The Comfort of Six

With Typhoon Maria shoving buckets of rain at the windows, it seems like the right time for a zero-constructive blog post. After 2 weeks in Phoenix and Las Vegas, followed by 5 days in South Korea, it was really hard to get back into the office chair. Not gonna lie, I thought about faking an illness just to get the first morning off, though in my defense I had a legitimate reason: the first treatment plan waiting at the starting line was an 18-unit case. Fortunately, I had known ahead of time that I wouldn’t be at my 100%, so I scheduled her for two days of back to back treatments: one for each arch.

That’s what’s going on outside, like, right now.

The thing with doing same-day deliveries for multiple units is that it is incredibly taxing both physically and mentally. It’s like a marathon, and if I was to try and maintain some sort of preparation quality, then being 100% alert for the entire day is key. And that’s hard to do sometimes, even without the effects of jet-lag, because once the number of units reach a threshold, the rules and strategies change. With a few years of experience, I’ve developed a certain sensitivity to a few of these numbers.


This is the number of units that I find most comfortable for tooth preparation, like as in I can whip out the micro, the cameras, and the works. If I’m dealing with fresh teeth, then I can usually have the CEREC machines carted over to our techs before noon, sometimes with time to spare. The only problem with this number is that from a prosthodontic perspective, six units is sometimes not enough to restore a full smile. A more common problem is that patients will usually choose a lighter shade, which is not a great look if their premolars haven’t been bleached.


So this I think is the best number for an aesthetic outcome. The two extra units will add a bit of time to the prep, especially if the premolars have funky vonlay designs, but the biggest drag is the increase in scanning difficulty. Intraoral scanners don’t like long-span arches, and so more time is dedicated to making sure there aren’t any significant distortions.


This is the threshold for stealing those extra CEREC machines and activating Ghost Mode. Now you’re doing exponentially more work for a mere 2-unit increase. This is actually the worst number.


Now you’re doing both arches with Ghost Mode. Sure, it’s almost twice the work as before but if you’re getting beaten with a stick, what’s a few more hits anyway? Usually by the time I get to the lower premolars I’m so sick of looking at teeth I want to smash the microscope to pieces.

For 18+ units, these are usually the last stretch in the treatment marathon. Material is e.max B1.