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Misconceptions That Lead to a Lifetime of Dental Problems

Dr. Waji Khan, dental surgeon from Kingston , Ontario, spoke with Dr. john O’Keefe about patients’ misconceptions surrounding dental treatment that lead to a lifetime of dental problems. Dentists are confronted daily with patients’ requests for quick and yet long-lasting fixes, not taking into consideration what really needs to be done for the treatment to yield positive outcomes. 

Dr. Khan attended the University of Toronto Faculty of Dentistry and graduated with his Doctor of Dental Surgery in 2001. He served as a dental officer in the Canadian Forces between 1998 and 2007. Dr. Khan began practicing dentistry in Halifax, Nova Scotia with the Canadian Forces. In the CF, his learning experiences was enriched through mentorship with dental specialists and advanced dental training courses. After a ten year career in the Canadian Forces, he then moved to Kingston with his wife and life partner Dr. Sohela Vaid.  He started the Top Gun Dental Implant Study Club in 2016 as a not for profit club to promote the dissemination of knowledge in the discipline of implant dentistry.

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Until next time!

CDA Oasis Team

 

Read/download the transcript of the interview (PDF)

Oasis Moment (1.51″)

Full Conversation (9.57″)

 

2 comments

  1. I feel that Dr. Khan is right on the money on the issue of dentists needing to step back and look at the big picture. I would step back even a bit further and when you see patients with failing dentitions and restorations simply ask, “Why are things failing?” Too often I find that some of our colleagues are a bit myopic. Something breaks, they fix it. It breaks again, they fix it. Then it breaks again, they pull it and place an implant. Then the implant fails. And you end up with patients with a lot of patchwork dentistry and things are STILL failing. One of the biggest growth areas in my orthodontic practice are people who are 50+ and are exactly in that situation. And the reason for it is very simple: it’s the occlusion.

    Occlusal disease is not a new concept, but somehow it still seems to be foreign to many. But there’s more to it than just TMD. If you have a poor occlusion, the best dentistry in the world will fail. If you have a poor occlusion, the best home and clinical hygiene will fail. Case in point; only yesterday a 50-year-old patient came in with a 13-year-old litany of dental work that started with a fractured 16, which led to multiple restorations and replacements, endo, tooth extraction, implant placement and subsequent failure, and implant removal. Now 16 and 17 are gone, and all this time the patient has had a history of chronic jaw pain and headaches, and her neurologist is giving her Botox for her “migraines” (that in itself would be hilarious if it weren’t so tragic – obviously Botox paralyzes the muscles and if you get relief they obviously aren’t a cerebrovascular problem!). This patient obviously has TMD/OD, but nobody knew better (or didn’t really pay attention) and just did the patchwork dentistry without ever figuring out the over-arching problem. I guess the good news out of all this is that it is a “garden variety” TMD problem, and we should have no problem getting her stable and comfortable, at which point we can figure out what the REAL occlusal problem is (because the bite WILL be different) and then and only then can we treatment plan its correction.

    Occlusion and occlusal disease remain a mystery to many, sadly. I have found that these core fundamentals are not being taught well at all in our dental schools. Please, go out there and learn. Kois, Spears, OBI, Pankey I don’t care what, it’ll be more than you know now, and in the end your patients will benefit from you being a better dentist. And they will be more likely to have a lifetime of dental health than a lifetime of dental problems.

  2. I enjoyed Dr. Khan’s presentation and the comment by Dr. Antosz. “Teeth-in-a Day” is a copy write description for complete arch treatment only, not for a single tooth. The discussion underscores the importance of a complete examination and diagnosis. Very often we are faced with a patient who wants only their concern addressed with a limited examination, assuming that this will be less or fee than a complete examination. Dr. Khan explained his approach to moving the patient beyond their initial concern to increased awareness of their dental status. Good records are not only required for diagnosis and patient education, but provide evidence of the pre-treatment condition. When I discuss tooth position and occlusion with a patient, they often assume this is addressing “cosmetics” only. When they accept that these are actually functional concerns that affect their dental prognosis, we move towards more ‘co-diagnosis’. Our goal is a healthy mouth and dentition with minimal inflammation, comfort and function, and a smile that they are at least satisfied with. A durable long term prognosis is also desired. We assume nothing and present this to every patient (except those with emergent concerns) for their refusal. The patient always make their treatment choice. We function as a trusted advisor.

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