The image attached to this blog is the implant I place on my wife on Friday 8th September.
This could be a blog about 'walking your talk' and providing the type of treatment for your family that you provide for everybody else who comes to your practice but it isn't. It's actually the consent letter that I would sometimes like to be able to write, but for obvious reasons don't... enjoy!
Dear Mrs Campbell,
It was a pleasure to meet you in the practice today to discuss possible options for replacing the fractured tooth in the lower right part of your mouth which has resulted due to all the sweets and rubbish you ate when you were in your early teens.
During that time you were also a bit wild and didn’t always brush your teeth, I imagine that at that stage your mouth was quite minging and you gave no regard to the future health of your mouth or otherwise. As a result of that I had to provide a sub-standard crown to this area after it has been root filled approximately six years ago and, due to the combination of your neglect and my inability to provide reasonable restorative work in dentistry, the crown broke leaving retained roots which were a bit stinky and made us all go a bit “eurrrgh” when you came into the practice.
I am writing in this letter the options I discussed for your treatment but of course, we never mentioned those and I have merely put this here to protect myself from dental regulators who I am extremely scared of and therefore write copious and enormous consent letters in a vain attempt to try and protect myself.
I fully understand that this consent letter will be turned around should there be any difficulty and be used against me. The detail in the consent letter which actually be the noose with which I am hung.
I also appreciate that if there are any significant complications relating to this that this document will be used in divorce proceedings to prove that I am not fit to be a father and to ensure you get 75% of my assets.
Following the examination and x-ray examination of your rancid, rotting root stump in the lower right part of your mouth I washed my hands. I will ensure that I wear a mask and goggles at all times when I see you for treatment to avoid that horrible halitosis smell that I have to put up with from your neglected lower right first molar.
I have recommend provision of a dental implant because, if truth be told, it’s the only treatment that I can actually provide and I resent having to pay for anyone else at the practice to provide any other treatment. I have made up various stories about not cutting down adjacent teeth or the fact that you won’t like a denture or a gap but, if truth be told, I’m a clinical hammer and implants are the nails that I use.
My plan at this stage is to bring you into the practice to remove the roots and place an immediate dental implant using a guided surgery technique to achieve immediate primary stability in a good restorative position followed by production of a custom healing abutment which is digitally designed and milled within the practice. This will ensure exceptional emergence profile in the area as the tooth heals, reduced appointment times for you and the best possible crown fit and soft tissue health following completion of your treatment.
It’s obvious that you will not understand the last paragraph I have written because I don’t understand it either but I think it sounds extremely credible and full of large medical terms which, although confusing for both of us, make me feel quite important and I feel it’s more likely to get you to uptake the treatment.
With that said, your treatment plan is listed below. If you have any questions regarding this please don’t contact the practice at any time as I will be far too busy to speak to you on the telephone. Please don’t send any emails as my staff will not identify them and they’ll be left in an inbox for a prolonged period of time leading to some sort of dental complaint. Please do not attend the practice yourself to ask questions and please only make an appointment to attend for questions which I will try to keep as short as possible and delegate to any other member of staff.
Treatment Phase One – Diagnostic Phase
An opportunity for me to delegate some of the work to other members of the team in the practice so that I can have a coffee in my office.
This involves various aspects of digital dentistry that I have little understanding of but that my staff tell me are extremely good because it doesn’t take them an awful lot of time and allows them to also have a coffee.
On completion of this I will review all of the digital material with my technician Mark who will then tell me how I should proceed because he is better than me. Clearly he doesn’t have a dental degree so I can pretend to be more important than him.
Treatment Phase Two – Hygiene Phase
After the planning stages of treatment you will undergo the hygiene phase with my hygienist at the practice in order to brush your teeth with a toothbrush which you should have been doing before and if you had been, would have led to retention of your own teeth and no need to have a dental implant in the first place. We will of course charge you for this.
