That’s what Calculus asked me today.

We’re short-staffed for the week but we have been preparing for the week for a while now, so it’s completely planned out. AssistantGirl is working the front desk during the mornings while Calculus helps in the back. After lunch it’s just AssistantGirl and me.

We have scheduled long appointments with lots of space in between so it’s actually quite a nice slow pace of work for me. Reminds me of the early days of the practice. Except without the stresses of trying to get things up and running.

We’d just finished up with our last patient before lunch when Calculus asked, “Hey, who’s that cutie?”

I followed her gaze out the window:

Being a good dentist, I notice details like the exposed thong.

Anyway, this is one of the favorite times of the month for most of the guys in the building where I work. It’s gardening day!

But I have to take Mr. Meatloaf‘s lead here:

Dear Jean-Marc (and Simon, and everyone at Genus Loci),

The Girl and I found our home quite unexpectedly. An unfortunate circumstance provided us the opportunity to visit real-estate properties. From the time we set our feet upon the earth around our place we felt a call — an invitation to explore further. We felt it at that time, but didn’t understand. It was just a piece of land with a house on it. How could there be anything spiritual or soulful drawing us in?

We decided to acquire the property and although the convolutions of life ebbs and flows one’s spirits, we have always felt anchored and at peace here. We felt something else though. It is impossible to express with one or two words what the energy was that we felt around us. There was a sense of harmony between us and the environment, but on the other hand there was a feel of burgeoning unsettlement. We felt a need from around us for something — but what?

I felt that construction of our home in this conservation area destroyed significant habitat and had left a very unstable landscape. Many mature trees were in slow decline, we noticed fewer fauna around the property, and neighbours were constructing on their properties with even less regard for these issues.

Somewhat by coincidence we found your company. We liked your ideas of landscaping with minimal ecologic impact. Your expertise in this area gave us confidence in your ideas. We hired you to design and build a landscape around our house that would restore some of what was destroyed. It was the least we could do, we thought, and yet the work would likely not restore the ecology to the nature of what had been here.

This project turned into a massive undertaking fraught with obstacles of every type. But I have found this to be true of anything worthwhile in life. The value of a thing is only understood by the difficulty to achieve it.

And now it is done.

The professionalism of you and your crew helped to carry us through one event after another and in more ways than one you facilitated a successful completion of the project. You carried our stresses on your shoulders so that we wouldn’t have to.

Although the project demanded more of you and your resources than any of us expected, I know that your creations here will forever contain some of your spirit. The Girl and I will do everything within our power as long as we live here to keep that spirit resonating.

From the natural pool that you created, frogs sing. From the Birches in the back that replace those wise ones lost, I hear the wind sigh happily. From the Sumacs and Dogwoods in the front, and the ferns in between, sits a single turtle looking out to the road. He is at peace. So are we all. We are home again and it is far beyond any home our dreams could have conjured.

Thank you for recapturing the spirit of our place.

Every so often I think about the idiot dentist that we wrote about in this post a while back. For some reason he is one of the few things that aggravates the hell out of me. It is probably because when you mix ignorance and arrogance you get a bully, and when you have a bully working on patients, trouble usually isn’t too far behind.

He has some fairly popular ideas about dentistry and the various subspecialties. He believes that endodontics in particular is merely a technical skill that can be improved upon practice. Continuing to improve your endodontic skills over time will put you at the same level of training as an endodontist.

Basically, as a general dentist, you would take a few hours of continuing education courses. These sometimes consist of weekend courses that involve both a didactic and hands-on component. They are usually taught by endodontists, and are often sponsored by an equipment manufacturer (the one whose equipment the specialist will be teaching about). These courses are meant for general dentists who are interested in how to do good root canal work.

Continuing education courses that specialists take are also given by specialists, but the goal of these courses isn’t usually about how to do good root canal work (since we already know that), but about more academic ideas. The controversies and thoughts that these lectures bring about are responsible for ongoing research in our field. The findings from this research evenutally trickles down to GP dentists through their courses as improvements in patient management and technique.

As much as administering the Canadian Endodontic licensing exam is a real pain in the ass (takes up a lot of time, and I don’t get compensated for it) it is rewarding.

My partner during the oral exams last weekend is the new chief examiner. I am confident that with his leadership we will see some very positive and constructive changes to the examination. The examination brings some of the brightest minds in Canadian Endodontics together — both examiners and candidates. I always find this refreshing because I work alone.

Working alone means that I only have myself to critique my work, I only have myself to toss ideas off of, and I only have myself to decide what journals and articles I should read that are most relevant to what I do. When specialists meet as part of a conference or an examination, we bond through the sharing of each other’s ideas.

But what about that asshole that I mentioned earlier? What does all of this have to do with him? Here is a summary of what it takes to be an Endodontist in Canada.

Now think of yourself as a patient in need of a root canal. Even if the procedure is merely a technical skill (which it isn’t) and your family dentist might have done hundreds to this point, would you not feel more comfortable having it done by an endodontist?

The answer is fairly obvious. The less obvious fact is that millions of root canal procedures are done annually by GP dentists and endodontists. GP dentists are trained to be competent at the procedure but annually as well there are thousands of cases that lie outside of a GP’s competency level. It is for those cases that we specialists exist. Any general practitioner dentist who states that he or she never refers patients to an endodontist leaves me wondering about the standard of care in that office.

It’s that time of the year when storms in Workland can knock power out for seconds to hours. It’s an annual ritual for us to have at least 1 patient per year experience a power failure during a procedure.

I only work during the day and we have lots of windows in the treatment rooms at the office but storm clouds are quite dark and so we usually have to break out the flashlights in order to finish things up. I haven’t needed a power generator…yet. That’s unlike the periodontists next door.

A patient that I saw back in 2005 during a power failure returned yesterday for me to check out an unrelated tooth. Here’s my treatment note from back then:

Here’s my post-op xray of the tooth I worked on (I did the 5 and the 7):

And here’s the tooth as it stands today:

There’s a massive screw post that her dentist has placed almost to the apex. I don’t know how long this tooth will survive before it either splits along the root or bacterial leakage happens alongside the post.

Morale of story? Not really sure, but it has something to do with power failures affecting root canal treatment prognosis less than irresponsible dentistry does.

…If this was my excitement for the day of work that I put in:

It’s an upper second premolar (an uncommon morphologic phenomenon) with 3 canals that I retreated the root canal work on. The first 2 pictures are the before ones, the second 2 are the afters.