Often, we see new patients who may not have the optimal dentition. They may have missing molars combined with heavily restored teeth, combined with some that are root treated with apical areas. Yet they may have been in this situation for years. They have managed to function adquately with the missing molars, the heavily restored teeth are working fine and the apical areas may have been unchanged for decades. We don't know unless we have a history of the patient.
A history provides so much more information then we give it credit it for. Long standing patients coming back again and again, provide us with so much more context. I digress. My point is without that context do we intervene or do we observe?
I hear of people who say that we should intervene. That those heavily restored dentitions will eventually fail. That those missing molars will eventually affect the anterior teeth. That those apical areas are niduses of infection. With that mindset, intervention is the default. We have to stabilise and treat everything before it blows up.
However what if we say, it does not blow up in everyone. So why intervene if the patient has no concerns. How about we observe and follow up over time? How about we build context? Is that also not a default we could adapt? (Ofcourse we have to inform the patient and warn of consequences).
Now that is the dilemma - but only the clinical one.
So far, we are thinking clinically.... now step in these marketing gurus, conversion experts and sales and communication geniuses. They tell you - you have 6 figures sitting inside your list or they convince you how to get the patient to take up high end treatment. Ofcourse, they are influencing you towards the first default. After all, convincing the patient would bring in money that helps pay the bills (or feed the high end lifestyle for some) but that approach is thinking about your needs more than the patient's needs.
Now that is the second dilemma - are you making the decision for your commercial gain or are you genuinely doing it because default 1 in the clinical dilemma is more justified.
Now imagine being influenced even more by the products or the courses that change your mindset? https://www.dentinaltubules.com/content/do-certain-things-bias-your-decision-making
Decision making is hard - the real dilemma is knowing all your influences - and then finding THE DILEMMA....