Treatment Phase Three – Tooth Extraction
I plan to extract the tooth at the time of implant placement because to be entirely honest I have taken lots of teeth out now and I can’t be bothered doing it in a separate appointment. I ‘might as well’ keep all the rubbish in one slot so we’ll do it all at the same time. I once read somewhere that immediate implants were a good idea but i’ve never checked any literature on this and couldn’t tell you whether they work better or worse than normal treatment planning. I did see a guy with bleached blonde hair and extremely white teeth present at a conference and he sounded really credible. I couldn’t pronounce his name but his pictures look great and therefore I have tried to copy his treatments without having any understanding of his situation and whether it relates to mine in any way.
Treatment Phase Four – Implant Placement
I’ll place a dental implant following extraction of the tooth but I intend to keep the description of that very short because my fear is that I will frighten you if I tell what it’s really like and you won’t buy the treatment.
Treatment Phase Five – Restorative Phase
We will immediately restore this with a custom healing abutment but again, I have no understanding of that and my technician will provide the help for that. I will attempt to pay the technician as little as possible for that so that I can keep the majority of the money in pretending that my expertise has been heavily involved in this and it’s all about my ‘intellectual property’.
Approximately six weeks later we will provide a final crown in this area which is made from a material that I don’t really understand but I saw a really credible British Prosthodontist present about it at the British Dental Conference and therefore I have decided to use it myself without any further investigation.
A few quick warnings about undertaking this treatment which I’ll ask you to sing below:
We might have to provide a bone graft. The material to be used here might be:
- Your own bone.
- Somebody else’s bone.
- An animal’s bone.
- Various other types of animal bone.
- Broken plates from a Greek restaurant.
- Part of the Great Barrier Reef.
- Some stuff made by Unilever near Liverpool as a waste product from washing powder.
- Some crushed peanut scrapings out of the bottom of an old Tesco peanut bag.
- A material a guy came into the practice and gave me for free. He told me it was definitely related to bone material although he did used to work for a vet.
I may also have to use a type of membrane related to your bone graft but I really have no idea what these are made of. You can rest assured though that I have bought the cheapest one.
There is a significant risk of nerve damage related to a lower implant placement. If this becomes apparent during surgery I will utterly panic. You will see me sweating and my hands will shake. I will ask for the air conditioning to be turned on and my focus will become so directed at you that all I will loose all concept of time. It’s possible that I may stare at the operating site for up to 60 minutes without doing anything. Following that it’s likely that I will take five – seven small periapical radiographs before placing the implant in any event because I’m worried that if I don’t I won’t get paid.
If you have a numb lip following this or permanent pain related to this it is of course your fault because you should have brushed your teeth when you were a teenager.
Your implant may fall out after I do this. I will maintain that my early survival rates are extremely high but I don’t actually count them so I don’t know.
I indulge in an enormous amount of ‘cognitive dissonance’ where I automatically delete a complication when it arises and therefore am convinced that I don’t have any.
I will pretend that I’ve guaranteed the implant for you and will replace it but I will do everything I can to talk you out of having it replace should it fall out.
Finally, many other things might go wrong in relation to the provision of this treatment but there’s really no point in me explaining these to you here. Despite how extensive I might make this consent letter and despite the fact that I might get you to sign it in multiple places we all know that the signature is not worth the paper it’s written on. My advice to you, should something go wrong, would be to just say that you didn’t understand the consent letter because it was:
- Too short.
- Too long.
- Too simple.
- Too complicated.
Any credible lawyer will be able to take that on in a civil action legal case or through a regulator and make sure I get hung out to dry. In all honesty I have no protection whatsoever so getting you to sign a consent letter is probably a worse action on my part than not getting you to sign one. So sign it if you want.
My team and I very much look forward to seeing you (no we don’t) when you next attend for treatment. Please don’t bring anyone with you as the practice is too small for guests.
My very best wishes.
Colin Campbell
BDS FDS RCS
(lots of other letters that not even the profession understand)
(some title about being an assistant tea boy for the Vice President of an association somewhere in the country which sounds credible but nobody understands)
(award winner of many self nominated awards which I wouldn’t have won had I not been the only person to pay a £5000 for my team to attend)
(visiting professor at the University of the Post Office)
Blog Post Number: 1068
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