Everyone is a specialist now, or are we?

And the importance of wabi-sabi

Author

Dr Rosemary Morgan
September 17, 2023

Wabi-Sabi

The aesthetic is sometimes described as one of appreciating beauty that is "imperfect, impermanent, and incomplete" in nature

I had a patient in recently; the note on her appointment read “wants ten veneers”. I thought that was a very specific request.

I looked at her file and I had seen her previously where we had discussed her smile, which was really pretty nice, and the difficulties of improving it (previous ortho x2, existing bridge...)

A few years later she was back. Her smile is still nice, there are some things that could be changed but nothing that a layman would notice. To the patient it was an immense problem. And I repsect that. It’s a tricky situation; I don’t want to diminish her genuine anguish about her smile and I dont want to disappoint her.

I referred her to a prosthodontist for a consultation.

Then this popped up in my X feed this week. It’s quite a lengthy article and very interesting.

@veneercheck is mentioned in the article which is an entertaining account for dentists.

Dr Kia Pajouhesh has posted a series of articles on Lnkedin over the past couple of weeks relating to poor treatment outcomes for patients from maybe one particular practice in Melbourne. It might not be the only one though. He refers to the “dark underbelly of our cosmetic dental industry”.

Poor clinical outcomes, over zealous marketing and treatment planning initiated for complex cases by non dentists; these are just some of the issues.

The articles are worth a read to see what’s happening out there.

Once upon a time, complex cases of multiple veneers, multiple implants or full mouth rehabs would commonly be referred to prosthodontists.

With the ready access to continuing education, an overwhelming choice of courses in aligners, digital design, implants etc, it is very easy to overreach. To feel like you should be taking these cases on. Straightaway.

There’s a culture in dental social media, advertising and marketing that if you’re not doing these cases then you’re not trying. That if you don’t do these cases then someone else will (and not as well). I’ve been to a course where that has been a line to use to inspire greater production.

The tricky thing is, even a four day course in digital planning won’t teach you everything you need to know about managing the occlusion so the veneers dont pop off or chip. It might not train you in global treatment planning and comprehensive diagnosis of the case, which is so essential before you start.

Assembling the building blocks of professional development in the correct order and having sufficient and a solid foundation is the key to success.

You might even have to take a few steps back to go forward.

This is a quote I use when referring patients to a specialist:

“The better part of valour is discretion, in the which better part I have saved my life.”

Shakespeare Henry IV Part1

You just might be doing the patient a favour too.

Have a great week, please refer a friend

Rosie

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