About 5
years back my regular dentist informed me that my molar problem was beyond him,
referred me to a couple endodonists. I checked them out on line, decided from
the look of their posh offices without even seeing fee schedules, I could not
afford them and called the University of Iowa Dental Clinics.
Though the drive to Iowa City is
off-putting, I feel I have not only received unparalleled care, but an
education in the soft underbelly of dentistry and the human dimension of
delivering it. At UIDC, there is a Mayo-like approach: much discussion and
explanation between/among pros and patient. Every student has a teacher, so you
automatically get a couple opinions—one young, gung-ho; the other older, circumspect.
A fine balance.
Once, the teacher
changed. The first teacher had said a filling, which may have been installed by
Dr. Bisenius should be replaced. The new teacher said, “What is the point? Keep
an eye on it, and replace it if/when caries appears.” We don’t think of these
things as judgment calls, but clearly they are.
Though in
your mouth or on the road, it’s bad news when a bridge moves! Both the student
dentist and his teacher warned me there was probably decay under there, and all
were surprised when he cut it lose and it fell in! No decay; the forward anchor
tooth had split.
Re-anchoring
to an already compromised tooth was problematic, even with a dual-anchor that
would require a post and build up. “Not only more expensive, but more difficult
to clean,” the teacher noted. Negative for the likes of me—alternately diligent/negligent
about brushing/flossing, depending on life’s other pressures.
They went
on to consider the 2nd option, cap the anchor and implant where the
bridge was. First, they checked with the periodonist and the prosthodonist to
see if the bone and surrounding gum tissue would tolerate those. All agreed
that this approach was superior. “In your case, the best option is the
cheapest,” the teacher said.
Cheap it is
not--$500 over the $1,500 but at 70, I feel will last as long as me. Anywhere
else pulling them all would have been the option.
Sometimes, the
human dimension makes a Critical Eye smile. The young endodonist I originally
drew 5 years back was a good-looking, confident sort. When he began having
difficulties he explained, “Patients over 60 have calcium deposits that make
the canals difficult to find.” When he left the cubicle to consult with the
teacher, the tech observed slyly, “I am so glad he got you. Yeah, he’s the best
dentist here, but he’s arrogant!”
Probably what made him so good!
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