I’ve been trying to get The Girl to stop watching CSI: Miami because there are just so many better things to waste our time on.

Remember this post?

Well now you can see Horatio in action:

I was watching this video, thinking that the dentist was doing an ok job. The only things that made me a little worried were the lack of eye protection on the patient and the extremely long hair the assistant was tossing around.I was about to give a passing grade until he said that he’s putting a titanium post into the tooth to strengthen it. That’s completely false. He should know better and if he does, he’s doing an unnecessary value-added service (that will increase the fracture potential of the tooth)…from what I can see of the tooth the post is unnecessary from even a restorative-retentive perspective.

So why does it matter to me what the restorative dentist does in the tooth? The answer is ethics for one, and the second reason is more selfish. Often the first thing to fail in a tooth that is having trouble is the endo. In today’s society where people take no responsibility for their actions and find it much easier to assign blame to others, the patient shows back at my office with the impression that their tooth is having trouble because of inadequacies with my work:

March 2006, consultation appointment. A long discussion about why this 1.5 year old endo is episodically symptomatic. Her dentist did the work. I recommended retreatment, another discussion ensued about the post and the reason it was placed. She was not optimistic about root canals in general because of the history of this tooth.

December 2006. Because of the patient’s trepidation about endo, I decided to medicate the tooth and only complete the retreatment once signs of osseous healing were evident. I babysat the tooth while it was medicated for a few months and saw some obvious signs of healing. Symptoms had also disappeared. Retreatment was completed. A discussion about posts ensued again because the patient was wondering whether one was necessary or not. I told her I didn’t see a need for it because of the amount and strength of internal structure.

Last week. The patient’s dentist sent her back to see me because the tooth has been episodically symptomatic (demonstrating recurring parulis formation) since the retreatment was done. Upon further questioning, the patient said the tooth started acting up after the permanent restoration in the crown was done. She said she told her dentist she didn’t want any posts and he said he wouldn’t do the filling unless he put posts in. He insisted, so she felt she had no choice.

From the film it’s obvious that a non-metal post was placed in the P canal, gutta percha has been removed from the coronal 1/3′s of the buccal canals and material consistent with the core resin was placed into those areas. Apical bone appears good still, a lesion has developed in the furcation. The lesion in the furcation is associated with all of the work that was done in the coronal canal areas. There’s likely been a strip perforation in one or more of the roots. My guess is the MB root.

As much as I tried to diffuse a potential situation with this patient, I know that she’s going to have a few unpleasant words with her dentist.

To have loved and lost is the theme today.

Besides Bryan Adams, when he used know how to rock, Roxette back in the late 80′s/early 90′s influenced my musical taste immensely. Marie’s looks and voice have haunted me to this day–so much so that The Girl and I recently performed a Viennese Waltz to one of their songs.

Marie is a survivor of brain cancer.

Here is “Crash, Boom, Bang”, the Viennese Waltz, and “Spending My Time”, the unplugged version:

Thanks to Leil Lowndes for this contribution.

When talking with writers ask:

• What do you do when you have Writers’ Block?
• From where do you derive your inspiration?
• How do you structure your days?
• Are you working on something now?