How to Criticize an Endodontic case presentation

By Dr.Mandar Joglekar

Disclaimer : Some people may find this presentation "Tongue in cheek " and " not to be taken too seriously".... They may decide to think like this, at their own risk.

Do you frequently visit websites and discussion forums where endo cases are presented ? If yes, do you feel happy seeing their cases ? or you get bored and feel uncomfortable with the continuous praise some presenters are getting... Do you want to criticize their work ? Do you feel your confidance gets shattered seeing good endo work? These are some tips to win back some self esteem .... No.. you don't have to improve your own endodontic work. This is possible without presenting any of your work... Please don't hit "LIKE" button immediately if you don't want to... :) Confront them.... annoy them... Here is a step by step guide to annoy, confront and provoke a presenter in any endodntic discussion forum .... Routine to moderate tactics.... 1.Continue to say.. " This case has poor prognosis"... Worry about size of the lesion,... Even if the X rays are showing good healing, still worry about possible future cracks, weak tooth structure, restorative failure etc. and confidantly say, "THIS WILL FAIL EVENTUALLY" 2. Talk about isolation requirements.. " Where is your rubber dam?" 3. Number of visits : Ridicule multivisit treatment as waste of time and money. If it is a single visit, say the it is too risky. 4.Access : If a good conservative access cavity is prepared, talk about a possible tissue

left in pulp horns, which will give problems later.. and worry about the possibility of missed canals. If the access looks large, criticise the presenter for hogged out dentine making tooth weak...

5. Criticize the shape of the preparation... If smaller preparation, worry about lack of cleaning.. If larger, worry about strip perforations and weakening of tooth structure / possible cracks. 6.Sealer extrusion : If the case is showing sealer extrusion, say how that is painful, unnecessary and toxic and risky for general health. If there is no sealer extrusion, talk about lack of 3D fill and this case will fail eventually. 7. Core material : This is very much basic but works quite well... "Oh my god, Are you still using Amalgam?" 8.Ask questions.... a.Which file system do you use? b.What is your irigation protocall? c. Which obturation system do you use? If you are having time,you can challenge everything... :) e.g. My new flexible wonderful + magical + miraculous + extraordinary " one file per canal" file system is wayyyyyyyyyy better than your old, cheap,pitiable less tapered handfiles. 9. Irrigation : Ask " why don't you use this "GODKNOWSWHICHmonohypochlorus acid" by XYZ company made in Timbaktu? 10.If you see the post.... Ask whether they are really needed? then if you have time, you can criticize metal posts, threaded posts ... If you see fiber posts, challenge the concept itself. Ridicule the monoblock concept. 11.Magnification :Criticize armamenterium e.g. " This case needs good magnification... Why don't you change your cheap loups? or OMG, Are you still using your old microscope?" 12. Nemesdropping : This technique is great... There are many many presenters in the world from Mexico to Moscow and from Jamaica to Korea... Google around for five minutes and collect data of endo gurus.. Use them in your posts.. e.g." But Dr.XYZ from Alabama says this and Dr.ABC from Wyoming says that; "works quite well.... 13. Draw arrows, circles and diagrams on X rays.. *( Learn some basic photoshop) and teach the presenter by showing his own X rays..e.g. Show him that he has missed canals, / transported apical foramen. Two dimensional IOPA X rays are so good for this , you can draw anything on the X ray and start thinking that it is true. Works well.

Some tangent tactics .... If endo is fantastic, still don't praise... try some of these lines.. 1.Please post better quality X rays. 2. Do you have Pulp chamber pictures? 3. Which camera do you use? 4. Why don't you change your mirror? 5. Why is your developer so bad? Does your assistant know , they have to change it? 6.Your rubber dam clamp looks quite old.. you can change it. 7. Cheap X ray machines always give cheap results. 8. The main reason for horrible isolation is leaking rubber dam...

Some Extreme Tactics and arguements... If you really want to annoy the presenter, try some of these lines. They work well.. 1.Do you think you are educated and qualified enough to attempt this difficult treatment? 2.Would you have accepted the same kind of treatment in your mouth? 3.Was the endo really necessary? 4. Please refer in time before the case becomes hopeles... 4.Why do you like herodontics? This is going to fail anyway... Why are you making patients suffer? 5.Most of the endos fail sooner or later... Why do them anyway? Let's extract and implant every carious tooth... 6.Endodontics is on the death bed... Implants are the way to go...