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Cracked tooth syndrome

From: Terry Pannkuk
To: ROOTS
Sent: Friday, March 12, 2010 1:10 PM
Subject: [roots] Single visit for Pat

This was a tooth demonstrating cracked tooth syndrome.  I treated it in one visit today having
seen him 2 days earlier for consultation.  Had the patient come in earlier in the day where
I had a gap and an additional 2 ½ hours after a consultation open for treatment I would have
treated him the same day.  That situation is extremely unusual and most of my patients want
to receive a treatment plan, talk to my front office person regarding the fee so that they
understand everything completely and then schedule the appropriate amount of time that isn’t
rushed to deliver my best effort.  There are many good reasons for the space of time between
consultation and treatment; like requiring a Xanax prescription, sometimes premedicating with
an anti-inflammatory regimen, sometimes coordinating with the referring dentist for immediate
provisionalization, sometimes calling a physician to get a medical clearance, and sometimes
just to allow the patient to think about the plan and evaluate that they trust me and validate
the plan with their spouse, friends, or parents.   The point is that many of my patients have
the perception that root canal treatment is a major event in their lives; I don’t trivialize
that perception even though I have performed 10’s of thousands of root canal procedures.
The next patient I treat or examine tomorrow will be considered the most important patient
I’ve ever treated in my life.  Why?....simply because that next patient is the only one I have
to be focused on to make sure I don’t put the dam on the wrong tooth, make sure I understand
their medical history, make sure I’ve checked their pulse and BP, make sure I don’t prescribe
or inject inappropriate drugs, make sure I understand their fears, make sure I understand their
root canal anatomy, make sure I identify a subtle crack if it exists, make sure I don’t miss an
oral cancer, make sure I don’t perf, make sure I don’t block myself out, make sure I don’t
blow out an apex, make sure I don’t create a paresthesia, make sure I don’t create an hypochlorite
accident, make sure, and basically make sure I don’t fart.   It’s  doesn’t’ matter what I did
yesterday or 10 years ago. The only thing that matters the patient  I am going to treat next.

To presume that that root canal treatment can be performed by spa-focused amateurs and is a
minor trivialized event like an insignificant stop between going to Starbucks and getting back
to work; is the reason Dentistry has the lost its  status as a health care  profession and
resembles an unskilled trade performed by clowns.

Endodontics is deserving of dental specialty status and should be performed by professionals,
not clowns.  -  Terry