10 Things Your Dentist Doesn’t Want You to Know

by Barry Polansky on January 5, 2012 · 57 comments

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About a month ago there was a blog post that got a lot of attention.  It was titled 10 Reasons Your Dentist Probably Hates You Too.  It created quite a stir and wrote a post that I called 10 Reasons Why My Patients Love Me, in response.  The author of the first post wrote it with her tongue firmly planted in her cheek, and I wrote my response to sho

English: Street dentist in Bangalore with a pa...

Wild Wild West Dentistry

w that our profession needs more relationship building in an age where the professions have tipped toward business rather than health car

What is the truth about dentistry these days?

There are many ways to practice dentistry.  Every dentist is faced with the problem of balancing the paradox between duty and desire...the desire to live a great life and the duty to be a great dentist.  We live in a material world and as much as we claim that less is more…so many of us still want more.  Yet I truly believe we also want to to find meaning in our dentistry.

It gets confusing for the dentist as he tries to earn his daily bread in an age where the business of dentistry is like the Wild Wild West.

I try to practice in a manner that helps balance the paradox…some might call it “business ethics.”  I am truly bothered when I see the breakdown of ethics in our profession…so I give you these things that I see some of our colleagues doing on a fairly regular basis…that I think patients, and the powers that be should know about.

  1. Your  dentist sees you as a profit center rather than a patient.  Everyone gets the business thing.  Football players tell us this all the time…but this is health care and an ethical dentist MUST put the patient first.  That is the real definition of professional.  Dentists who do this usually relate everything to the “time is money” philosophy.  They usually run behind and are over-scheduled.
  2. Your dentist just took a weekend course in an advanced surgical technique—-and you are his Monday morning experiment.  Yes, it’s true…we call these dentists gunslingers.  Many procedures dentists do are fairly safe and reversible, but others are way beyond the skill level necessary for performance.  When dentistry is a business and new “profit centers” are available…some dentists go beyond their limitations.
  3. Many dentists are nothing more than tooth jockeys.  That means that they don’t look at the whole patient.  Granted, some patients may be satisfied with this standard, but most people go to the dentist for a long-term result.  If a practice is set up to treat single teeth, it’s unlikely that the patient will accomplish anything worthwhile.  You know if your dentist is committed to your comprehensive care and long-term results if he does a comprehensive examination which includes the teeth, the gums, the bite and an oral cancer examination.
  4. The dentist uses the cheapest materials available and charges you for “the best.”  Dentistry is a blind service.  Look, every business tries to cut down on expenses but at least it should be disclosed.  When the patient goes to a dentist because of price…duh, how do people really think that works.
  5. They use cheap labs.  Just like number 4…this is an area where the dentists can save a lot of money.  These days a dentist can send lab work overseas to China or Thailand.  Google those prices.  Yes…he can pay as low as $50 for a crown and charge the patient or the insurance company up the wazoo.  If you really want to get nervous check out the labor standards in some of those countries.  (Lead in crowns?)
  6. The dentist charges patients one fee and charges the insurance company another, or plan patients get a lower fee.  There seems to be a war between insurance companies and dentists on this issue.  C’mon, is insurance fraud something new?  The problem is that the public accepts a lot of these practices.  But what about the patient who REALLY wants the best and is willing to pay for it.  Sorry…”let the buyer be aware” doesn’t work for me.
  7. Your dentist hasn’t taken a legitimate continuing education course since he graduated dental school.  Many dentists these days spend a lot of time and money trying to be better.  There are many great lecturers and courses available.  But too many dentists only go to courses that are free or are sponsored by manufacturers that are selling the next new thing (profit centers?)
  8. His sterilization techniques are outdated.  Dentistry has changed for the better with the preponderance of disposable supplies, but still plenty of tools need to be sterilized.  This was a hot topic some years ago when OSHA put their foot down hard.  But if you are seeing a trend here about ethics and business, maybe it’s a good time to rethink how patients choose their dentist.
  9. They let the dental assistant perform tasks they are not licensed to perform.  Lots of controversy here.  Certain states allow assistants to do more than others.  Making temporaries, taking impressions and even giving injections.  Some dentists however really push the envelope on this one though…
  10.  They just don’t like their patients.  Okay, this is where we started with Lolabees blog post.  The truth is the dentist (and his staff) don’t even like some of their patients.  This is what got dentists all over that post.  It’s true!  Unprofessional, but hey, that’s human nature.  The real truth is that the dentist should not treat people he doesn’t like.  Jerome Groopman, author of How Doctors Think,  tells us that mistakes in diagnosis are more likely to occur when doctors treat people they don’t like.
    Cover of "How Doctors Think"        I try to avoid writing anything that is cynical or pessimistic about the dental profession.  The last thing we need is someone giving the profession bad press.  When Lolabees blog post came ou and I read the comments, I was once again reminded of the elephant in the room.  Just like the Readers Digest article of the nineties…Is Your Dentist Ripping You Off? or the 1970 book, Dentistry and its Victims, these thoughts are out there and they should be addressed….hopefully the guilty dentists will stop their ways, ethics will be restored to the profession and maybe patients will start to apply better guidelines when choosing a dentist or a dental plan.
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{ 2 trackbacks }

