Techniques & Materials
Limitations: Know When to Fold 'Em
By Glen Doyon on November 20, 2014 | 0 comments
I think that knowing one's limitations is equally important in dentistry, providing that one's intention is to provide the best care for one's patients. We all make mistakes, like having a bad day perhaps with eye-hand coordination, for example. But if we are honest with ourselves, taking on cases for which we know we are qualified, judgment errors should be infrequent.
Knowing your Limitations
Rachel, all of 4 feet 11 inches and 89 years old, accompanied by her husband of 70 years, presented to her general dentist earlier this month with a problem that was easily identified as being of endodontic origin associated with tooth #24. This presentation had Warning, Danger Ahead written all over it. (Fig. 1)


Five, the composite splinting has obscured the anatomy, meaning the precise location, shape and size of the crown as well as the tooth's inclination. Six, it's a lower incisor, one out of five have two canals and even in ideal situations there isn't much room for error. Seven, it's an old tooth and no matter what, it's going to be somewhat calcified. And eight – did I mention she is swollen and in pain?
Now, if you practice dentistry alone, say, in Barrow, Alaska, and you have developed some skills in endodontic access and treatment, then I say go ahead; what does your patient have to lose? In Scottsdale, AZ, this general dentist could drive a golf ball in any direction and hit an endodontist.

If, after seeing it, you still want to tackle this tooth, the takeaway lesson is to start your access in the right location. And remember, there are old pilots and bold pilots, but no old bold pilots.
Glen E. Doyon, DMD, Spear Contributing Author [ www.CMSEndo.com ]

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