Medical Forum / General / Dentistry / June 2006
Why is finding a good dentist like finding a good auto mechanic?
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Culican - 19 Jun 2006 05:43 GMT We have auto mechanics who say you need your brakes re-done. You go to another who says they are fine. And guess what, that brakes last 30,000 miles more.
I had a dentist that said I had 6 decayed teeth. Another that says they are fine. And guess what, those teeth are still fine 30 years later.
I have a great dentist now. But that seems to be a matter of luck.
Why should it be so hard, especially with so-called "professionals?"
Clinton - 19 Jun 2006 06:03 GMT > We have auto mechanics who say you need your brakes re-done. You go to > another who says they are fine. And guess what, that brakes last 30,000 [quoted text clipped - 6 lines] > > Why should it be so hard, especially with so-called "professionals?" Hint...see other thread in this group. Now ask yourself who regulates automechanics? Who regulates drugs? Who regulates dentists? Would you have more faith in the quality of a randomly selected mechanic, dentist or drug?
Steven Bornfeld - 19 Jun 2006 14:00 GMT > We have auto mechanics who say you need your brakes re-done. You go to > another who says they are fine. And guess what, that brakes last 30,000 [quoted text clipped - 6 lines] > > Why should it be so hard, especially with so-called "professionals?" Two reasons: First, it's nice to think that dentistry is hard science, but it's half dark art. Sometimes we have to make judgements about appropriate treatment without knowing the patient's history, health, diet, etc. that can tremendously affect the outcome of treatment. Some dentists are also by inclination more "aggressive" about filling questionable cavities, replacing serviceable but wearing prostheses, etc. While it's convenient to say the more aggressive dentists are overtreating, I can tell you that many times my admonition to patients that "something may need to be done to that tooth next year" leads to a next visit 5 years later for an extraction. It is not always easy to tell which patients will follow your advice and which will go their own merry way. IOW, what goes on between a patient and a doctor is supposed to be some kind of partnership. You must feel comfortable with the dentist's style as well as competence. Some patients need to be told what to do; others will be very good about return visits to check something that may need to be done. Then of course there are the crooks and incompetents. They are there because dentists are people. The question as to how to weed out these losers is difficult because weeding them out is going to be an imperfect process as well, and it's not always easy to tell after the fact exactly what has gone on. Regulation of the professions doubtless can be improved. I am not a public-health expert, so I'm not aware of all the issues involved. I know it's difficult because the professions are regulated by the state, and doctors move around. Maybe there's a public health forum where these issues are discussed, but I haven't checked.
Hope this helps, Steve
JimSocal - 21 Jun 2006 07:35 GMT >> We have auto mechanics who say you need your brakes re-done. You go to >> another who says they are fine. And guess what, that brakes last 30,000 [quoted text clipped - 36 lines] >Hope this helps, >Steve I think you hit on a lot of the answers to the poster's question.
I would only add that I think one major problem is the whole "dental insurance" scam, that is HMO dental plans where dentists can't make any money off of the participants without using bait and switch techniques and talking them into procedures they don't really need, in order to make a buck.
It would be a major task to fix this problem, and with insurance companies like CIGNA and DELTA involved, they have so much power it is unlikely any bought and paid for government official will get anywhere trying to regulate them...
So one tip I recommend to anyone looking for a good dentist is: Don't go to a dentist who accepts HMO dental plans.
Another tip: Go to a Graduate School of Dentistry dental office where they are more interested in teaching grad students the right way to do dentistry, than in making a buck. (Though surely they do operate at a profit, so prices are not that low. However, my experience there so far has been great.)
L505 - 21 Jun 2006 05:34 GMT > We have auto mechanics who say you need your brakes re-done. You go to > another who says they are fine. And guess what, that brakes last 30,000 [quoted text clipped - 6 lines] > > Why should it be so hard, especially with so-called "professionals?" This can go the other way too - in my case I had a dentist who said my teeth were fine, each year, for 3-4 years of 6-12 month regular checkups!
But I was looking in the mirror myself every odd week, with my own bright LED light and pick. I found several cavities myself in the mirror with my light.
I went to see two new dentists. Second opinion and third opinions do help. But guess what? The second and third opinions cost money.
But how come if I go into a grocery store or a computer store I don't get charged for an opinion or advice on what to buy? Stores offer free advice on their products - to get you to buy the product! Dentists offer no free advice (at least the ones I've seen). They charge you just for an opinion! And they charge you for the actual product, AND the service!
