How To Choose Your Dentist

The best book in the world on what today's dentistry can do to treat and cure dental disease, prevent it from occurring, and improve appearance is of no use unless you, the reader, form an important relationship of trust and understanding with the dentist who is going to oversee your dental health.

It should be easy, shouldn't it, to find that person. There are fixed standards of training, techniques, and information on new developments that any dentist can take advantage of. But as in any other profession, there are individuals who are good at their work and some who are not so good; there are individuals with different personalities and attitudes, varying expertise in certain areas, and differing degrees of dedication and ambition.

One dentist, though skilled and competent, may simply not be the person for you; the feeling of trust in his or her judgment is missing. Another, for some unexplained reason, gives you the confidence that you're looking for. Yet both are equally capable dentists. How can you choose a dentist, and be sure that he or she is the right one for you?

Of course, you can get advice from many sources, but nothing will be guaranteed. A friend may recommend their dentist, and you may find them a good choice-or you may not. The local dental society can recommend a dentist to you, but then again, there's no built-in assurance, other than that they are a member of the society. The factor of personality and how it matches yours looms very large in the choice, and no list or recommendation is going to assure that it will be a match made, if not in heaven, at least in the dental office. You may be dissatisfied, but you have one important option: if you don't have absolute trust, if you are not at ease, you are free to choose again until you find the right dentist for you.

In making your decision, there are a number of points to consider about what you want-and about what the dentist looking for patients wants.


How the Dentist Finds their Patients

Dentists go about finding patients-namely you-in a number of ways, and we think you may get some insights into how to choose yours if you understand what they are.

Some dentists advertise; others are very social and will always be seen at important functions. A lot of dentists who also teach to build practices from contacts with patients and other dentists met at schools and hospitals. The ideal dentist builds his or her practice by being understanding and doing the most conscientious work he or she is capable of.

We don't suggest you choose a dentist who advertises. Unfortunately, it has been our experience that advertising is replete with false promises and prices that cannot be contained. We should also be wary of the social dentist-not that they are by virtue of their socializing less capable, but rather that they may spend so much time and energy in socializing that they have little left for their practice. As a general rule, you will probably not go wrong in getting a recommendation for a dentist from a nearby dental school, if you happen to live in or move to an area where one is located. At the very least, you should get a dentist who is up to date and aware of the newest techniques. The area dental society, listed in directories online and in phonebooks, can also be called. It will recommend a member, but there may be a rotating list for such recommendations, and you may not be especially lucky in this kind of dental roulette. However, you will be assured that the dentist is an active member of the society, and the odds are that they are competent.

Most of us want more than chances give us, however; we want that conscientious, capable, ideal dentist. It has been my experience that the only way to find him or her is to approach people in your own social, cultural, and economic bracket until you find one who is really sold on their dentist. People you relate to and who share areas of common interests are more likely to have found the same kind of person you want as a dentist. If you anticipate moving, and have a dentist with whom you've had a satisfactory relationship, ask them for suggestions. They may be able to offer the name of a colleague they respect as a starting point in your search for a new dentist.

There's no sure way of finding Dr. Right, but recommendations that come from respect and enthusiasm and common attitudes toward people have the fewest pitfalls.


The Specialists

The general dentist that you choose is responsible for your overall dental health.

Their work is far ranging, and may include restorations such as fillings, crowns, bridges, and partial and full dentures; treatment of dental conditions such as periodontal disease or root canal; extractions; and orthodontia; also, they may insert implants and treat temporomandibular joint problems. They take X rays, advise on prevention programs, and see that your teeth are cleaned professionally at regular intervals.

The degree that is granted to a dentist is either D.M.D. (Doctor of Medical Dentistry) or D.D.S. (Doctor of Dental Surgery). There is no difference between the two degrees; which your dentist has depends entirely on the designation chosen by the dental school from which they graduated. From time to time, attempts have been made to choose one or the other to eliminate the confusion, but neither faction is willing to give in, so for the present the two designations continue to exist.

Behind your family dentist there are dental specialists whose expertise is concentrated in a particular area of dentistry. They are trained for and especially valuable in treating more than routine problems. If, in your dentist's judgment, you would benefit by being treated by a specialist, they will refer you to the appropriate one. The specialists are certified as such by boards designated by the American Dental Association.

As a rule you will not be required to find a specialist by yourself, but again, if you have a sense of dissatisfaction with the specialist, you may ask your dentist to refer you elsewhere. At the same time, if you have developed a bond of trust with your family dentist, you will probably be confident that they have referred you to the proper person. Remember, too, that if you feel that you should be seen by a specialist, you shouldn't hesitate to ask your dentist to refer you to one.

