DentaltownUK June 2018 - 20

message board

Kenphelps
Member Since: 27/09/03
Post: 70 of 102

One of the most important questions I had on my dental history form was a 'rate your mouth
on a scale of 1 to 10' graphic. If the patient circled a high number, I knew I had to tread carefully
when presenting any serious treatment, since I was going to transgress their self-image. If they
chose a low number, I knew I could be more matter-of-fact and start off on a 'Well, you were
certainly correct ...' tack. ■

2/12/2017

sjbnh
Member Since: 10/03/07
Post: 73 of 102

On a patient that I didn't feel had trust in me yet, I have definitely done the partial prep
then intraoral photo on #30. This tooth will definitely show caries in the dentin. People usually
believe what they can see. I will give the whole, let's be conservative and open up the most
obvious one and see what we find speech. I would look at mesial of #31 with #30 prepped. Looks
to me like you will find dentinal caries on #31 as well. ■

2/12/2017

Doctor J
Member Since: 08/03/10
Post: 82 of 102

I show all my patients their X-rays on the computer monitor. Whether they have cavities or
not. I show them what healthy enamel looks like and what a sealed amalgam/composite looks
like compared to a leaking one. To me, scheduling the pt for 30/31 is a no-brainer. You prep 30
and inspect 31. On the off chance 31 is fine you're the hero and they get away with one filling
and a warning to floss floss floss.
At some point you have to learn how to educate patients and not be afraid to tell them when
they have cavities.
Our Dexis software has a contrast/invert setting that helps show patients. For what it's
worth, I would simply tell the patient, 'If 30/31 are bigger than they appear on the X-ray then
we'd do 4/5, otherwise monitor. Either way, even worst case they need fillings they won't change
appreciably in a few months.'
And get an IO camera on Amazon or eBay and take before/mid/post procedure pics. Best 150
bucks you'll ever spend. I show my patients a lot of my work. Preps, cord packing, endo accesses,
decay, fillings. Showing patients your work on a big screen makes you better clinically. ■
22/1/2018

sandcastle
Member Since: 12/26/11
Post: 85 of 102

Brian
Member Since: 03/22/00
Post: 89 of 102

Is anyone using Icon instead of just watching? I've been using it for some time and it is quite
impressive. Admittedly very technique sensitive. ■
27/1/2018

There is a patient ed module on my office iPad that I use to show patients how decay
progresses and what I am looking at on the X-ray. I show how the damage is worse once it
progresses past the DEJ. I can always get a better understanding once I pull this out. ■

28/1/2018

How would you treat this patient?
Search: 'Interproximal Lesions'
This Townie received a lot of advice on treating this young patient. Do you have anything you would
like to add? To view the entire conversation and share your thoughts, go to dentaltown.com and
search the message boards for 'interproximal lesions'-this conversation will be one of the top results.

JUNE 2018 // dentaltownuk.com

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