CBC Marketplace Wants You to Second-Guess Your Dentist!
This past weekend, CBC aired a segment on their show Marketplace about dentists entitled “Money Where Your Mouth Is”, which you can read about here . Specifically, it was geared to prove how untrustworthy, and out-to-make-money dentists are. A researcher was sent “undercover” to 20 dental offices for examinations to discover what the variations were in treatments recommended. Before attending these offices, the patient was examined at the University of Toronto Dental School by an “expert”. This terminology is used, in my opinion, to have us believe that the remainder of dentists “in private practice” are not also experts in the same field in which many have worked for 15-20 years or more. CBC set this scene to immediately cast doubt and suspicion on any other dentist shown during the segment, as now the viewers believe that only that which is recommended by the “expert” could possibly be correct.
The narrator continues by airing the names of any dentist whose treatment plan varied widely from the one given at the dental school, but not airing the names of those who CBC producers considered to offer a “similar” treatment plan to the dental school. In fact, 3 out of 5 dentists provided a similar treatment plan, but they were not “outed” to the public. Finally, an accusation is made by a retired dentist working for an insurance company that dentists often treat patients based on their insurance, trying to “scam” the insurance into paying for “expensive and unneccessary treatment.” Again, a dentist who is not treating patients in practice is passing judgement on the treatments recommended, but because he has worked in the field “for 40 years”, his opinion carries more weight.
How is it possible that 20 different dentists and two “experts” couldn’t come up with the same treatment plan?
All of us practising dentistry were trained at different schools, in different decades, by different “experts”, and had different patients with which to build our experience. Some of us continue to take many hours every year of continuing education to stay on top of the latest innovations in our field, and others of us purchase more modern equipment to be able to provide state-of-the-art dentistry for our patients. We may use different methods in looking for dental disease, from the standard “xray and poke” exam that many are used to, to using magnification, adding digital photography or diagnostic lasers (such as Diagnodent) to show us changes on a small scale that can help patients eliminate bigger problems down the road. Many dentists would like to say we are in the business of preventing dental disease, whenever possible, and acting proactively when we see a small problem.
What else was interesting?
I found it interesting that at least two dentists mentioned recommended a “night guard” or “bite splint”, which indicates to me that these dentists saw changes in the patient’s teeth that not all of the other dentists noted. Not even the expert. Also interesting to me is the dentist badmouthing “expensive dental treatments” that once greatly increased his own income, to the point that he was able to spend a ridiculous amount of money purchasing the tooth of a now-deceased singer/musician. During his interview, this same dentist promotes a book he has written meant to increase distrust of dental professionals everywhere (except of course, himself).
What should patients believe about dentists?
As in any health profession or business, the majority of us went to school to learn how to help people! I know that most of my colleagues provide the best possible care they can with the knowledge they have, and most of us only recommend treatment that we would provide for members of our own families. Some of us focus more on prevention via proactive treatment, because we know that dental decay is typically painless, tooth wear is typically painless, gum tissue should never bleed, and people shouldn’t regularly have bad breath. These are the dental “need” portions of what we do…but what about cosmetics?
Why cosmetic dentistry isn’t actually evil
The public is lead to believe that it is bad to offer or suggest cosmetic dental treatment, and positions those of us that do offer such treatment as “money-hungry”. I wonder if the same can be said about weight-loss programs, or fitness programs that talk only about “dropping a dress size”…isn’t that cosmetics? What about women coloring their hair and having manicures/pedicures on a regular basis? Or Botox or injectable fillers and plastic surgery? These are all procedures occuring world-wide because we all want to be able to look our best. Why is it then evil to want your teeth to look their best also? I will speak to my own motives in providing cosmetic dental treatments–they are the most fun service I provide! Many of my patients have waited years to improve their smiles, and when we do so their faces are often lit with joy! Today I had the amazing fortune to treat a wonderful lady 72-years-young in my practice, improving her smile in ways that she has dreamed of for years…so incredibly rewarding! Maybe that sounds corny, but I don’t usually get hugs from my patients after root canals…only after cosmetic treatments. It has been said “change a smile…change a life”, and I have seen that happen, and it’s amazing!
How often do dentists tell me what I need based on what my insurance will cover?
I am truly happy for my patients who have dental insurance, because it is a benefit for them to receive partial reimbursement for needed care. However, dental insurance does not care about prevention of oral disease, or quality treatment of oral disease, nor about how your teeth look. Dental insurance companies care about dental insurance companies! I am happy to help my patients maximize their dental benefits, but I plan treatment based on what patients need, not based on whether or not they have insurance, or what it allows. It is up to the patient to decide how and when to begin dental treatment, and this decision may be based upon many factors, one of which might be financial, in which case insurance will pay a role for the patient.
So what about recommended dental treatment?
I know it is confusing to be a patient in 2012. My best suggestion is to find a dentist that you feel you trust, rather than finding a dentist with free parking or next to your favorite grocery store or open late a night. I’m not saying that dentists in malls are not to be trusted, but I AM saying that a convenient location should not be the primary factor in your choice. Your dentist should always allow time for you to ask questions about recommended treatment, the dental team working with the dentist should be able to do the same. Progressive dental offices will show you and educate you about the health of your mouth. You will learn how to best prevent dental disease, and how your dentist can help you by using all of the technology available to us in 2012. Understand that getting a second opinion may also, as was shown on CBC, give you a different treatment plan when your teeth are viewed with a second set of eyes, which can only add to your confusion.