blogitto ergo sum

December 11, 2011

#202 – Due Diligence Drill

Filed under: business buz,Opinionated,reading material — yael [ya-el] wagner @ 07:15
Tags: , ,

Latte and fruit pie sound harmless, right?  Well, if you don’t count calories they might.  On a Sunday afternoon, I was having just that with Edna and Pessi @ the Fillmore’s Grove.  We were appreciating Edna’s latest amazing creations, enjoying the atmosphere of the place and all was good until I suddenly had a suspicious object in my mouth.  As I let it out, Pessi was the quick to identify it for what it was.  A piece of teeth.  Mine!  No pain, no stones in the pie, just a tooth that decided to split.  Wrapped in a napkin, I put it in my purse for future reference.

Three days later, at the dentist’s office, I heard about drilling into my jaw, titanium screws and implants.  A week later, Thanksgiving behind, I’m back to start what should be a 4-6 months dental reconstruction process.

Before I get to see the DDS, there’s that little form I need to read, initial, sign and be happy.  I start reading and my mood is quickly moving to red.  Apparently, the casually discussed process carries multiple risks, ranging from the harmless no drinking from straw for a few weeks to breaking or cracking parts of my jaw, “accidents” that will lead to additional surgeries at unknown cost, blood clots, prolonged pain…  all the way to killing a nerve that happens to reside in the neighborhood of the broken teeth.

Needless to say, NONE of those was mentioned by the nice dentist who came highly recommended by a good friend.  I refuse to sign the form without a serious discussion about all these delightful risks.  When I first express my concerns to the eager dentist, he dismisses the form as a standard requirement by the ADA.  “So are these risks non risks or real risks” I ask.  “Well, these are potential risks.”

“Why should I proceed with the process,” I question.  “Right now, I’m in no pain.  Lucky for me, unless I truly LoL with my mouth wide open, it’s unlikely that anyone will notice the broken teeth, and I can eat hot, cold whatever.  Why do anything?!”

“You have other options,” says the now a little less trusted dentist.  20 minutes of Q&A later, and much better educated, I know I have FOUR different options; all new three are of a lesser risk and potential complications, all at a lower cost.  Greedy, aren’t we?

Armed with this new knowledge, I ask the nice dentist, “So if I were your daughter, which of these options would you recommend?”  “I need to look deeper, to see the exact condition of the teeth’s remains, the gum.”

Interestingly enough, he didn’t need to look deeper to recommend the most invasive treatment for me.  I don’t explode, I don’t point out the demonstrated little care for what’s best for me.   The least invasive option, second to doing nothing, involves getting an orthodontist to pull out the remains of the teeth, and then drill a titanium screw into it [instead of the jaw], building the new fake teeth on it.

So I drove to the orthodontist.  With one X-Ray shot I brought with me, and some poking around, he said he could do it, and would l like, while he is at it, to straighten up some rebellious tooth residing in the neighborhood?  I said “yes, how much is that going to hurt?”

OK, so now it’s no longer a cheaper option, but it comes with serious benefits.  This is where I swallow my embarrassment, and admit that I took the orthodontics route twice before in my life.  2nd-3rd grade was a disaster that is best remembered in my family with my dad’s constant complaint that he is not sure why he pays for straightening the bath tub.  Yes, that was often where I “forgot” my retainer.  Can’t remember how many times I broke it while in my pocket, for whatever reason.  Eventually, my parents gave up, and I got a free ticket to crooked teeth.  It wasn’t until late high school that I asked my parents for a 2nd chance.  I was denied a private dentist, but was welcome to go the HMO way.  And yes, I went to the army with a retainer.  This time, I was as committed as one could be, and it came with unpredictable fringe benefits.  Once a month I got an “after” to go visit my dentist and get the screws tightened.  What a nice break and a chance to visit home for an hour or two.  Unfortunately, even this treatment didn’t reach its happy ending.  As an army tour guide, I found myself lecturing to eager and not so eager soldiers about this Crusades site and this battlefield.  The whistling “sh” and “s” sounds that come with talking with a retainer in your mouth were good enough reason for me to take it out before talking.  On one such trip I lost it.  Never went back.

and it comes with color options

Fast forward to today, I get yet a third chance, at least for the lower jaw.

I see the orthodontist again a week later to get my mouth model [I thought it’s called a mold, but turned out I’m wrong].  I happily share my recent experience with dental consent forms, and casually mention to the nice DDs that I expect him to call out each and every potential risk, before we get to the part where I read a consent form in his waiting room and learn about multiple interesting risks.  “A medical due diligence” I say, “must be proactive.  I find it hard to trust a Dr. that hides behind a form.”  I definitely got his attention now.  He seats down and goes over all the risks, which I find reasonable.  He also instructs the receptionist to give me the consent form which is not due until our next appointment “to go.”

Next stop on this day is the C Dental X-Ray in San Mateo.  As the technician is getting ready to take the first head shot, the Doctor that doesn’t believe in proactive due diligence calls and offers to take the X-Rays in his clinic, thus reducing the cost.  Aha! My inner self is laughing.  You got an interesting call from the orthodontist, didn’t you?!

Turned out he can’t do it.  No worries, we’ll meet again when it’s time to slice my gum a bit.  And I will be asking a lot of questions.

Sometimes the right thing is to question the consent form.  Un-consenting is a real, good valid option.

art sources:


  1. Opus FX

    #202 – Due Diligence Drill | blogitto ergo sum

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