‘I learnt about Dentistry from that’

Readers are encouraged to submit clinical experiences, good and bad, in a culture of open reporting, so that other clinicians will learn from these experiences. Unlike articles in Dental Update, in which published articles are peer reviewed by two experts in the field of the article, this page is not subjected to review other than by the Editorial Director.

My orthodontic colleague asked me to see a patient ASAP. She had finished her ortho treatment and was getting married in 10 days. He had tried to whiten her previously root-filled UL1 and it was not improving. She was ‘squeezed in’ a very busy schedule to see me and then she was late for her appointment. I briefly discussed ‘inside-outside’ whitening and she agreed to try this and we proceeded. I saw her twice more and we did get a good result – she was happy – orthodontist appreciative. Six months later, she e-mailed me with a photo and was worried about a red area on her gum near the tooth. I had just read an update on tooth whitening issues in Dental Update and had been thinking that I do not routinely warn patients about the risk of resorption with this treatment. I had now convinced myself that I didn't warn her of that risk and that this was the issue. The happy ending is that it was not resorption, or a failing root filling; the tooth is stable and we think it may be a type of Lichen Planus. I have had time to reflect on the entire situation and have summarized the salient issues.