Craftsmanship

Dentists seem to fall into two categories: craftsmen and non craftsman.

I hope to fall in the former.

As a craftsman, I believe that it is vitally important to keep inspired.
People are never static objects, and each patient has different needs, demands, and an outlook on life.

Anyways, all this may be my way of rationalizing my impractical hobby/obsession with crafting fine things. I'm a tinkerer, a self-taught luthier, and a former martial artist...and now, I'm thinking of reproducing some of the fine old tools from the past.

Hell...I might buy a new camera to take some better pictures of stuff.

Here's a link to a guitar builder who has always inspired me.

Sorry I haven't been posting much...

I've been building a guitar.

I've been rethinking this blog, and what it is.
Originally, I was going to create a separate persona to educate patients and make dentistry less scary. However, there's a lot more to life than just pure dentistry.

Anyways, don't be surprised if my posts become very, very different.

Dental la-la-land

A couple hours ago, I realized that I'm probably too far into dental-la-la-land.

As a dentist, I know that dentists can easily get caught up in the new toy of the week: dental lasers, CERAC, underarmor sport guards, and stick on veneers. While these technologies offer very real benefits, I'm pretty sure that most people don't really care about it.

At the end of the day, most patients care about their smile.

At the end of June, I'll be going to a very well-regarded CE course on smile restoration by William Strupp. It'll be in Clearwater, CA. It's expensive. It's also supposed to be the best of it's type.

However, when I think about my patients...it'll be worth it.

-Matt, Dr. Goodtooth

Two weeks later

Two weeks after coming back, I've started to process my experiences in Cambodia.
However, I don't really know how to use the picture function on blogger yet.

I'll probably be posting up some memories (without pictures) the next couple weeks, and adding pictures as I figure out how.

-Matt

"I'm not going to rob you"

On the way to work today, I walked past a young black man with a 1990's era Marin Mt Tamelpias...a nice, underappreciated hardtail from an underrated company.

In my head I was thinking, "Nice bike."

The bicycle was on the ground. The gears looked intact, but I wasn't sure if there was a slipped chain. Overall, the cabling looked nice with minimal stress points.

As he lifted it and rode past, I respectfully made way for him.
And he said "I'm not going to rob you."


Wow.

There's something to be said for a society that creates such a terrible misunderstanding.
It feels like those shouting about equality and tolerance, are causing more problems than helping.

If you have any suggestions on how I can help, please leave a comment.

Back from Cambodia

I'm back from Cambodia.

It was an amazing, very blessed time.
There were amazing dental needs, and very amazing people.
Honestly, I learned a lot more from these people than they from me.

However, I've got to recover from jetlag before I can post more about it.

-Matthew

Durable goods

Sunday, I went to the "Man up" event hosted by the Durable Goods movement.

It got me thinking about the state of dentistry, and about value to the consumer.
In particular, I thought about the value of my service.

Many dentists follow established guidelines by insurance companies regarding how often they need to replace restorations or crowns. For instance, a crown can be replaced as often as every 5 years, and a filling every couple of years .

However, these insurance companies aren't dentists, and these standards are the minimum accepted. Additionally, one should look into the modes of failure:

1. Recurrent decay (most common):
If you don't brush and floss, all bets are off. Recurrent decay will set in, and undermine the area holding your restoration in place. Most failure is due to recurrent decay from bacteria that feed from stuff between your teeth. If you keep it clean, you should be good.

2. Crown Fracture (common for porcelain, amalgams)
If there was not enough material, or too much stress, or some sudden trauma, porcelain will fracture. Porcelain crowns look nice, and have a higher hardness than enamel or gold. However, porcelain fails by fracturing. Gold will deform into place.

3. Tooth Fracture ( Amalgams)
Amalgams are retained by mechanical retention. This means that they wedge against the teeth to stay in place. Amalgams tend to have a different thermal expansion than enamel, so will constantly wedge against the sides of teeth. That being said, they have self-sealing margins and can 10+ years if taken care of.

4. Shoddy work
I hate to admit this, but I've seen shoddy work. These include crowns with open margins, bad contours, and grossly plus or sub margins. Largely, this is from some non-American accredited provider. Often these are from patients that ask for a workup, go to China, Mexico or XYZ, and get cheap dentistry.
Frankly, I don't touch these unless a.) it's fixable and b.) my patient allows me to redo them.
I believe that you get what you pay for. Although, in my case you probably get more than you paid for. If I believe my work is sub-par...I'll make it right. Period.

That's my policy, and I'm sticking to it.
-Dr. Goodtooth