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    • silvercar
    • By silvercar 16th Oct 16, 10:58 AM
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    silvercar
    Quadrant dentistry: sensible or scam
    • #1
    • 16th Oct 16, 10:58 AM
    Quadrant dentistry: sensible or scam 16th Oct 16 at 10:58 AM
    I saw an emergency dentist yesterday (crown fell off but sadly this dentist said the post was broken and the tooth underneath too insignificant to re-attach), in talking he said he advocates quadrant dentistry where you assess and treat a whole quadrant at a time.

    I have a number of issues and unfortunately constantly seem to be returning to my dentist for one thing or another, this dentist was saying that it is because each tooth is considered in isolation whereas quadrant dentistry would provide a better long term result.

    Is this a myth or a genuine new way of treatment planning?
Page 1
    • brook2jack
    • By brook2jack 16th Oct 16, 12:09 PM
    • 3,849 Posts
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    brook2jack
    • #2
    • 16th Oct 16, 12:09 PM
    • #2
    • 16th Oct 16, 12:09 PM
    To be honest the major factor is not how the damage is repaired but making the changes to stop the damage in the first place.

    If you are constantly having fillings, infections, broken teeth etc the dentist is constantly fire fighting without being able to address your oral health in general.

    So first things first address the issues that might be causing your oral ill health eg cleaning, diet, smoking , etc then your teeth can be fixed and have a better chance of remaining fixed for longer.

    Quadrant dentistry just means when someone has a lot of work that needs doing you do it one corner at a time in a rational order rather than constantly fixing what's painful or broken as it occurs.
    • silvercar
    • By silvercar 16th Oct 16, 12:19 PM
    • 34,061 Posts
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    silvercar
    • #3
    • 16th Oct 16, 12:19 PM
    • #3
    • 16th Oct 16, 12:19 PM
    Unfortunately most of the problems are a combination of old amalgam fillings with decay underneath or very large fillings with little remaining tooth surrounding. Cleaning, flossing and diet are fine and I've never smoked.

    This crown that just fell out is 18 years old and was last re-cemented 4 years ago. I have a few amalgam fillings still when I made the decision in 2000 not to have any further amalgam, so they are well past their 'use by' date. Current oral health is fine according to my dentist and the emergency dentist, its just I have a mouthful of problems waiting to happen.

    I also have what I would call patchwork dentistry, where a dentist has advised trying something like a small white filling on top of an amalgam filling just to see if it lasts in order to save a tooth. Eventually these problems come home to roost.

    So I think my dentist, knowing my history, tackles each problem as it occurs, whereas a new dentist is looking at my whole mouth.

    I just wondered if there was any merit in doing quadrants at a time.
    • brook2jack
    • By brook2jack 16th Oct 16, 12:45 PM
    • 3,849 Posts
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    brook2jack
    • #4
    • 16th Oct 16, 12:45 PM
    • #4
    • 16th Oct 16, 12:45 PM
    Every time you take out a filling you remove more tooth and shorten the lifespan of that filling. Current thinking is , if there is no decay , it may well be better to patch a tooth up rather than replace the whole lot.

    Decay does not just happen under an old filling , the sugar intake has to be there to cause it.

    Many people in their fourties and older are part of the "heavy metal" generation. They have huge crowns and fillings which are now starting to fail. Unfortunately very often once these massive fillings and crowns fail there is little left to be saved.

    Different dentists have different philosophies about how to proceed. Some like to intervene early but then you may cause problems in symptomless teeth. Some like to conserve and wait but then things may go too far to save.
    There is no right and wrong approach and the best thing is to find a dentist you trust and stick with them.
    • silvercar
    • By silvercar 16th Oct 16, 7:21 PM
    • 34,061 Posts
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    silvercar
    • #5
    • 16th Oct 16, 7:21 PM
    • #5
    • 16th Oct 16, 7:21 PM
    There is no right and wrong approach and the best thing is to find a dentist you trust and stick with them.
    I was happy with one dentist for years, then decided that all the little problems meant the quality of work may not be brilliant, so I manouvered over to see another dentist in the same practice. Also good, but I possibly should have stayed with the one who knows my teeth. Or possibly not. Now I'm just embarrassed everytime I walk in to the surgery in case the first dentist sees me. The receptionist assures me its fine as the first dentist owns the practice, so would rather I see one of his team than go elsewhere, but I still feel awkward.
    • welshdent
    • By welshdent 16th Oct 16, 11:21 PM
    • 1,816 Posts
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    welshdent
    • #6
    • 16th Oct 16, 11:21 PM
    • #6
    • 16th Oct 16, 11:21 PM
    Quadrant dentistry isn't really a philosophy as a way to schedule the work. If someone needs a lot done then it makes sense to do all in that area under the same anaesthetic rather than doing one at a time and having you numbed up repeatedly. It won't really be something that you would even need to think about and it would have no major bearing on the end result. Another approach is when a crown is needed as well as some fillings, you may do the preparation first and schedule the fillings between that appointment and the fit so you finish treatment with fitting the crown. It's just scheduling.
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