Many of us go through our lives without ever seeing a specialist. Every dentist understands and many do the work the specialists concentrate in. However, at least two types of specialists are becoming increasingly common in the lives of young people: the pedodontist, who specializes in children's dentistry, and the orthodontist, who straightens teeth. Of the two, only the pedodontist might be selected by you, very often on the recommendation of your pediatrician. On the other hand, most general dentists treat children as well as adults, and very often in small towns or rural areas the general dentist may be the only dentist available for the whole family.


Types of Specialists

The pedodontist and the endodontist treat specific dental diseases: the former, conditions of the gum and supporting structures of the teeth, and the latter, conditions within the teeth relating to the root and nerve.

The prosthodontist specializes in replacing missing teeth with bridges and dentures. Although the general dentist can and does perform many of the prosthodontist's functions, the special training is especially valuable for difficult cases.

The oral surgeon uses surgical techniques to correct many problems, ranging from the extraction of teeth to the repair of faces damaged by accident or natural defects. Although a good deal of his work may be considered the last resort in dentistry, his special surgical training enables him to perform procedures that may ultimately save lives.

The oral pathologist and the public health dentist complete the list of dental specialties.

The TMJ dentist, who treats conditions of the temporomandibular joint and its related problems provides relief from ailments related to an imbalance of the jaw joint and will doubtless play an increasingly important role in dentistry.

The implantologist is also concerned with missing teeth. Implantology, the art of implanting artificial supports for false teeth, is developing rapidly and can be a future solution to many problems of missing teeth.

The most recent and exciting field of dentistry today is aesthetic dentistry: dental attractiveness accompanied by dental health. Also not a specialty, aesthetic dentistry creates dramatic results in the areas such as teeth whitening, bonding, veneers and even non-surgical facelifts.


The Other Members of the Dental Team

The dentist is assisted in their work by trained individuals who enable the dentist to make the most effective use of their time, to serve more of the public, and to keep costs down.

The dental hygienist is trained to scale and polish the teeth; this professional cleaning is an important aspect of good dental health. The hygienist may also be trained to take X rays, take case histories, chart conditions of the mouth, polish restorations, and apply fluoride treatment. The hygienist is also permitted to assist the dentist as a chair-side assistant and teach preventative home care.


The dental assistant works largely as a chair-side assistant to the dentist, handing them instruments and helping in all phases of treatment. The dental assistant is generally responsible for making appointments, sterilizing instruments, developing X rays, and keeping the office in order. To aid the dentist even further, dental assistants are to take wider responsibilities, under supervision, such as taking X rays and study cast impressions.

The dental technician is a skilled, valuable member of the dental team. Their responsibilities, and what they may legally perform, are the mechanical and technical tasks specified by the written authorization of the dentist. The prescription may call for an inlay, bridge, or denture, to be made from impressions and bite relationships taken by the dentist, and to specifications the dentist suggests. Dental laboratory technicians are employed by small family-type labs, large commercial laboratories, or individual dentists. They also individually, or as partners, maintain their own laboratories.


Peer Review: The Dissatisfied Customer

The American Dental Association feels that its responsibilities are to the patient as well as the dentist.


Toward that end, the ADA has encouraged the formation of peer review committees composed of dentists who will critically and fairly examine any justifiable complaint that you, the patient, may have about your dental treatment. The dental profession supports the system of peer review in every state through the state dental societies, and if you believe that you have received inadequate treatment, you can call the local dental society with your complaint.

The peer review system is not weighed toward the dentist, but seeks to evaluate complaints and treatment fairly; surveys have shown that, in general, more than half of the cases heard by peer review have been resolved in favor of the patient.


How to Afford Dentistry

Money has to be paid somehow, and many people are concerned about an economical way to have good dental care.


Dental insurance plans are now becoming available through trade unions, and companies themselves take up a great part of the burden. There are also private dental insurance plans that are especially valuable for families with a number of children. We like to believe that prevention is the best form of insurance, but if you are offered the opportunity to participate in a group plan for dental insurance, it seems an ideal way to make good dentistry affordable.


Most people prefer to be treated privately, but there are, particularly in cities, other ways to obtain dental treatment that are less expensive and make dentistry available to people who might otherwise not see a dentist. Part of the function of a dental school is to serve the community, and dental care is available to the public, with the work being done by students training under the supervision of their dentist teachers. The cost is much less than private care. Hospitals often have residents only for emergency care, but others have full-time staffs that handle all dental problems. Care here is generally not as inexpensive as at dental schools, but hospitals often make allowances for patients with limited funds. The work is likely to be administered by recent graduates under the supervision of an attending staff of teaching dentists.

Medicaid also covers provisional dental treatment, although some people feel that the mass-production aspect of some Medicaid dental treatments-because of the low fees paid by the government, a large volume must be handled for the dentist to profit-makes them less satisfactory.