Aggressive Dentistry

The statement, “The last dentist told me I had 14 cavities!” is one I’ve heard again and again. Patients get frustrated when they feel over diagnosed; sometimes to the point that they seek a second opinion. OPINION is the key word here. We all know that in healthcare, we see variability between doctors. Dentistry is no exception. How does a patient know who to trust?

If a dentist tells you that you have 14 cavities, do you trust them? Two modern dental technologies help dentists educate patients. Digital x-rays allow dentists to enlarge an x-ray of your tooth and make the tiny cavity visible to the untrained eye. Intra-oral cameras can take a picture of your tooth and do the same thing. Patients who view these images before the dentist sometimes point out more possible problems than the dentist! If your dentist doesn’t treat your exam like Show-N-Tell at kindergarten, then blind trust is your only option. Seeing your problems through the eyes of the dentist is now a great way to make trust a smaller part of the picture.

Some patients (and dentists) believe in a wait till it hurts philosophy. When this is the prevailing opinion, patients are worse off in the long run. They spend more money on more complex treatments with higher failure rates. Root canals, Implants, Bridges, and Dentures aren’t as good as the teeth you had when you were 12 years-old, but they may be better than a hurting tooth. Preventive services and less invasive procedures are preferable to aggressive, major treatment. Regular cleanings and sealants are better than fillings and crowns; and fillings and crowns are better than root canals, bridges, implants and dentures.

Most insurance plans pay for preventive services like cleanings and sealants. However, every patient is different. For example, many insurance plans cover sealants, but in the fine print we may learn that your plan pays for sealants only on molars and only under the age of 14. If you are an adult patient with a deep groove on the back of your front tooth then you are more likely to get a cavity, which gets bigger and you may eventually need a root canal or lose that tooth. A sealant could prevent the cavity and prevent the loss of that front tooth. If your dentist isn’t “aggressive” and only recommends what your insurance pays for, then you may end up having bigger problems. In this case, it pays to have a Preventively Aggressive Dentist – one who recommends treatment based on need or benefit to the patient, not just recommendation of insurance coverage.

If your dentist is telling you that you have 14 cavities (or even 1 cavity), then a second opinion is in order if your trust doesn’t close the deal. Find a dentist who is aggressive in preventive care, not aggressive in treatment – especially treatment you don’t trust. Find a dentist who believes in Show-N-Tell; after all, it worked in Kindergarten!