dental dilemma, what should I have done?

RE: dental dilemma, what should I have done?

Bob Russell — Fri, 04 Sep 2015 09:23:54 GMT

I have to say i would probably check after six months rather than three. Probably be shot down in flames but if it remains the same at six months it can stay. If it has deteriorated it should have done badly enough to reduce the do we or do we not! Seems a bit more 'acceptable' to clients as well.

How nice it would be if our patients could just tell us when a tooth is uncomfortable!

RE: dental dilemma, what should I have done?

Suzanne Kelly — Fri, 04 Sep 2015 00:49:52 GMT

Thanks I feel a lot better now. He's coming back in 3 months to check UGA so I'll see then. Yes I've other rads of the 8, I'm off work till Tuesday ( woohoo) so I'll post them then.

RE: dental dilemma, what should I have done?

Evelyn Barbour-Hill — Fri, 04 Sep 2015 00:26:02 GMT

[quote user="Suzanne Kelly"] I HATE reading 9s and 10s[/quote]

Could be worse, might be 108 and 109 of a cat.........

Upper 8s, 9s, 10s........ The trouble is, the roots are at quite an angle to each other so you cannot get anything like a decent bisecting angle of all of them in a single exposure. Then there's all the overlapping.....

I'd have tried a couple more exposures, in the hope of a better idea of the buccal roots of the 9, and maybe to be certain about the distal root of the 8 (but perhaps you've got another view of that).

You can more or less see though, on this picture, that there is bone loss on the interproximal face of the distal of the 9.... but you knew that anyway from your probe.

I think the answer to the question you ask is: you did right.

Just because there's an interproximal loss doesn't mean you have to do something dramatic. The periodontal health could now be stable at this level. You won't be able to get any reduction in pocket depth, but that may not matter. If the owner is brushing, get them to aim deliberately at this point.

If things don't seem to be going well when you check it again, just extract the 10. That should enable the gingiva to heal on the 9 (especially if brushing, as the brush can now get round the back of the 9.

Sometimes, it can be best to say to yourself , well, what would I have done if I hadn't got any Xrays?