"Ohhhhhhh,  Crap!", ran through my mind as I observed a failed mandibular, labial frenectomy.

I had only been out of dental school for 2 months when a good friend of mine came in with a strong labial, frenum attachment.  It was pulling on the gingiva, causing periodontal issues with teeth #24 and #25.  

"No problem" I thought to myself.  After all, I studied how to perform that kind of surgery in school last year.  How hard could it be?

As I steadied my Bard Parker above the tissue, a little voice came into my mind suggesting that I should think about referring this one out or at least consulting the local periodontist first.  Unfortunately, the mix of pride and the $450 payment overshadowed my inner-voice.  Snip, Snip, Suture, Suture and it was done.  

I snapped my gloves off, pulled down my mask and with a confident grin patted myself on the back for a job well-done ........ or so I thought.  

To my dismay, a week later I found myself staring down at a wound that had totally healed back onto itself.  No amount of pulling was going to separate the lower lip from the newly formed attachment to the gingiva.  Not only did it not work, but it was much, much worse than when she first came in. 

My heart sank as I walked into my office to call the local periodontist, whom I had never spoken to before.    "Hi, Dr. X,  Ya this is Dr. Rob, the new doctor in town.  So, I haven't been out for more than a few months and ya, I TOTALLY BOTCHED IT on my good friend."   As I muttered some sort of dismal explanation to Dr. X, what happened next surprised me. Instead of the expected reprimand, I received a kind voice telling me that it was going to be ok. He told me to send her down and he would take care of it.  

You wouldn't believe the relief I felt as this periodontist reached out and helped pull me out of the deep abyss.  

I can only imagine how difficult it must be for specialists to wade out into the muddy mess to try and rescue generals who find themselves neck deep.    Whether it be perforated sinuses, broken root tips, ledged canals, severed nerves, failed grafts, or failed implants, the risky job of a rescuer can result in a specialist being a hero or a fall guy.  

Dental Specialists, you are the "Hot-shots", the "He-Men", the "Wonder-Women", or the "Special Forces" of dentistry.  When crap hits the fan, you are the ones there to swoop in and help pick up the pieces; to make things better.  This sentiment can bring satisfaction and pride to your profession, but it can also bring frustration towards generals who dive head first into risky situations with little-to-no experience or training.  "Heck, if something goes wrong, Dr. X will bail me out."   How frustrating that must be. 

I am confident that every specialist out there has been burned and has taken the fall for attitudes such as this.   There is much to be said to the Generals with this type of attitude.  But for now, let's address 3 sound reasons why specialists should still step up and save the fallen and broken cases of the generals.

Behind every failed procedure is a person in desperate need of help.   There are few opportunities in life where only your specific set of skills can truly make a difference.   

To best illustrate the feelings of a saved patient, let me introduce Sally.  Sally had the unfortunate opportunity to be on the receiving end of a kind and competent specialist.   (Long story, made short) Somehow, during an implant delivery by a general dentist, the implant perforated through the buccal plate of the maxilla and lodged itself between the connective tissue and bone, just mesial to Sally's left eye.  

I could only imagine what was going through the doctor's mind who was performing the surgery.  This GP had a long tenure of quality dentistry.  To say that this routine implant placement was beyond his abilities would be unfair with the limited knowledge I have.  One thing is for sure, he and Sally were in one heck of a situation.  *

With the help and quick thinking of a local oral surgeon and an ENT doctor, Aside from some emotional scars, Sally was able to be restored to full health. 

Take advantage of these unique opportunities to truly help your referring doctors.  Sure, cookies are great, but situations like these offer the opportunity to build lasting relationships through selfless acts of service.  To rescue a doctor who is in trouble is the absolute best and most effective way to solidify their referring pipeline.   

The specialists who have put their necks on the line to help my patients will always hold a place of deep appreciation in my thoughts. 

How could helping out a doctor and patient in need be a good thing for yourself?  Aside from solidifying a referral partnership and increasing referrals, just helping others and providing meaningful service is what this life is all about, isn't it?  Sure money is great, but honestly, at the end of the day, or even the end of this life, what an amazing feeling knowing that you truly served and helped your neighbors in need.

If the patient and doctor are too far out in the mud and up to their necks, do not attempt to save them alone.  You may just find yourself stuck out there with them.  There is no shame collaborating with other great minds in the profession or even in other specialties.  With multiple hands locked and a chain formed, the strength of multiple people can save the messiest situations.     

The best way to sum up this article is to remember the Golden Rule. "Do to others as you hope they would do to you."

*For General Dentists reading this article, please see the other side of Janet's story found in "When to Refer".  

by:  Robert L. Barrick DDS