When I started teaching dentists from around the world as a clinical instructor for Full Mouth Reconstruction (FMR) courses in 2002, I saw my role as a Mount Everest guide. I have often shared that analogy with those doctors, experts all, to be taking that course in the first place, to emphasize the dangers on their path to the summit of successfully completing FMR. In dentistry, preparing all of the teeth at one time – 28 or even 32 teeth at times – while precisely maintaining the jaw alignment through the provisional stage and in the bonded porcelain restorations is the equivalent of an Everest climb. There are so many things that can go wrong and the path to successful completion is quite narrow. The doctors will still have to do the climb. My role when teaching FMR is to keep them in that narrow predictable path to success for the patient and the treating dentist just as an expert guide would on Mount Everest.
As I provide this FMR option to my own TMD / CCMD patients as a phase 2 solution, the financial cost is a barrier for many. It is even beyond the reach of many. That is why I never recommend any treatment option. My role is always to educate the patients on the options and their consequences first. Then once they choose an option, competently delivering that treatment option is also my role.
What does FMR has to do with Mount Everest, besides my comparing them to my students? The dangers of cutting corners.
“Deliverance from 27,000 Feet” on NY Times from yesterday is a superbly written and illustrated article by John Branch. It chronicled the death of three climbers from India who perished on the mount. He shined the spotlight on one aspect. https://nyti.ms/2kG615e “Climbing Everest is an expensive endeavor……. Some spend $100,000 to ensure the best guides, service and safety.” Speaking of those that perished, Branch writes, “These four climbers measured monthly salaries in the hundreds of dollars. ..….They cut costs and corners, because otherwise Everest was completely out of reach.”
In the end three of the four suffered a horrible death on the mountain. The fourth one only survived because of the kindness of a self-sacrificing stranger who gave up his own climb to save that woman.
The lesson? Don’t cut corners and opt for a cheaper way to get Full Mouth Reconstruction. Risking your health and quality of life when things go awry is only slightly better than the fate of these climbers.