quandary |ˈkwänd(ə)rē|
noun ( pl. quandaries )
a state of perplexity or uncertainty over what to do in a difficult situation:

It’s the quandaries in dentistry that make dentistry challenging for me. “Dental Compression Syndrome” (DCS) is a quandary. This is a condition of excessive tooth wear that causes the face to slowly collapse as the distance between the jaws shortens as the teeth are ground down. It occurs as we clench and grind. It is painless and progresses very slowly. Most patients don’t even know it is happening because it is not usually painful except when teeth chip and break. I was taught that it occurs commonly in farmers who are bouncing around in a tractor out in the gritty field, but I have seen it in many other occupations. The quandary for any dentist is when to treat it… or even treat it at all. The treatment for DCS is partial or full tooth reconstruction. This can be accomplished with crowns, or more conservatively, ceramic onlays. The goal of treatment is to open up the bite and recreate the proper function of the teeth. This minimizes future wear and can help keep the jaw joint comfortable and healthy. Cosmetically gaining back the longer teeth they used to have is probably the greatest benefit the patient experiences. But this treatment is a BIG DECISION. If a person waits too long and the teeth are too short, the reconstruction may not be possible… thus, my quandary! Ultimately, as with most all dental decisions, I am happy that we work with our patients as partners to decide what is right for them and where it fits into their life the best. Have a wonderful holiday season.

Your friend, Dr. Matz