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Culture, habits, additions, omissions or substitutions can spell dental CHAOS.

One of the frequently quoted tenets in medicine is "First help, or at least do no harm". Yet even when dentists live up to this dictum, the patients themselves may be guilty of inflicting damage on their own oral structures. This may arise from Cultural practices, Habits, or may be due to personal Additions, Omissions or Substitutions (hence the CHAOS acronym). This paper illustrates a number of such cases, and where possible offers suggestions as to how the problems could have been avoided or how they should subsequently be managed.