Understanding Foundational Issues 

 

As a profession we have failed to or lost our understanding that the bacterial contamination of dentin is a completely different process than the acid dissolving process that destroys hard enamel.  This oversight has led to consistent and predictable durability issues with shortened time periods between failures and costly retreatments.

 

The early diagnostic teachings of disassembly and removal of old restorations and the cleanout of all bacterial contamination of dentin and other damaged tooth structure before an evaluation or correct determination of what treatment needs to be done has completely been lost to the billing reimbursement system that cut this step out of a third party payments.

 

These are the basic exploratory procedures necessary to accurately decide what should or needs to be done. Instead high ticket and frequently unnecessary procedures that are poorly executed are done for the survival of the provider based on direct third party interference.                                                                                          

 

 

What is a dis-assembly? 

What is a cleanout?

Why aren’t dis-assemblies and cleanouts a routine part of all dentistry?

What is the difference between stain and bacterial contamination?

Why is stain 99% or the time bacterial detritus (bug poop) 

Why can’t you seal duck tape to a dirt floor?

If everything is going to fail anyway why worry about small details?

How long should a well-sealed interface between the tooth and the restoration or filling stay sealed?

Should ongoing destroying or destructive activities take place under a well-sealed filling?

Should all restorations and fillings fail on a short cycle? 

Is this failure cycle an absolute or a bell shaped curve? 

What should the average or the mean life expectancy of routine work be?

Should all restorations and fillings fail catastrophically at failure?