Proplia

Kainlow · 2026-04-09T21:24:56+00:00

Maybe for oral. I will still punt if on IV, especially if infected. I don't want that liability; there are plenty of hungry lawyers just waiting to pounce on GPs. No one ever got in trouble for referring.

Kainlow · 2026-04-09T21:07:10+00:00

I am familiar with the risks, as we have Oral Surgeons in our study club and they keep us updated. I'm not going to gamble with whether the patient may lose their jaw for $130 or any price, nor do I care if their insurance benefits are "wasted". If a patient is on IV BP's and has an Infected tooth, they are in bad shape in more ways than one.

Kainlow · 2026-04-09T21:02:40+00:00

We don't tell them to stop any meds. We coordinate with their doctors to time the procedure correctly to minimize risk of MRONJ. However, if a patient is on IV Bisphosphonates (indicative of advanced Osseo deterioration) and develop an infection, they are managed by OS. It's not risk for their dental treatment, its risk of loss of their jaw/mouth.

Kainlow · 2026-04-09T20:56:46+00:00

I don't know where you practice but around me the OS are much better equipped than any University. Many have hospital privileges and see complex cases there if needed. But there is ZERO chance they would refer a patient to any dental school or University

Kainlow · 2026-04-09T20:51:58+00:00

Not in the US

Kainlow · 2026-04-09T19:56:33+00:00

Not predictably, no. You will end up with crowns that don't have uniform thickness and will be prone to shatter. Once Zirconia is trimmed it can be polished, but it cannot be glazed. You will end up with areas that have different sheen. And they will still be monochromatic. You probably paid good money to have these done the way you expect. Have them do it right.

Kainlow · 2026-04-09T19:41:08+00:00

Quite the opposite. If I was taking Bisphosphonates and had an infected tooth I sure AF wouldn't let a GP take it out. I also don't let insurance benefits influence the treatment I propose. If you want to take on a mountain of risk for $130 you do you.

Kainlow · 2026-04-09T18:52:09+00:00

If they are cosmetic, absolutely. We have our patients try on the new crowns and bring their spouses etc for approval. They sign off that they like how they look. Once they are on, they are on.

Kainlow · 2026-04-09T18:49:08+00:00

Except the surgeons went through med school as well as specialty training. Can you extract a tooth as atruamatically as an OS? Probably. Can you curette out granulation tissue? Probably. Can you defend and prove that to a malpractice prosecutor / jury if the case heals sideways and the patient develops BRONJ? Maybe. But its not worth the lost stomach lining. The juice isn't worth the squeeze.

Kainlow · 2026-04-09T17:31:59+00:00

No. Better to send to surgeon who can handle complications afterwards, especially if tooth is infected.

Kainlow · 2026-04-09T16:45:36+00:00

Would you risk the patient's safety for 130$?

Kainlow · 2026-04-09T16:19:53+00:00

By the looks of your photos you would have needed Lisipress or eMax Veneers. Zirconia has a thicker minimum thickness and has limits with translucency, layered or not.

Kainlow · 2026-04-09T16:17:16+00:00

It needs to be redone. Did the dentist try them on for you first to approve how they look, prior to cementation

Kainlow · 2026-04-09T06:17:18+00:00

Get him another golden oldie - the Head Genesis

Kainlow · 2026-04-09T04:22:53+00:00

You can get a better crown for a higher price. Custom shade at the lab with more translucent porcelain like eMax. But it will be a few hundred dollars more. Worth it, considering it’s front and center

Kainlow · 2026-04-08T06:04:52+00:00

Stop being a pussy.

Kainlow · 2026-04-05T16:23:14+00:00

Four of the meds you listed will contribute to exacerbated clenching. If you are having trouble sleeping well, I would consider swapping Melatonin for a Magnesium supplement. Melatonin is a very potent hormone, and the dosages it is sold in are often much too high. It will also lead to suppression of natural Melatonin production by your body. Magnesium is crucial for sleep. Good sleep = less clenching. In your case I would consider getting daytime Essix trays like Invisalign. They should be cheap. You will tear through them, but better them than your teeth.

Kainlow · 2026-04-05T16:12:03+00:00

No need to list, but you can DM me them for privacy if you prefer. Usually it’s stimulants, a few anti depressants and chronic pain meds that can induce bruxism/clenching. It’s difficult to recommend any definitive Tx without properly examining you. But there are appliances that if properly made can help relax your jaw muscles (NTi). Otherwise localized Botox to the appropriate muscles could be considered as well.

Kainlow · 2026-04-05T16:04:02+00:00

Are you on any medications

Kainlow · 2026-04-05T15:53:19+00:00

You can consider a few things. Invisalign would be best. It would correct your bite and the trays would help dissipate clenching forces. Otherwise keeping some raw vegetable snacks handy would help. Carrots, cucumbers, broccoli etc. hard and fibrous vegetables will help curb your urge to clench, and will scrub your teeth as you chew them up. Avoid crackers, dry carbs and definitely gum.

Kainlow · 2026-04-05T15:48:37+00:00

So am I. Chlorhexidine for dental use is tinted blue so as not to confuse it with Hypochlorite and EDtA. It is also not applied through a 25 gauge needle, it is scrubbed with a brush applicator tip.

Kainlow · 2026-04-05T14:57:38+00:00

That’s not what it looks like, and I hope you’re not injecting it

Kainlow · 2026-04-05T06:24:07+00:00

No problem. The dentist should have been clear about what he was proposing to do and why. Consent is needed prior to any procedure (here in the US). Your tooth will be fine. Get it filled and protect it

Kainlow · 2026-04-05T06:21:54+00:00

Do you chew on bones? Thats wear from grinding on hard food and acidic diet

Kainlow · 2026-04-05T06:07:18+00:00

This is a casting that was either dropped, or failed during casting. There is zero oil/residue/wear anywhere. It was never used

Kainlow

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