by  C. M. Quillen, D. D. S.

                I approached a quandary of confusion and doubt as to what to say and do this afternoon concerning old Mrs. Pepper. She came in at three o’clock with her problem which was a very difficult one to solve, and at that time I could not correctly its right and wrong viewpoint.

She thought he have a grievance. She had an abscessed biscuspid tooth in which I had placed a pretty inlay about four years ago. Her gums were sore from heavy calculus deposits, There were two decayed teeth and another one decaying at the margin of a bridge attachment I had put in at this time when I completely overhauled her mouth. There was another that was breaking down around a large filling I had placed, and she looked at me accusingly as if I were to blame.

There was an impression in her mid that her dental work should last and she shouldn’t have these now present dental ills. She looked at me and I looked out the window contemplating it as it looked like trouble if it was not a free gratis job.

Where she got this impression and how, is a conjecture. The confusion and doubt is mine. I am wondering as I sit here and try to reason it out in a sane and reasonable light just where the error might be for this idea to have been inculcated in in her mind. I am taking it step by step, mannerisms and actions, and what was said and done in this series of appointments four years ago when I restored her mouth again to a normal functioning power, to see if I can find where I might have led her to this viewpoint she now holds.

I remember very well that first morning Mrs. Pepper came in. Apparently also she had been elsewhere as she seemed to know about some of the restorations needed for her teeth. It was apparent too that I made a favorable impression upon her, besides the point of being highly recommend by another patient of mine who was her friend.

I started the work for her the very next day, and along in one of the early appointments she had with me, if my memory serves me right in my reflection, she asked me about how long my dental work would last. She also told me prior to or about this time that another dentist had said that he could fix her teeth like new if they were restored like he had explained to her. I remember that I answered the question she asked by again stressing the lasting and imperishable qualities of the material I was using and that it was the best and would no doubt last for a great long spell.

I could also sense the voluminous aspect of the bill which had appeared in her mind and which she mentioned to me. Although a fairly good fee, yet there was a large amount of restorative work to do and I stressed this fact too, along with these materials once more, I was placing in her mouth.

And here at this point I am beginning to see light for right here is where I erred. The materials were of the best. That could be cancelled as a fact. They also had lasting and imperishable qualities, but I overstepped my bounds, no doubt, in leading her to believe or to form the assumption in her mind that this might be all of it. I failed to clarify the though that her teeth might not last and did not mention it.

I hadn’t seen her for the four years since I had restored her mouth, and from the  appearance of the heavy calculus deposits around her teeth it is a probability that she hasn’t been any place else since she saw me last. Here the error was made again at the finish of her work in not informing her of what to expect or what I could happen to her teeth from forces over which I had no control.

I remember that I was enthusiastic over this restorative job at the finish of it. It looked very fine to me and I felt that the work was good. The mechanical nicety of it no doubt overshadowed the inner sight of my eye and I honestly believed it would last a good long while. I guiltily overlooked the fact that although I had restored her teeth I had not removed the forces in her mouth which had caused them to decay in the first place and would eventually destroy them again, the length of time depending as far as we know upon the proper care of them, physical health and their resistant power to dental ills.

Thus the error was disastrous when I failed to inform her of the things which could happen, leaving her in ignorance of them. She didn’t know what to expect as I ignored telling her, which leaves me in the blame.

Tomorrow morning I will. I will probably not carry much weight now, but will tell her just the same as I do not wish to lose Mrs. Pepper as a patient nor her influence with her friends. Then do this restorative work free of which she thinks I was in fault about if she insists, as a compromise fee would put me in error again.

Hereafter I hope to avoid occurrences of this kind. I feel that I can. I will tell my patients beforehand in time to forewarn them, and not assume a guarantee, wittingly or unwittingly, that a condition will not develop when it might and common sense will tell one it can. I will tell them that there are destructive forces in the mouth over which I have no control and that decay could get rampant again and very probably would, necessitating future repair even in these teeth I have restored. A few minutes of educating them will rightfully place the blame and save the dentist a lot of woe.

Reynolds Arcade Bldg.,

Bristol, Virginia.