How much is your health worth?
She hasn't been to the dentist for "a while". She said she can't afford it but she had no choice today because one of the teeth was starting to hurt. "I only want that tooth fixed, nothing else.", she said.
I fixed the decay but can't help noticing the thick calculus around her teeth. Studies have shown the association between poor oral hygiene and systemic health, especially heart disease. It costs $65 to get scaling done once a year, that's less than $6 a month. You can't even go to the cinema with less than $15 these days, and I know ppl who burn $200 a week on cigarettes, so I don't think money is a good enough excuse to let your oral health deteriorate like this. It'll cost much more to replace those teeth once they start falling out due to periodontitis, not to mention being handicapped by it coz frankly speaking it's a pain in the arse to replace missing lower teeth with dentures, you won't be able to eat with it. If you want implants, get ready to sell your house.
I fixed the decay but can't help noticing the thick calculus around her teeth. Studies have shown the association between poor oral hygiene and systemic health, especially heart disease. It costs $65 to get scaling done once a year, that's less than $6 a month. You can't even go to the cinema with less than $15 these days, and I know ppl who burn $200 a week on cigarettes, so I don't think money is a good enough excuse to let your oral health deteriorate like this. It'll cost much more to replace those teeth once they start falling out due to periodontitis, not to mention being handicapped by it coz frankly speaking it's a pain in the arse to replace missing lower teeth with dentures, you won't be able to eat with it. If you want implants, get ready to sell your house.
Anyway, she seemed like a nice lady, no fancy clothes, no make up, no smoker's breath, maybe she does have financial difficulty. So I gave her the benefits of the doubt and did the scaling for free, boss doesn't know of course. I hate it when ppl tell me they can't afford it. I hate it even more if I can do something but sit around and do nothing. So I just went ahead and did it.
posted by Dentist Down Under at 12:57 am
10 Comments:
you know what? i think you did the right thing. props to you. yes, i picked this profession to make a good living and i do that well enough, but first and foremost i am a healthcare provider. besides, you can zip all that crap off in a matter of minutes with a cavitron. how much "overhead" does a scaling take up anyways?
Did she wonder why her teeth feel different now?
I remember the days when I was looking for patients like her for the perio part of my licensing exam in the States.
ameloblast, sometimes "different" can be a "bad thing" like when all that tartar is literally holding the teeth together, you take it off, and whoa, two degree mobility! even after you've let the person know about the advanced bone loss and how dire the situation is, they leave and they're like "well, my teeth weren't loose BEFORE you cleaned them, you must have done SOMETHING wrong." it's happened to all of us at some point in time, and if it hasn't it eventually will ;-)
my absolute favorite is the "alginate extraction specials". take the tray out after it's set and, and hey, wait, there's teeth in there! NOTHING prepares you for those! ha ha!
Yeah I remember taking an alginate on loose teeth while I was doing my internship in the States. It was for an immediate denture. I had to vaseline the teeth up like crazy so they would stay in the mouth.
There's no overhead for me, just my time, but my boss has to pay the DA's wages. :p It actually took me 30 mins to get that crap off, I'm obsessed with calculus and stain removal and just have to remove every single tiny specks I could see/feel. I ran late, too bad for the other patients, but I knew once she step out of the surgery the next time I see her she will not have teeth left due to perio so I just had to do it.
I have had a few patients who complained about their teeth becoming loose after scaling. I even had one guy complaining about his previous dentist "drilling off his teeth" with the ultrasonic scaler and I thought "dude that was calculus". It's funny how so many ppl can't differentiate between teeth and calculus. Sometimes they come in and said my tooth chipped off when it was just a piece of calculus. That's why I always warn them before I start doing scaling and explain what caused mobile teeth. I spend a lot of time on patient education and sometimes it pays off (though not financially).
"Alginate extraction special". LOL. It happened once when I was a dental student. This poor guy was punched in the face and the 11 was avulsed. Took him 6 months to get in for endo but I couldn't stop the external resorption so we decided to exo and make him an immediate. I was inexperienced and didn't know I could extract a tooth with alginate. He ended up with no front tooth for a few weeks. :p
i have seen patients whose teeth were only held on by the calculus, because it was growing higher on the teeth than the alveolar bone.
my coursemate has to get an informed consent from him, notifying that if he does the scaling the risks would be that his teeth would fall out. patient knows that and agrees.
i have also seen calculus growing ON TOP of the tooth (36). the minute i touch it with the ultrasonic scaler, the whole thing just crumbled into pieces. some of them were even big enough to jam up the suction.
i wonder what these people do to their teeth.
good on ya mate for providing the free scaling!! :)
you've got a good heart. you did the right thing.
I once had a patient who refused to have a scale because he said it would make his teeth loose. I told him that if he didn't get them cleaned then not ony would they get loose anyway, they'd porbably give him pain and fall out out by themselves. He didn't believe me.
Which is fine, I guess. When the inevitable exo comes around, the perio will make it that much easier on my wrists.
I didn't think it was possible for tartar to build up that much on someone's teeth. What's that old saying? "An ounce of prevention is worth a pound of cure". Or something like that.
GoRetroGirl:
Guess what, that's not the worst calculus build up I've seen. -_-"
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