Dr. Alan Paradis: So tell me what’s the consequence of having some optimal care delivered into patient’s mouth. Say a dentist season need for extensive dental treatment performs that dental treatment in patient’s mouth but yet they don’t have the knowledge and/or the skills to actually deliver prosthesis or a crown or bridge or an implant crown that meets the criteria for long term success. What happens to that patient?
Dr. David McFadden: Well the word for everything you are describing is failure. At some level that product being delivered is a failure but the discovery period is sometimes long. So if we put it, if a dentist put the crown in that doesn’t fit the tooth, it may take five years for a cavity to form around that crown and always the doctor, the dental profession has learnt to blame the patient for that problem that you didn’t rush right or you didn’t floss right but the reality was that crown never fit from day one. So you know our practices the dental implant center, philosophy is that we want to do restorations that we believe will last 20 years. Can we guarantee dental work for 20 years? Of course not but when we do our treatment planning, we think what’s going to serve that patient best for 20 years, not five, not one but 20 years. What are the chances of we want to give the patient, the best chance for the long term success? So when it comes to failures, levels of failure, we see a lot of the patients coming in for a second opinions whose dental work is failing within months or a few short years. So one of the things we do is we work with our patients, we accept part of that responsibility. We are not always going to blame the patient when something goes wrong. That’s called being ethical so we try to work with the patient. Should if they have early failures, we are going to fix it at no extra cost because we are partners with a patient in treatment. We are not dictating what you have to have and we are not putting all the burden on the patient. We accept the responsibility along with the patient when things go wrong. It’s just the right thing to do.