Dr. Alan Paradis: So a patient gets, it seems to me that this makes it obvious that a patient should learn about what all his options are for a given condition before he lets the doctor starts working on his teeth. I think that visiting a prosthodontist, if you have complex dental needs is going to prove the most cost effective way that you can spend your time. The more complex your dental needs are the less you are going to be able to figure out what those dental needs are and how can they be addressed. A prosthodontist, someone who has spent three years in training just to answer these questions and to be able to do the service that’s needed. So if you have poor dental work in your mouth, it’s a guarantee that you are going to have more dental work done later. I think for example in the practice of implant dentistry, we spend a large expenditure of our time extracting teeth that were treated by unskilled general dentists and especially I have to say the root canals performed by people not trained well to do it are almost a guarantee of an extraction in the future.

Dr. David McFadden: And just as a side, there is a speciality for root canals also is called endodontics, same as cardiology, same as dermatology. It’s a person who took three extra years beyond dental school to learn how to do root canals well and give the tooth the best possible chance for long term success but you are right, root canals I think we take out more teeth that have been treated with root canals in any other problems with teeth.

Dr. Alan Paradis: And I have to say I mean this is kind of something that we didn’t know was a big part of prosthodontics dental practice and indeed a big part of implant dentistry is extracting teeth which had root canals done by general dentists. I cannot remember a time I have extracted a tooth where the root canal was performed by endodontist. It’s a huge problem, no one will ever talk about this.

Dr. David McFadden: Yeah and I think it also sideways into the fact that if there’s something about Dr.Paradis or myself that doesn’t appeal to you, see another prosthodontist. It’s the right thing for your mouth. The speciality training and maybe we haven’t hit on that hard enough. I know we said it a dozen times but dental schools four years, speciality training is three more. So if you think about that just pure numbers that , four years you learn the basics and we are talking about just the basics, there’s not time in the dental school curriculum for you to become a master at anything in four years, continuing education also a few hours here and a few hours there does not translate into becoming an expert so three additional years beyond dental school is enough time for us to learn in depth philosophies, theories, treatments and also substantial research to back up the comments that we are making today so if it’s something about Dr.Paradis and I you don’t like, find another prosthodontist.