Exam and Treatment

At Eric Yaremko DMD PS we take the process off a thorough examination and discovery process very seriously.
Dr. Yaremko handles complex reconstruction cases and has spent countless hours training with the most knowledgeable doctors in dentistry to bring the highest level of diagnostic knowledge to you and your exam. He helps other dentists with treatment planning and was one of the founding members of the WA Creating Restorative Study Club -devoted to treatment planning advanced cases. We ask that patients be sure to set aside the appropriate time for this procedure. This is not a five minute or 30 second check-up that you may have had in the past. We are actually taking the time to talk to you and assess your current situation and what your risk is of having problems in the future.
We do not insist that you treat your condition. We do ask that you allow us time to explain to you what we see as risks to your dental health and possibly your whole health in both the present and the future. You will be asked as to how you would like us to care for you and what risks in certain categories you are willing to accept. We understand that there are times when you may not have the time, energy or finances to manage your treatment ideally. Please understand that it is our job to tell you of the problems and potential problems that we see and your job to work with us to come to a plan where you balance your concerns about your conditions and what is going on in life to come to a realistic treatment plan for you.
We have had some comments lately on the internet that we frankly find quite odd. We DO examine and check for problems regarding gum disease, cavities and weak and infected teeth, wear and jaw problems. We DO explain what future problems and risks are involved in those categories and how those may affect other conditions. We DON’T tell you that you have to manage and treat those conditions. We DO tell you what YOUR risks are if you don’t treat these conditions and how it may come to affect treatment and what potential pitfalls that you may be accepting by not managing those, including not being able to guarantee some of the work we are doing for you. Also there may be some re-do of work that we do for you if you choose to manage those problems in the future. These are after all your teeth and your risks not ours.
Some treatment planning mistakes that have walked into our office due to patients and dentists not looking past the one tooth–
Case 1 Patient came in to get an opinion on a recommendation that he had received elsewhere to have 2 crowns done. However he was unaware that he had numerous decayed and infected teeth, and moderate gum disease and also confided that he disliked the appearance of his teeth.
After looking at his problems as a whole HE DECIDED that he could not afford the time and finances to restore his teeth and that he would prefer to have an implant supported denture, which we eventually provided for him. Had he gone through with the treatment of the crowns on the 2 teeth ( which was appropriate treatment if everything else was alright ) he would have wasted his time and money having them extracted later.
Case 2 patient came in to us as he was concerned about his teeth becoming shorter. He had several crowns done in the last five years.
After consultation HE DECIDED to have those crowns re-done and several others done in order to fix the bite issues related to the shortening of the teeth. The other crowns had been done in an uncorrected bite, and had to be re-done as part of the correction of other problems.
Case 3 Patient had severely worn teeth. He had a crown done 1 year ago. He broke another tooth. In consultation he understood that he had a wear problem and that any crown restorations would be built “in the wrong place”. HE DECIDED that he couldn’t afford to treat the bite now so he accepted the risk of breakage by having us build a tooth out of filling for now and he would address the bite issue later. He would crown that tooth as part of the more comprehensive case later.
These are but a few examples of why we have some conversations about more global issues. It is our job and our moral and ethical obligation to tell you what we know and counsel and work with you to come to a mutual plan of action. This is not some conspiracy to coerce you to do more things but rather an attempt to get patients to do less elaborate immediate treatment until we and they understand the more comprehensive problems and solutions that they may have, and any potential and often expensive and incorrect treatment incompatibility issues– you can’t have 1 really nice crown in the middle of a denture! Wouldn’t it be a good thing to wait on that expensive treatment until you know that?
We think it is, and that is really what you pay me for- my education and experience at discovering it and my time in helping you figure it out and managing it.
Sincerely,
Eric Yaremko DMD