patients up front about the fee and the
reason and benefits. We also tell them to expect
to get derogatory comments and poor payments from the
insurance. For insurance plans that claim to pay 80%
UCR, we have the patient pay 50% up front. And still we
often have to bill them more after insurance payment."
Whew!
**
Jon Corzine is running for the US Senate seat from New
Jersey. This guy spent $35 million of his own money to
get some name recognition, just these past few months.
This guy really knows how to make and spend money! His
1999 income was $44 million!
He supports a minimum $8 an hour wage for any industry
that is connected to government through contracts.
Others poo-poo it. I'm wondering how the heck can a
normal guy get a composite done? A three surface
restoration (at $295) is around one and one-half week's
worth of salary, considering taxes! What does he do
about eating during that period?
Dentists are getting to be some kind of elitist snobs!
**
Now if you do NOT have a severely broken down root
c{*filter*}tooth, a nice post will certainly help out.
Among these are EDS Flexi-Post system, EDS Access
Retreatable Passive Post, SuperDent Chairside Post,
Dentsply Radix Anchor System, Kurer Crown Anchor, Cytco
Titanium Posts, Whaledent Parapost XT, Parkell,
Integra, Filpin, Cosmopost, Filpost, too many to name!
I will stop here. You get the idea. These posts are
passively inserted and bonded in place. They can
strengthen the tooth where tooth structure still
remains. Still, sometimes they come out! Quite
amazingly so. Why? It has to do with how much tooth
structure still remains! Duh?
Now Hans Lennros tells us that the Dentatus screw-posts
are not meant to be screwed in place. Dentatus agrees.
They just call them{*filter*}posts just to confuse
everybody.
Hans says that the "key" (one of two different keys, as
if one would not be enough!) that Dentatus supplies
with the posts is really just some kind of a fancy pair
of tweezers. I guess that Hans does not have his
dictionary handy.
Random House, College Edition says, "Key: a device for
turning a nut or a bolt."
Yep. That's a tweezers for you, every single time!
"KEY: To fasten, secure or adjust with a key."
If you buy a Black and Decker power drill, you get a
little key, something that is shaped like an "L" with a
gear on one end, and is always getting lost, just to
tighten the drill bit into the chuck when you can find
it.
Dental catalogs use the word, "wrench" kind of
interchangeably with the word "key," because that's
what they really are. A key is a key. A key is a
wrench. A dental key is a device that was used for
hundreds of years to remove (or to twist out) rotted
teeth. I have some antique dental keys{*filter*} on my
walls. Trust me. They are not tweezers!
But Hans still persists with this line of argument. He
tells me that I do not know what a key really is.
Pretty soon, he will be asking me to sing something and
then to send him the sound files, just to see if I know
what a key is.
Back to the dental problems at hand.
If you DO NOT need a post then any old post will do.
In that case, forget the Dentatus and use the passively
cemented or bonded ones. This is because the Dentatus
is tapered, and in fact, they are not quite long enough
to be effective in this circumstance. Use one of the
longer, parallel walled posts of which there are many.
That is, use it if the tooth can accept it!
The shortest Dentatus{*filter*}posts are a scant 7.8 mm.
The long ones are 11.8 mm. The X-long are 14.2 mm. I am
holding the 7.8 mm post in my hands. This one is so
silly, even to look at it. If you saw this, you would
know that Lennros and Dentatus are changing their
story, after the fact! If you could hold this between
your fingers, you'd laugh! It is so short that it of
little value anywhere!
A penny measures three quarters of an inch at the
diameter. This little bitty post measures a shade over
one quarter of an inch! Hans tells me to just drill a
hole and drop it in!
That is pretty much standard procedure when the
insurance company is willing to reimburse the dentist
$100 for two minutes worth of work. Will it help the
patient? Absolutely not! Will it hurt? Nah.
What to do?
A good root is best served with a straight, long
enough, passive post. A gnarled root will not have
enough straight wall length to accept a long post.
Insert two posts, one into each root if possible. This
prevents radial rotation that tends to occur around a
cylindrical post.
Make sure that your crown has adequate ferrule or
collar, to prevent the splitting of the root. Do not
place excessive loads on these teeth. Precision
attachment partial dentures are contraindicated. They
will torque the tooth too darned much for my
satisfaction.
Perform crown lengthening, if possible. This exposes
more of the clinical crown, for additional stability.
In severe cases, consider extraction and implant, where
finances permit.
In severe cases, inform the patient that this tooth is
devoid of adequate structure to make this treatment
predictable.
In short, every circumstance has a different solution.
My advice to Hans and others: Never say never. We have
many tools at our disposal.
Many patients have teeth in place due to the heroic
efforts of dentists. Heroic dentists do not get rich,
by the way. But they do have plenty of fun and
enjoyment from their careers. That is worth something
too.
In the 1970s, 7-Up marketed itself as the UnCola. May I
suggest to Dentatus that they follow suit. They could
market themselves as the manufacturers of the "Un-Screw
Posts!" That would certainly please Hans!
Sincere thanks to everybody who e-mailed me saying how
much they enjoyed this little series of posts. It was
all posted in some good fun. Hans is so knowledgeable
with just about everything, that I do enjoy getting
Hans to beat a hasty retreat, every once in a while.
Hey Hans! I dreamed last night that we were two trial
attorneys meeting in a courtroom. Guess how much fun I
had!
Of course, the astute student could read between the
lines. In between the lines is written, "there is no
one solution in dentistry. Keep your options open and
tailor an individual treatment for each and every
tooth!"
Another message is this: We have an international
group. I
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Sixth Sense