Why It Is Called Big, Complex, And Difficult Case?

I practice in lower Westchester, where the most people come in from all over the world for the "best". They want to live in the best, send their kids to the best, shop at the best mall, etc. Naturally, they want the best dentist. Not in a glitzy environment, but competant and caring so forth. So, for those people, they are already "fixed" their teeth and in good shape. A lot of people think that beautiful model or rich people goes to the cosmetic dental practices and fix their teeth all the time. The opposite is true. For those people, the job is already done long time ago. Therefore, mostly, my job is to "babysitting" their teeth, which is perfectly fine with me. 

Second need for people, albeit small segment, is called big, complex, and difficult case, where many skills are needed to "resurrect the teeth" from the brink of extraction and dentures. In some sense, for them, I become a "dental hero". I don't think I would have gotten this much passion for dentistry without serving this segment of the population. 

Still, the number of patient who need the big case and goes through all the treatment is extremly rare. Someone calculated approximate of 3% from who need the work. The reason is many folds. Trust, fear of pain, cost, findng the right denitst, not knowing what is available dentally. In order to follow through with the big, complex, and difficult case, the dentist must be able to utilize all the skill "at the fingertip" to make it work. 

Often a dentist doesn't do certain procedure or develp disliking to perform certain procedure and favor one type of treatment to do. Still, if specialist is involved, it can be done very nicely. After all, that is why specialist exist in the first place. In dentistry, there are five practical specialists who can do just that. Endodontist for root canal, prosthodontist for bridges and crowns, orthodontists for braces, pedodontist for children, oral surgeon for extractions. For example, in Minnesota, there are seven prosthodontist, who are doing just that work. In comparison, in New York, we have so many prosthodontist that even one practice has two!. 

But reality is that it just throws in another "monkey ranch" to the system rather than simplyfying the big picture. Imagine five busy dentist get together and decide what to do with one patient. The cost of spitting the fee among them often increase the burden toward the patient. The list goes on and on. No wander why no one does get through with the treatment!