Dentaltown August 2022 - 48

by Dr. David Sherberg
Dr. David Sherberg graduated from the University of Connecticut School of Dental Medicine, then
pursued an Advanced Education in General Dentistry residency at Virginia Commonwealth University.
Sherberg, who has received extensive dental implant continuing education, is a certifi ed DOCS Education
member. He is certifi ed in moderate sedation and is an oral surgery volunteer at Remote Area Medical in
Florida. An avid researcher, he is also a fellow in the Academy of General Dentistry. He lectures nationally
to dentists and is a faculty member of the Phelps Institute. He has received numerous " Best Dentist "
awards throughout his career, including Best Dentist in Tampa Bay, and has been featured on ABC News,
News Channel 8, Vibrant Living and the Wellness Hour.
What's a doctor to do when a patient
opts out of previously accepted ortho?
D
uring my fi rst few years of practice,
I read as many dental magazines as
I could to learn the nuts and bolts
of this profession. I found their articles so
amazing, so inspiring! They portrayed case
after case of beautiful smile transformations
performed fl awlessly by master practitioners
whose hands seemed anointed by
the Almighty himself. The photos in these
articles showed surgery being performed
seemingly without any bleeding, amazing
tertiary anatomy placed on second molar
restorations and patients whose deep satisfaction
was only rivaled by the depth of
their wallets. One day, I thought, I was going
to be that great, and my patients would
adore me for it.
Now that I'm older (yes), wiser (hopefully)
and balder (defi nitely), I've come to
realize such dental perfection is rare in everyday
practice. There are too many obstacles
in our way preventing magazine-level
success. The reality of practicing dentistry
is one of compromise. It's doing your best
with limited resources. It's creating a meticulous
treatment plan while understanding
you may need to zag in the middle of
it. The following case is such a zag.
The patient presents
This patient (Figs. 1a-1c) presented
with the very innocent chief concern of
wanting whiter teeth. I had recently completed
a full-mouth rehabilitation on her
fi ancé, and she was unhappy his teeth were
now whiter than hers.
Periodontally, she was healthy except
for a few areas of mild recession. One area
of Class II decay was noted, which I fi lled
with a composite resin restoration, and
orthodontically she was Class III with an
anterior open bite, likely because of tongue
thrust. Palpation of her lateral pterygoids
revealed some discomfort and after a load
test using a leaf gauge, the patient exhibited
symptoms of tension and tenderness
in her TMJ musculature. At this point the
patient revealed that she often woke up
in the morning with headaches and TMJ
discomfort. I proceeded to deprogram her
chairside with cotton rolls placed between
her maxillary and mandibular posterior
Fig. 1a
Fig. 1b
Fig. 1c
dentaltown.com \\ AUGUST 2022 47

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Dentaltown August 2022

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