Many many years ago I had a patient that we had been seeing for a number of years who obviously shall remain nameless. She had a tooth that had been bothering her on and off for some time and was very unreliable about keeping her appointments. The tooth got to the point that it failed and I addressed the issue of this failure with one of my good friends the owner of Endodontic Associates. I addressed the issue in a letter and he wrote me back the following letter “thank you for your letter dated 3/5 regarding your patient. I think your letter summarizes the probable causes of the sudden periodontal breakdown nicely. Periodontal therapy as you know can maintain teeth for many many years but for some teeth in spite of ongoing care may cross an age or wear and tear threshold that leads to a change for the worse in their periodontal health. Fractures are definitely a common cause of this type of periodontal failure some periodontal issues develop suddenly and others build up gradually. A change like this with periodontal breakdown is analogous to the physiological change that can lead to a heart attack in spite of the ongoing care to prevent such an event. I suspect that the perio breakdown associated with these 2 teeth was severe enough that I had some doubts regarding the ability to successfully treat them.” I have kept this letter for many many years in my desk because I firmly believe it is indicative of how we perform our jobs. We try to do the best we can every day but I am not God I am a dentist and sometimes things just fail. It is unfortunate when it happens to you as it did to this patient many years ago but sometimes failures just occur and despite our best efforts to prevent them. These are some of life’s learning tools and I believe we can benefit from all of our life’s experiences whether positive or negative.