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Browsing 3 posts in second opinions.

There’s no such thing as a cosmetic dentist

No, really. There are plenty of general dentists that love doing cosmetic dental work. There might even be dentists that limit their practice to esthetic cases. However, a dentist cannot be officially designated a “cosmetic dentist” or “cosmetic specialist.”

Dentistry actually has 9 recognized specialties.

  • Public Health Dentistry: this field of dentistry is involved in the assessment of dental health needs and improving the dental health of populations rather than individuals.
  • Endodontics: deals with the tooth pulp and the tissues surrounding the root of a tooth. They perform root canal treatments and retreatments.
  • Oral and Maxillofacial Surgery: these dentists treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. Oral surgeons remove injured or diseased teeth, treat oral cancers and deal with temporomandibular joint problems.
  • Oral and Maxillofacial Radiology: is the study and radiologic interpretation of oral and maxillofacial diseases. They are trained in reading and interpreting x-rays of the head and neck.
  • Orthodontics: focuses on the straightening of teeth and modification of midface and mandibular growth.
  • Prosthodontics: specializes in replacing missing teeth using crowns, bridges, implants and removable prostheses.
  • Pediatric Dentistry: specializes in treating dental diseases in children and adolescents.
  • Periodontics: specializes in treating the supporting tissues of the teeth such as the gums and the bone that surrounds the teeth.
  • Oral and Maxillofacial Pathology: specializes in the diagnosis of less common dental and head and neck diseases.

General dentists are allowed to perform procedures within any of the specialties, if they choose to. However, as of right now a dentist cannot “specialize” in cosmetic dentistry. Kind of confusing, right? Let me explain a little more.

Let’s say you go to a general dentist with a toothache. The dentist performs some tests, takes an x-ray and determines that your tooth has an infection and will need a root canal. Many general dentists perform root canal treatments in their office while others might prefer to refer root canal procedures to a specialist called an endodontist. Some dentists will choose to do some, but not all of these procedures themselves for  different reasons. Perhaps they don’t enjoy doing them, they don’t find them time efficient or perhaps the tooth is particularly challenging. The endodontist has specialized training in root canal treatments. By choosing to specialize in root canals the endodontist doesn’t spend their time placing crowns or making dentures. They get very good at a very specialized procedure.

So you may wonder why there isn’t a cosmetic dentistry specialty.  My best answer is that cosmetic treatments are often “interdisciplinary” in nature. I’ve treated cosmetic cases where we first sent the patient to the orthodontist, to straighten their teeth and make room for a dental implant. Then sent them to an oral surgeon to place a dental implant. Finally, we whitened the patient’s teeth and restored the implant with a beautiful porcelain crown. The goal of all of this treatment was cosmetic improvement, but it involved a team of specialists organized by me, the general dentist. Some general dentists may have the skills required to do all of the different phases I’ve described. But for now, there’s no cosmetic dentistry specialty.

How can you know if your dentist has skill with cosmetic dentistry? The very best way to know is ask them! Dentists who do a lot of cosmetic dentistry usually take photos of their work. Not only is this a great way to show other patients what cosmetic dentistry can offer them but it helps them see what they can do differently or better for the next time. Dentists who enjoy doing cosmetic cases usually take a lot of continuing education classes in order to learn new and cutting edge techniques. Be sure to ask your dentist if they’ve taken courses on cosmetic dentistry.

And remember, cosmetic dentistry isn’t limited to super expensive veneer cases! Orthodontics (braces) and whitening can give a really dramatic result with little or no “drilling.” Replacing stained fillings or replacing silver fillings can lighten the color of your smile, too. Dentures can make a huge cosmetic difference for some people even though most people don’t really think of dentures as “cosmetic dentistry.”

Would you like to improve your smile? I’d be happy to take a look. I don’t charge anything for a cosmetic consultation. I can take a look and give you some ideas about what we could do to improve your smile. I’m also always available for second opinions at no charge! We place beautiful cosmetic restorations every day at Mead Family Dental, but remember…I’m not a “cosmetic dentist!”

Did you like this post? Would you like to share it with friends? You can click on the heart shaped icon next to the title of this post and automatically share it on Facebook, Twitter or Google+! Or you can leave a comment by clicking the “ballon” shaped button next to the title. Or send me an email at alan@meadfamilydental.com. I’m happy to answer any questions and appreciate your input! If your looking for an improvement in your smile in Saginaw, MI I’d like to help!

Dentistry in the News: “Why Your Dentist Costs So Much.”

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This post is a follow up to an article I wrote about a few months back.

My conclusion: if you don’t trust that your dentist has your best interests at heart, you need to ask them about it or find another dentist.

A couple more points were made in the second article that are worth reflecting on. One commenter was quoted to say:

“My wife saw a dentist who quoted her $750. Then halfway through the job, when she was numb and had a big hole in her mouth, he told her he misquoted the price and it was going to be $1,500. She could not exactly argue.”

What can I say about this? I’m about 99% sure that the dentist was preparing a tooth for a crown and realized that there were bigger problems with the tooth than expected. The tooth was probably going to need a root canal treatment as well as the crown in order to save it. I’d love to say something like this has never happened to me, but it has. I try to explain possible risks and complications prior to starting a treatment. However, it’s not unheard of to need to revise my diagnosis and treatment plan once I’ve had a chance to look closer at a problem. I try to avoid these kinds of surprises, but when it happens I explain it in plain English. The patient always has a choice to refuse treatment. I’m guessing that this patient didn’t feel like their dentist explained what was happening very well and the patient came away feeling like the dentist was putting the screws to them. Unfortunate, to be sure.

