There are times when we like to blame patients for the failure of our dentistry. And at times that may be true. But often, we are to blame ourselves for the breakdown and failure of our patients dentistry. Of course it is a shared responsibility. When we don’t provide the best quality dentistry to our patients, we immediately contribute to the responsibility of a large portion of the failure. Below is a simple illustration of the mishandling of the concept of provisional management during combined periodontal and restorative treatment. The first image is someone’s attempt at the four week reline after periodontal corrective surgery. This provisional is poorly contoured, not barreled in, open margins remaining, rough marginal edges and poor finish and polish.

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The second image is after I saw the patient at the request of the periodontist to correct the situation.  The provisional was re-lined appropriately. The restorative contours barreled in, the occlusion treated correctly, the provisionals finished with a fine marginal edge, and finished and polished with precision. Cement cleanup was performed meticulously.

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The difference was taking the time to understand the concept and taking the time to perform the treatment properly. Getting paid is a large portion of being motivated to take the time to perform the treatment properly. Our outcomes will be most always be excellent. And gives the patient a fighting chance to keep the dentistry they trusted us to provide for them.

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Daniel Melker

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