Meet Procrastinating Phil
We all procrastinate occasionally but my long-time patient, Phil, makes it a hobby. He drives a rusted, 17-year old car that he calls “Chitty Chitty Bang Bang”, because he doesn’t have time to look for a new one, despite the fact that he retired at 62. We are all entitled to these choices. However, Phil also procrastinates his dental treatment…and toothbrushing.
The “Pulp Chamber”
Looking at his most recent visits, his care begins with an overdue dental exam and cleaning. He needs a second appointment to finish the cleaning and evaluate his gum and bone support. We find a new cavity under an old molar filling and schedule an appointment to fix this, but he cancels. He cancels the next one, too, but shows up for the third one several months later because the tooth is now sensitive to sweets.
As I remove the old filling to access the decay, I discover that the nerve is now infected because his decay has progressed into the “pulp chamber”, where the blood supply and sensors exist. Now he needs a root canal to remove the infected tissue and sterilize the area so all the bacteria are gone. This makes the tooth more brittle, over time, so a crown is necessary to keep the tooth from cracking. Otherwise, the crack makes a portion of this tooth move when chewing and this causes discomfort to the surrounding tissues.
Well, Phil puts off the crown and the tooth cracks straight through the root four months later. The only course of action is to remove this tooth and place an implant (which may be unsuccessful if he procrastinates brushing) or a bridge because, if we leave this space open after it has healed, nearby teeth will drift into it. They may tip or rotate in the process. This alters the way his teeth come together, often changing the appearance of his smile as well.
Think about how much Phil’s procrastination has cost him already.