Most of the rest of the article tried to explain why a) dentistry is expensive and b) why one dentist costs a different amount than another. I think dentists spend way too much time trying to justify their fees and way too little time explaining why we suggest the things that we do!

The very best part of the article was in reference to “how do I know if my dentist is a good one?”

“Ask a dental specialist, like an endodontist. One specialist wrote to tell me, “The best way to find a good dentist is to find a specialist who sees everyone’s patients on a referral basis. He or she will know who is good and who isn’t. Trust me, as a specialist, I know who is doing what, because I see their work every day.”

That’s a tip I had never thought of, but I think it’s valuable.

After reading the follow up article I come up with conclusions similar to the first article:

  • Dentistry is expensive.
  • No one* likes having to have dental work done.
  • No one likes paying the bill.
  • Prevention is MUCH less expensive than needing work. But having work done immediately is similarly less expensive than waiting if something is broken or it hurts.
  • “Dental insurance” isn’t really like insurance at all. Dental benefits are kind of like a gift card. Usually it’s like a gift card that covers about half of the gift you’re looking for. It may help with some of the costs of dentistry but is not likely to pay for more extensive needs.

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So talk to your dentist. Ask a lot of questions. Get a second opinion. Or third! Try to be a good consumer and you’ll feel a lot less like a victim.

If I can answer any questions about this post or any other dental questions I would love to hear from you! I can be reached by email at: alan@meadfamilydental.com. I answer all of my own email and would love to hear from you! Or you can call the office at (989) 799-9133. I would love to be your Saginaw dentist!

*I know there’s probably someone reading this who thinks “I like seeing my dentist so much I’d go more often if I could!” You are great people to have as patients, but frankly, I wonder about you.

Your “cousin” in the business

 

I got an email from my cousin last week. He described going to a new dentist. He liked the office and thought the dentist was a good guy.

My cousin is a pretty level headed guy. He’s certainly not distrustful of professionals that I can tell, but he didn’t have a relationship with this new dentist. He was concerned that maybe his dentist was trying to oversell him on dentistry. The dentist was suggesting some pretty expensive treatment that he had never had before.

Health care professionals have a dilemma. There’s an inherent power imbalance in the doctor/patient relationship most of the time. The doctor is highly trained in a very specific area and the patient usually doesn’t have a lot of knowledge in this area. Last year National Public Radio aired an interview with an economist by the name of Dan Ariely that infuriated a lot of dentists. The interview essentially described what a lot of people believe about dentists. Since dentists diagnose dental problems as well as treat them, there seems to be a distinct conflict of interest. Why wouldn’t a dentist represent problems as bigger than they are if they’re going to get paid more?

Dentists got mad. Really mad. The story challenged the dental profession’s ethics and integrity. I have to admit that I was pretty mad about the story myself. You might notice that I commented on Dr. Ariely’s blog and was disappointed that he never replied to the fact that data he quoted in this interview doesn’t seem to exist.

However…when I took a step back I realized that his major point is worth thinking about. Why wouldn’t a dentist take advantage of such an opportunity? There’s no way to standardize dental diagnosis. One dentist might see a cavity where another dentist might want to “watch” the area for changes.

What’s the solution here? Is there any way to know if your dentist is ripping you off?

I suggest that there are things you can do as a patient:

  • Have a relationship with your dentist. If you don’t feel comfortable asking your dentist questions about the condition of your teeth and the treatments that they offer, then you’re probably at the wrong place. This one is pretty tough if you’re in a new town or going to a new dentist.
  • Ask them to show you: if a dentist or their office staff cannot explain and show you the problem that they’re asking you to fix with expensive treatment, then be skeptical. It doesn’t make you a jerk, it makes you a smart customer. A dentist confident in their diagnosis and treatment will take the time to make sure you understand and believe in the treatment.
  • Get another opinion: I know for a fact that most dental patients won’t do this. I’m convinced that they think that their dentist would be offended. Perhaps some would be. I’m not. I know that a patient that understands the treatment that I’m offering them is more likely to be happy with the treatment. If they check with someone else and they say, “yup, that’s what I would do” then everyone wins. If they take a look and say, “whoa, I’m not sure I agree” then the patient can gain more understanding and perhaps make a better treatment choice. Dentists don’t all treat dental problems the same way. A disagreement with treatment plans doesn’t mean that one dentist is doing it wrong. Second (and third, and fourth…) opinions make for better understanding.

Cousin Oliver This Saginaw dentist is happy to be a second opinon. Further, I will happily give a second opinion at no cost to the patient or nominal cost if we need more diagnositic information is necessary to reach a diagnosis. We need more patients making excellent decisions about their health and they shouldn’t avoid getting second opinion because it’s very costly.

So are you wondering what happened with my cousin? After we talked (actually IM’ed on Facebook) he actually emailed his dental office and asked for his x-rays because he was seeking another opinion about the proposed treatment. They obliged him and he emailed me his x-rays. Although I couldn’t render a diagnosis simply by looking at x-rays I was able to explain that the treatment his new dentist offered didn’t look out of line from what I could see on the x-rays. You know what’s even better? The dentist called to make an appointment with my cousin apologizing for not explaining the treatment in more detail.

Second opinions make for better treatment decisions. And no one stole anyone’s patient and no one got hurt. Isn’t building relationships with your dentist grand?

Do you need a “cousin” in the business in the Saginaw Valley? I’m happy to do it for you. Email me at alan@meadfamilydental.com or call the office at (989) 799-9133. If you’re not from around here I don’t mind doing some leg work to make it happen. Patients who are better informed make better decisions and that’s good for everyone!