Anyway, and only one of these two new dentists finally confirmed all of my suspicions. The first dentist said that yes there were problems with my teeth, and that there was a large hole in one tooth - he pulled it out and the hole was GIGANTIC. I am going to take pictures of it because it is so disgusting and huge. He wasn't saying there was a hole in my tooth just to make a quick buck - he pulled it out and I SAW THE HUGE hole with my own eyes, and I have the tooth in my drawer for proof.
Even though this dentist found that hole, he didn't really tell me about any other problems in my teeth - while I new I had more problems. I pointed out another cavity to him that I'd been monitoring - and he filled that. But I had to point it out to him. I could see it in the mirror and I had to point it out to him! It was maybe 3MM-4MM deep and I kept getting food caught in it. And it was a bit painful when I cleaned it out. So you can't say that it didn't need to be filled.
Then I saw another dentist, a third dentist. This third dentist confirmed that I did have more problems and confirmed my suspicion about another tooth that was rotting away, and a couple more cavities that needed to be checked later this month. One needs either a root canal, or if he can preserve it - a large filling. I have looked in the mirror myself and this hole is huge - it definitely needs attention. When I shine my light in I can see black inside the entire back of the tooth!
Yet the other dentist didn't seem to mention ANYTHING about these huge holes? For 3-4 years? And the second dentist didn't mention anything except one hole, when in fact there were at least 2 major and several medium holes.
I'm very humble and not aggressive at all in person. I'm conservative and slow moving. So it's not as if I'm exaggerating here.
I'm dead serious when I say 2 dentists have basically MISSED two huge cavities which have cost me YEARS of stress.
It's not the PAIN that is causing me stress, but the continual THINKING I do about WHAT IS THE WORLD COMING TO? Why do we have to put up with this? That is what is causing me stress.
Get your OWN bright light (LED, WHITE COLOR) and get your own pick. Get your own dental mirror from a drug store or pharmacy store. Because you cannot trust a professional! You cannot. Don't do the dental work yourself, just check your own teeth yourself. Then go in to the dentist knowing what needs to be done and let him do the work - but pay close attention and be educated.
I will regret not paying attention to my own assessment of my teeth for the rest of my life.
I trusted them - I thought that maybe I was just hallucinating, and maybe there really weren't two HUGE holes and several medium holes in my tooth. I trusted the experts. I made a big mistake.
JimSocal - 22 Jun 2006 07:59 GMT >> We have auto mechanics who say you need your brakes re-done. You go to >> another who says they are fine. And guess what, that brakes last 30,000 [quoted text clipped - 75 lines] >maybe there really weren't two HUGE holes and several medium holes >in my tooth. I trusted the experts. I made a big mistake. Wow. That's almost hard to believe. I say almost because I do believe you, and because I have seen some really bad dentists, myself. This one guy did a bad root canal on my wife, then when we went back to point out the problems she was having, he looked at it and said, "No, it's perfect. I did really good work on that!" He complemented himself on the work!
Then we went to another dentist who took xrays and said, "That is really a bad root canal that guy did!" I took those new xrays and showed them to several other dentists. They concurred that it was a bad root canal job.
Meanwhile this guy had the nerve to continue to send us reminders for our dental appointments and say hello to my wife in public, as if he'd done nothing wrong.
I threatened to take him to small claims court unless he gave us the money back for the root canal. I did not threaten to charge him for the apicoectomy my wife had to have as a result of his bad work, but I should have.
He finally paid us back for the bad root canal and we of course changed dentists.
Lesson learned: I will never let a regular dentist do a root canal again. I know some CAN do it, and I hate to discourage anyone from going to those GOOD dentists who CAN do good endodontia. But I personally will only go to an endo for root canals in the future.
I also now (as a result of the above AND several other bad dentist experiences) go into any dentist's office with the attitude that I am dealing with the likes of a used car salesman, someone who may just be out to cheat me, and/or is just incompetent and really knows nothing about cars (or teeth, as the case may be).
I know that Dr. Bornfeld and other dentists here are not like this and I hate to bad-mouth dentists, but it just seems like it is necessary to let people know that the dental profession is no longer one that is full of trustworthy professionals as it may have been in years gone by. Now you have to really question every one, and be careful, and educate yourself. At least where I live, which is a big city.
Joel344 - 25 Jun 2006 15:06 GMT Why would an auto mechanic say your braces need to be redone? Are the teeth noty straight enough for him?
And when driving past as forty miles per hour its barely noticeable.
Joe
-- Joel34
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