Destination dentistry

Editor's note: Dr. Doniger's column, Dental Diaries, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

I recently visited my good friend Jean at her summer home in New Jersey. We had planned a total "girls weekend" that included golf, a shopping trip in New York City, and a night at the theater. We bought New Jersey corn and tomatoes (since, according to the local legend, they are the best) and barbecued salmon.

Then we returned to New York for one of the main reasons I had wanted to visit Jean: to have a Cerec restoration placed on a tooth with a failing amalgam restoration that had been placed eons ago by a dental student friend during my dental hygiene years at Loyola. I knew Jean had purchased a Cerec unit and was enjoying fabricating restorations. We had discussed the opportunity for me to experience the process, and I was very excited to participate as a patient.

I have had a few dental restorations placed over the past year. One dentist I visited in Chicago had a slightly different approach to chairside manner than Jean. First, the anesthetic was completely different. In Chicago, the dentist did not believe in a topical and, sorry to say, was not gentle in his technique. In New York, Jean used a monitored delivery system following topical placement.

I have always been a proponent of topical anesthetic. I believe the procedure does allay patients' fears and, depending on your injection technique, makes the process go a little smoother. This was a completely different experience for me. The delivery is much slower than my own very slow injection technique, but definitely as effective. Something to consider for a future purchase.

Now, the Cerec experience involves a long time in the dental chair. It is fascinating to watch the digital image of the impression and the onlay being created. It is one thing to watch a demo on the exhibit hall floor at a conference, but it is more meaningful when it is happening to you.

I watched Jean create the proper contours, then send the information off to the milling machine for the restoration to be fabricated. They don't always come out perfectly. There is a learning curve, she explained. But the ability to have a milled, porcelain restoration delivered in less than a four-hour time period is truly amazing. I was able to leave Jean's office with my newly minted porcelain onlay and make my plane back to Chicago on time.

Cerec is definitely an interesting option. It may not be for everyone, but it was pretty amazing to experience the process. Jean is an outstanding clinician, as well as an early adopter of many of the technologies that have been available to dentistry over the past several years. Personally, I would not have the return on investment for a Cerec machine in my office. But in the future, if a group of dentists got together to share the cost of the machine, I might be interested in participating. Maybe Cerec should consider mobile dental units, similar to the food trucks that tour around many big cities.

It is always good to see how other dentists practice, especially if you are a solo practitioner. Study groups, webinars, and lectures offer one aspect of learning. Being a patient is another, more practical approach. You can always pick up tips and tricks (she gave me at least six while I was in the chair). You are able to confirm what you are doing right, along with something new you may consider adding.

All things considered, even with my horrific golf game, I am very pleased with my mini summer vacation that included destination dentistry in New York. I plan to do it again. If nothing else, there is always more theater to see!

Sheri Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at [email protected].

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