A few basic principles serve as a useful guide in treating patients with defective dental restorations. First, know your limitations. Dental pain in general, and a defective dental restoration in particular, is rarely if ever, a true emergency.2–4 Chronic problems should be treated with equal measures of conservatism and reluctance. Refer the patient to a Dentist if you are hesitant to treat or are unfamiliar with an appliance or a presentation. Always consider a secondary or comorbid process. Consider the utility of dental radiographs when in doubt. Never remove a fixed appliance without first discussing it with a specialist, preferably the one who placed it. Save anything and everything that belongs to the patient, whether it be appliance or tissue, as it may have utility for the definitive treatment.5,6 Treat pain, inflammation, and evidence of infection. Consider a reversible or temporary solution over all others. Remember to treat a tooth for dental trauma if a restoration is determined to be defective secondary to trauma. Always consider ingestion or aspiration when dealing with a multiply fragmented tooth or appliance. Consider facial, neck, chest, and abdominal radiographs if all fragments cannot be accounted for.5,7–10 Whenever a patient is actively involved in an ongoing treatment process, it is probably best to do as little as possible. Always use caution and tact when discussing the possibility of a defective dental restoration with a patient. Remember that you are not an expert. The treating specialist may have insight into the patient's current condition that you are unaware of. Attempt to consult before treating. Always arrange follow-up within 24 to 48 hours.