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Hi all, this is an interesting case that I just have finished recently. Patient came in last year, from an adjacent state, complaining of severe pain following a composite filling on the buccal ( facial area) of tooth #5 ( upper right first premolar). The pain eventually became unbearable, and patient couldn't sleep at night for few days.
Patient contacted the dentist that did the work few times, but patient's concerns were dismissed, and was informed to give it some time for the pain to subside.
Patient came in to our office for a consultation/ second opinion.. Upon examination, the filling looked abnormally discolored even though it was two months old.
The gingiva next to the filling was red and inflamed.
Tooth was very sensitive to pressure, and the pain was spontaneous.
The filling was removed, then the gingiva was trimmed to be able to see the cavity clearly. Tooth had severe decay, which was removed.
A root canal treatment was done, through extremely small access to preserve the tooth structure ( 1.5 mm diameter).
No further treatment was done that day, and patient was dismissed.
Patient comes back in few weeks to finish the treatment. The gum looks much healthier now, and a final restoration is placed.
Six months later, patient comes back for a follow up. The gum settled down completely and the tooth looked normal.
Patient was extremely pleased with the final results, that were achieved in the most conservative way, and the tooth felt normal on chewing
I think that all dentists have an ethical obligation to preserve tooth structure, and suggest the least aggressive procedure.
Advanced conservative techniques can be learned by committing to continuous learning.
When it comes to advanced surgical procedures, I have always followed this rule: "Think twice, cut once".
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From your cosmetic dentist in Laurel, MD