knowing your dentist

[ckent]

I posted this before but I may have worded it politically incorrect. I have not been to the dentist in 7 years. One of the main reasons that I have not been is that I saw a 60 minutes episode (or 20/20, I don't remember) where they sent a man with perfectly good teeth (examined by their own dentist) to 6-7 respectable dentists and he got 5 different diagnosis with 5 different recommended invasive treatments (on different teeths). Their own dentists called each one of the diagnosis and recommended treatments ridiculous. Now my question is how do you konw if your dentists is being honest when he/she makes a diagnosis and wants to start drilling? I don't have the expertise to look something up in a dental manual, so I just decided to stop going because my teeth don't bother me and what's the point if you don't know whether or not to believe your dentist? I guess another question that I am trying to get answered is do you guys really know what you are doing when you start drilling or is a lot dentistry arbitrary like when how they did it in the 60 minutes episode?

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[Djanaba]

You base your medical and dental decisions on 60 minutes?

Regardless of the drilling, dude, get your teeth CLEANED twice a year. You've just got yourself a "diagnosis" by letting your teeth rot. I don't mean at all to be harsh, but please don't do yourself the disservice of not going! You don't have to accept each recommendation for further work that anyone gives you, and you can always get 2nd, 3rd, 50th opinions before someone pulls out your last good molar, you know?

 

[DrJeff]

First off, the line "my teeth don't hurt" so I won't go. Thats a recipe for a potential future painfull and expensive trip to the dentist. The two major causes of dental problems, caries(decay) and periodontal(gum) disease are similar to heart disease(and may even contribute to it) in that by the time you realize that you have them, generally quite alot of damage has been done. Most of the time, when a tooth becomes symptomatic due to decay, the decay has reached and infected the nerve of the tooth, and to save the tooth, a root canal and then generally a crown for long term structural support will need to be done, verses a smaller and much less expensive restorative proceedure(filling) when the decay is caught early. For gum disease, by the time you realize you have it, generally its has spread its wrath by causing the loss of significant amounts of supportive bone, and thats really expensive and painful to fix (if it can be at all). Regular, twice yearly cleanings and examinations with x-rays generally every 18 to 24 months for an adult will allow your dentist to catch and treat decay and periodontal disease long before they become symptomatic and problematic.
As for how to choose a dentist, and can you trust their reccomendations, there is alot of opinions about different treatment situations. Some dentists may reccomend a crown for a large filling/filling replacement while some will reccomend a filling. Some dentists will choose aggressive remineralization techniques for small new areas of decay, while some will do the filling. There definately is some degree of subjectivity when treatment is reccommended. Places to start, ask your friends if they've been happy with their dentist and feel comfortable with them(I know its not scientific but it will say something about trust of your friends). When searching for a new dentist, ask about education, advanced residency programs, continuing education, that will give a good grasp as to the dentists commitment to advancing thier education. You could try 1-800 DENTIST, but to be honest with you, the special research that they say they do for the dentists that they list and refer to is basically seeing if their check clears.

 

[ckent]

Thanks for the advice. I will purchase dental insurance in a few months and make use of it.

 

[kris]

CK,

I've had similar experiences to the 60 minute episode you saw.

I had a dentist in DC tell me that a tooth needed a filling. I just had a bad feeling about it, since they never took any Xrays or anything.

I went back to my trusty dentist of 15 years in Nebraska, and he informed me that that tooth already had a filling in it (one of the white kind). This was about 7 years ago, and the tooth is fine.

He also suggested (and I don't know if this is true) that dentistry is most reputable in the pacific NW, followed by the midwest states, with areas like DC coming in dead last for reputable (statistically) dentistry.

Of course, that doesn't mean there aren't great dentists in the DC area, it just means your chance of finding one is statistically lower (assuming my dentist is right).

I imagine there are crappy dentists as there are crappy plumbers, mechanics, doctors and anything else out there.

Getting second opinions may be costly, but worth it. Follow your gut.

BTW, my dentist always shows me the Xray and explains why he feels the need to do any invasive work. He also told me that I have particularly good teeth, and as long as I floss EVERY DAY I can go back only once a year. So no matter where I live in the US, I go back to him in Nebraska. I trust him.

--kris