Monthly Archives: December 2008

Primum non nocere (“First, do no harm”) Part 2

This is a story of a nice lady that sought our help recently. 

Sue is a 40 something woman who wanted to improve her smile.  So her dentist provided aesthetic all ceramic crowns for the upper front teeth.   

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She also had tooth colored crowns to restore some Max  Mand of the back teeth with large amalgams.  

















Sue had several bite adjustments to these restorations since it did not feel right.  The symptoms gradually progressed to the point of “debilitating”.  She loved her work caring for mentally challenged people.  But she simply could not carry on, when she had constant pain that had worn her down.  The list of symptoms is long and they were present constantly. 


I will talk about these symptoms and what was done….in the next post:  Part 3

Primum non nocere (“First, do no harm”) Part 1

Primum non nocere is a Latin phrase that means “First, do no harm.”


While this is often erroneously attributed to Hippocrates, this maxim has nevertheless been a foundational principle of medical ethics for many years.  I believe that it equally applies to the practice of dentistry as well.


Cosmetic dentistry and orthodontics provide tangible benefits to patients.  A confident smile and improved self esteem greatly improve the quality of life of many.  But if the principles of physiology and function are violated there could be more harm caused than no treatment at all.  “First, do no harm.”


This is by no means an indictment of all cosmetic or orthodontic services.  But it is a call for prudence and careful consideration of the patients that trust us as their dentist.


I will describe a case to illustrate this point in Part 2.