The Periodontist, deep pockets in LA.

from the Lefsetz Letter…

“I don’t want to be the bearer of bad news.”

Huh?

I thought the hygienist cleaned and the dentist evaluated.

But not at this joint.

My old dentist had a love affair with Alaska. For three months every summer he took his boat up north and regaled me with incredible tales thereafter. The only problem was if you had a crisis during those three months.

I did.

So I went to see his old associate, the one who bailed when the seaman wouldn’t cough up his practice as promised. This young man said the tooth in question was unsavable and would have to be extracted and replaced with an implant.

But then I called Irving. Medical consigliere to the stars.

Irving had been imploring me to see his guy for years. And Irving’s track record is impeccable. He always hooks me up with the top guys, with an appointment right away, oftentimes outside scheduled business hours, with no wait. And if you don’t think that’s important, if you don’t think that’s an asset…

You just haven’t been broke down and busted on the side of the road, with no direction home, wondering how you’re going to escape this pain.

So I got an appointment.

But just before I went, Irving said he’d forgotten to tell me this was the most expensive dentist in the world.

And he is. He’s 50% more expensive than any dentist I’ve ever seen. Assuming you need serious work. Cleanings? Routine stuff? That’s all reasonable. But if you need a crown…

You’re gonna pay $1500 more than anywhere else, but this dentist has his own lab and there’s no waiting, from drilling to replacement it’s two, maybe three days.

And he saved the tooth.

So, ultimately I saved money. Instead of paying for an implant, for half the price I continued to use my own tooth, which is always preferable.

The next time the crack was below the gum line. I had to go for an emergency root canal, on my birthday no less. The endodontist, another Beverly Hills bigwig, told me there was no way the dentist could save the tooth, that an implant would be necessary. But this guy, my guy, Irving’s guy, said “I’m gonna work my magic.” And he did, he put on a crown.

And it’s been an endless series of crowns. Is it my age? My affinity for trail mix stirred up in Dannon coffee yogurt? I don’t know, but I’ve given up the trail mix, it’s just too expensive and aggravating in the long run.

Worth reading to the end HERE

The Good Practitioner’s Guide to Periodontology – Launched!

screen-shot-2016-09-13-at-15-56-36Philip Greene changed my life in a hotel room in Leicester.

In Autumn 1987 I was having one of my off periods in my on/off affair with dentistry. I had been working as an associate in a nice new-build practice for a couple of years and was negotiating to buy a share. To my surprise the owner gave me the news that he had sold the practice and the new owners would be taking over “later that week”. The new owners sacked the two hygienists and were were soon encouraging me, “to do at least four crowns on every patient”, as I was, ” a nice guy and wouldn’t have any problem convincing them.”  I found another job, gave three months notice and was subsequently locked out, there had been a (totally false) allegation of my telling patients where I would be working next.

Move on, and I started work in the next practice, it had a new-build branch without an autoclave and a main location with no hot water…

Two courses marked that period firstly was Stockport Dental Seminars’ “Introduction to Occlusion” or the “Battle of Bolton” as it was affectionately known where Roy Higson removed many scales from my eyes. The other was Philip Greene and David Cohen’s evening on perio and endo respectively. The approach to perio was totally different from anything I had been taught as an undergraduate or that practised in any of the practices where I had worked.

I bought 6 CPITN (aka BPE) probes, they were the only ones in the practises where I worked, and set about examing people for signs of periodontal disease. I was a convert, the new zealot took the very first BUOLD course in periodontology with the wonderfully outspoken Marsh Midda and Jerry Rees, joined the BSP and eventually married a hygienist!

I still treasure Jan Lindhe’s textbook and also Colgate’s literature on examining and diagnosing.

So I was delighted to see that the BSP have launched The Good Practitioner’s Guide to Periodontology. It is available as a PDF here and online here. Do take the time to take a look and even consider joining a society that has always been relevant but is most definitely on the up.

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