My epiphany with Mrs. Z

By Jimmy Earll

March 19, 2009 -- Editor's note: Jimmy Earll (not his real name) is a practicing dentist in Northern California and a stand-up comic who performs all over North America. His column, Laughing Gas, appears regularly on the advice and opinion page, Second Opinion.

Removable prosthetics have always been a thorn in my side. Why do some of these cases come back for adjustments when I see no indications for it using PIP? I double check the occlusion and it looks fine. I see no visible denture sore spots on the mucosa. The retention looks good. We run through the numbers 60-70 and the patient recites them like she's the star pupil in the class. Yet, she demands that they need adjusting.

This problem is enough of a nuisance that I decide to try squeezing removable prosthetics out of my practice. I raise the fee from $800 to $1,200 per unit. But still I remain busy with dentures and patients that I cannot turn away.

But one day I figured it out, thanks to Mrs. Z. She was my "road to Damascus" experience. I made her the most perfect CD over RPD, but she continued to come in for adjustments. I checked for sore spots but could not find the irritant. Finally, as I was going over her case for the umpteenth time, I remembered she had a cat. Out of frustration, I asked her how Waffles was.

A huge smile came over her face. The flood gates opened, and I found out more about that cat than any human should know. I was ready to take it and enter it in the David Letterman stupid pet tricks segment. I also found out that her granddaughter was premed. I heard plenty about her bunions and arthritic joints too.

With a little smirk on my face -- not enough for her to notice -- I adjusted the nonexistent sore spot she had been complaining about. She smiled again and said it felt much better.

I have a whole new approach to dentures now. I still hate them, but I allow unlimited "Waffles the cat" adjustment appointments. I even put notes in the patient's chart: cat's name, granddaughter's name, in premed, etc. to help keep things moving along. Sometimes it's been a challenge, like when Mrs. Z is sandwiched between a single crown and an anterior veneer case. But that's when I take a step back and mellow out for a few extra minutes with her.

This demographic of our patient base is very lonely. They look forward to their dental appointments. They look forward to catching up with my front office girls. Mrs. Z was so excited the day she was able to tell me that her granddaughter passed the MCAT with flying colors. Even the elderly males like coming in just to talk about the old car they're restoring or debate a little politics. These appointments have become as important to them as their afternoon bridge games with friends.

Mrs. Z passed away recently, but it's cool ... she was a happy lady, and her dentures were comfortable.

And her family is now taking care of Waffles.

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2009


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