Quick-fix dentistry is becoming more popular, especially on the back of six month smiles, television coverage, and ‘one day’ implants.
Unfortunately the patient’s desires and expectations can outrun the capacity of modern quick-fix dentistry.
Absent an overall comprehensive care plan, there is the distinct chance of overlooking other things which may be affected; the quick-fix approach obviously can’t address all the patient’s needs.
As an example, let’s take an aesthetic-only procedure where laminates will be placed.
Let’s then take it that some pre-existing, healthy and well-functioning amalgam restorations are visible when the patient laughs and, even if a laminate were placed, the discoloration would still show.
Arguably, the dentist is ethically bound to advise that those amalgam fillings may not provide good retention, and a replacement with a composite restoration would facilitate better bonding.
If the amalgam is quite large, the dentist could suggest that a full crown or laminate/onlay might be appropriate.
A patient unhappy with their new smile because dark fillings can still be seen is not a good outcome for them, or for the dentist who performed the quick-fix procedure.
A comprehensive treatment plan should address all of the patient’s needs, as well as their individual desires —a smile transformation, for example.
Supposing that upon examination it be found that existing amalgam restorations are in perfect condition, the patient should then be advised that this will most likely provide longer life than another alternative.
Conservative, comprehensive dentistry and the modalities available for quick-fix are not necessarily mutually exclusive.
The clinician’s primary concern should be to make sure restorations have proper function and promote the health of affected gum tissue. It would be the best to first present the patient with the most conservative option possible.
If it doesn’t match the patient’s aesthetic demand, a more comprehensive or invasive treatment can then be discussed.
The patient should know unlike the ‘overnight’ manner in which smile makeovers are usually shown on television, the best option will involve time.
He/she should also know that in order to achieve the most stable and aesthetic outcome, an interdisciplinary approach may be necessary.
We all want the most from a treatment, in as short a time as possible, but the reality is we can’t always offer an ‘overnight’ treatment to a patient.
Presenting options with the most longevity and potential for tooth health, and working backwards from there taking into account the aesthetic demands of the patient is the most ethical approach.
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Image courtesyof: Richard Hedrick