10 Things Your Dentist Won’t Tell You – Empower Yourself | Dental Tourism Resources
April 27, 2012 at 6:54 AM
Cui Bono? Who Benefits? | The TAO of Dentistry
August 13, 2013 at 8:57 AM

{ 55 comments… read them below or add one }

Barry January 26, 2014 at 1:27 PM

Hi Rita…although I am not an advice columnist and you will have to make your own decision…you should rely on your gut, and take money out of the picture. That is hard to do I admit, but in the long run, saving your teeth the right way will be much less expensive than shoddy work.
You must go on trust…but there are some tell-tale signs:
How responsive and empathetic is the dentist.
Is he willing to listen to your circumstances and work out an achievable plan of treatment.
What local and national organizations does he belong to? (Not what school he went to)
Photographs and testimonials from his patients.
Any achievements or acknowledgements about him or his work…not advertisements.

That should be enough to make a decision…not on cost alone.
Good luck.

kaitlin February 5, 2014 at 10:55 PM

If the dentist doesn’t like you, that means it is time to change dentist. That create an unsafe doctor-patient relationship, dentist-patient relationship.

Barry February 6, 2014 at 10:19 AM

Kaitlin…unless it becomes glaringly obvious…most will hide their true feelings. But I agree if the relationship sours…get out. Good advice for life not just dentistry.

Joshua March 9, 2014 at 11:15 AM

Hi Barry
Maybe you can help me out. I recently went to my dentist to have 2 loose impants tightened up(one front tooth and the one directly next to it which lies next to a canine). He informs me that the best route for me to go is to have a bridge installed and begins to sweet talk the benefits of having 4 more teeth drilled down so he can anchor the bridge to my canines.
He proceeds to show me other patients x-rays displaying crowns or implants that are in real trouble and says things like “you don’t want this to happen to you now do you?”
Now he’s really giving me the impression that what he was suggesting was the best and safest route to go and my other options would only lead to problems and big expenditures.
So I stupidly gave him the go ahead.
Now I’m sitting here with a temp bridge, 4 perfectly good teeth gone for good, 3000 dollars gone, and an all but used up yearly allotment for my company insurance..
I feel like the victim of a con.
I don’t know what to do but I’m stressed out, broke, and… well I’m pissed.
Is there any action I can take?

Barry March 10, 2014 at 10:29 AM

Hi Joshua…I am not sure what you mean by action. I am not a lawyer and I really don’t have all the facts. Was there anything wrong with the implants…from any perspective…health, fit, function or cosmetics? Without knowing that it is hard for me to comment. That said…a bridge is an alternative…probably my second choice if the implants were good. There are many dentists who still choose fixed bridgework over implants for a number of reasons.
Just make sure that the bridge is constructed on a sound base…strong teeth underneath with sound periodontal support…make sure the materials are quality and it works well and looks good. If all of those criteria are met the bridge can last for many years with good oral hygiene.

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