The Best Dentistry Is Dentistry We Never Have To Do – A Story About Dental Decisions
The Best Dentistry Is Dentistry We Never Have To Do
A Story about dental decisions.
There’s a type of patient every experienced dentist knows well. Smart, kind, consistent with cleanings but hesitant when it comes to treatment. Not fearful, just unconvinced.
I’ve cared for one patient like this for many years. She’s thoughtful and asks good questions, but her default answer to recommendations has almost always been: “I’d rather not do anything right now.”
At first, nothing seemed urgent. But dentistry doesn’t usually fail all at once, it fails slowly, then all at once.
Phase 1: Early Warning Signs
Years ago, I began noticing clear signs of clenching and grinding. Flattened edges, subtle wear patterns, and stress on the teeth.
The recommendation was simple: a night guard.
Non-invasive. Preventive. Protective.
She declined.
From her perspective, nothing hurt. From mine, it was like watching the early cracks in a foundation.
Phase 2: Damage Becomes Visible
Fast forward a few years, and those small signs turned into real structural problems—cracks in the teeth.
Now the conversation shifted.
Instead of prevention, we were talking about protection: crowns to reinforce weakened teeth and avoid bigger issues like root canals or extractions.
Again, she chose to wait, nothing hurt.
Phase 3: The Domino Effect
Over time, teeth began to fail. A few were lost due to fractures. Others became symptomatic and required root canal therapy.
At one point, we placed a crown on one of the affected teeth to try to stabilize things and prevent further breakdown. Because it was in a visible area, we used e.max material for the crown, an excellent, highly esthetic material that looks incredibly natural. But here’s the tradeoff most people don’t realize:
Aesthetic materials can be less forgiving under extreme stress especially when grinding forces are still present.
About a year later, the tooth needed a root canal because the trauma and cracks were already too far. That procedure had to be done through the crown, which compromises its strength.
A few years after that, the crown fractured.
Now we’re redoing work that was already done not that long ago, and that’s never ideal.
The Hard Truth About “Waiting”
None of this happened overnight. And none of it was unpredictable.
Each step followed the same pattern:
- Early signs ignored
- Preventive option declined
- Condition worsened
- Treatment became more complex
- Costs increased
- Outcomes became less predictable
Could all of this have been avoided?
Not always completely, but very likely minimized.
A simple night guard early on could have reduced the forces causing the damage.
Protecting the teeth later could have prevented cracks from progressing.
Even after crowns, protecting them could have extended their lifespan significantly.
Proactive vs Reactive Dentistry
Every patient in our office is given a choice:
Be proactive
Address issues early, often with simpler, less invasive, and more cost-effective solutions.
Be reactive
Wait until something breaks, hurts, or fails and then fix it under less ideal conditions.
Neither choice is “wrong.” It’s your mouth, your health, and your decision.
But they lead to very different paths.
Why This Story Matters
This isn’t about blaming a patient. It’s about understanding how small decisions compound over time.
Dentistry is one of the few areas of healthcare where we can often see problems coming years in advance. The challenge is that those problems don’t always feel urgent, until they are.
If there’s one takeaway, it’s this:
The earlier we act, the more options we have. The longer we wait, the fewer we keep.
Final Thought
The goal is never to “sell” treatment. It’s to guide patients with experience and foresight so they can make informed decisions.
Sometimes the best dentistry is the work we never have to do because we prevented the problem in the first place.
Take a look at our before and after photos for examples of waiting to long and things we had to do to solve the larger problems here https://streitzdental.com/before-after-smiles/
