Model of an implant from the lab.
Everyone in the office today was glad that it was Friday, well, except for the fact that Friday means opening an hour earlier than usual! So, we started our day nice and early with a variation of cleanings and only one “special” case. Everything was smooth sailing and just when the office was almost empty, two urgent cases were called in, and these two cases were by far the two most interesting of the day.
The first urgent case that came in was what I like to call an “arts and crafts” case because Dr. Sims built an entire temporary tooth on the spot. Unfortunately, this patient was missing an entire front tooth and had already undergone surgery for an implant and was waiting on her permanent tooth to place in her mouth. However, she had a temporary tooth that Dr. Sims sculpted by layering acrylic material and setting it with a light tool. He worked from each surrounding tooth inwards and created what looked to be a real front tooth. This patient can now have a regular and fully functioning bite until she receives her permanent partial for her front tooth (which is only a few weeks away!).
The second urgent case that came in today was a patient with severe gingivitis who was complaining of a pain in the upper right area of her mouth. The area where she complained of pain was in the rear of her mouth at the gum, so Dr. Sims took an x-ray to see what happened. The gingivitis caused a gap in the gum between two teeth, which caused a tooth that had already been treated with a root canal, to crack in a sideways manner. What made this crack particularly interesting is that the crack was a complete split in two of the root of the tooth. This is quite rare but the x-ray showed how the tooth had split into the hole in the gum caused by gingivitus. The next step was extracting the tooth to avoid further damage and prevent more infection of the gums from occurring. The tooth did come out in the two pieces that it split into, but it was with much difficulty. It was not difficult in the sense that the tooth would not move but rather difficult because of severe bleeding that took place. The patient had severe gingivitus and it was difficult to work because there was a constant need to remove blood from the mouth. Dr. Sims was able to successfully remove the tooth, but did have to go back to find a piece that was lost in the infected gum in the deepest part of where the tooth was lodged. It was through an x-ray that Dr. Sims was able to find this missing piece, and send another satisfied patient on their way.
While those two cases were definitely my favorites of the day, there was one regular cleaning that I found interesting because the patient’s x-rays were unique. This patient had several implants and crowns, some of which were done by Dr. Sims and others were not. With this variation, in the x-rays I was able to see the different types of implants and how they vary in brand, size, shape, height, and detail. I found it interesting to be able to explain and discuss with Dr. Sims the reasoning for why each type of implant was suggested and used for each different tooth scenario. I was also able to explain and understand why certain methods were used to insert these implants because of the initial situation. X-rays may seem like simple white and black photos, but in reality they are fascinating photos that tell a million stories.
Looking at several x-rays and a lot of implants today, along with the sculpting of a tooth from scratch, I’d say today was the best yet. I was amazed by the level of ease that it took for Dr. Sims to sculpt a completely new tooth and have the patient walking out the door in less that fifteen minutes. I loved to be able to continue analyzing x-rays and identify patient progress through the x-rays and see how far they have come from whatever their initial diagnosis was. I can’t wait to see more cases next week and continue to grow my knowledge of dentistry.
