A dental office gets a call like this:  Hi! My name is Barbara and I’m getting married in two weeks and my teeth are yellow.  Please, Please, Please–Can you see me today to do that in-office bleaching and send me home with those bleaching trays so that I can have white teeth for the most important day of my life?

Now the proper order of things is to do a full dental and oral examination on Barbara.  Is is right to whiten Barbara’s teeth when she has a large cavity on one of her molars? Of course not.  Invisalign does not come before a full dental and oral examination.  Porcelain Veneers and Crowns do not come before a full dental and oral examination.  And Teeth Whitening (Bleaching) should not come before a full dental and oral examination.  What if Barbara had a soft tissue lesion on her tongue that needed to be biopsied?  Just how wrong would it be for the dentist to ignore that lesion, but give Barbara a white smile before a full dental and oral examination.

This is one of the topics of conversation amongst dentists that emphasize cosmetics.  As a member of the AACD, the American Academy of Cosmetic Dentistry, the pursuit of excellence is following the proper order of treatment.  The organization cautions against  jumping  into cosmetics without getting the full examination including the taking of metrics and Xrays.  In the similar manner,  we sometimes get a patient that does not want Xrays.  Without Xrays quality care cannot exist.  We are unable to see beyond the clinical exam, and that could be a potential problem.  Fortunately today, we have digital xrays that can reduce the amount of radiation by approximately 75%.

Imagine for a moment that Barbara gets her teeth whitened as she requested.  She goes to her wedding with the most beautiful white teeth to match her beautiful gown.  And then on her honeymoon she develops a whopping, life threatening infection on a remote Caribbean island with little comprehensive dental care.  Her honeymoon is ruined; but more importantly, her life is put at risk.

The sum total of this is knowing what is right and what is wrong.  It can be right to see Barbara on the same day she calls and get her teeth whitened as long as we take the proper records and inform her of other ongoing issues that need to be addressed.  This is about needs and wants.  Barbara may want white teeth for her upcoming wedding, but she may need to have a cavity taken care of.  Cosmetics are in the family of wants, but dentistry has many needs that must be looked at first.  There is a proper order to things and that order needs to be followed.  We may, for example, whiten Barbara’s teeth and, at the same time, let her know that there is a cavity that exists that should be taken care of before she leaves the country.  Or, if the cavity is small, letting her know to take care of it after she returns from her honeymoon.

Thanks for the visit to my blog. 🙂