How Can I Tell If My Dentist is Good One?

[VictoriaF]

Perfect teeth are an American cultural phenomenon forced on the rest of the world.



Victoria

[bengal22]

so the size of the drill does matter?

[sscritic]

I was always more impressed by the size of the needle.

[Firewood42]

I may be wrong but I have noticed when a new young dentist takes over a practice, I think they push treatment on you that is unnecessary. Probably because they are in debt with with loans and start up costs. I dropped two dentists that took over from my old dentists because of this.

[wesleymouch]

The big scam is that you have to see a dentist in order to use the services of a dental hygenist. The fact is that it does not take much to be a general dentist. Its like being a pediatrician. You would be better off getting your teeth cleaned by a hygenist and seeing a dentist only when you have a problem. Dentists get laws passed to prevent hygenists from working independently. They have the hygenist do the work then mark up their services.

[Wading Ashore]

I have to chuckle. How did you know this person was a "top" specialist? Did it say that on the license plate of his mercedes?

No need to chuckle, Jerilynn, although you seem to enjoy that. The specialist was referred to me by his teacher in dental school, who has taken very good care of several of my friends and family members for many years. Luxury automobiles had nothing to do with it, although an additional factor in my choice was that he was a respectful individual with a professional manner, unlike some others.

[Frugal Al]

Brush your teeth 2x a day, floss, and use a fluoride rinse.

Oh, and don't chew ice, or any other hard brittle substance. Thanks for the good info, Jerilynn and lindisfarne, et al.

Sometimes good enough is good enough, although no one likes to cut corners on health services. It's nice to hear a pro say the same thing about their own profession. Not that I wouldn't like to have the best dentist possible, but I too came to the conclusion that I couldn't tell the great from the average. I used to see a dentist who was an acquaintance of mine. I had my teeth cleaned two weeks after I had major sinus surgery. In retrospect, I should have known better than to get a teeth cleaning then, but professionally, he should have known better, too (he was aware I'd had recent surgery). I ended up with a massive infection and high fever.

I now go to the dental school at OSU. As stated earlier, you learn a lot and they do a pretty good job--I think. The best cleanings I get at the school seem to be by the hygienists in training, rather than the dental students. In fact, I get the feeling that some of the dental students already think cleaning is beneath them. I could be wrong--just my impression.

[sscritic]

Oh, and don't chew ice.

You sound like my daughter. But I can't stop. Even my grandkids like chewing ice. Sometimes, when their mother isn't watching (and sometimes when she is), I will slip them a piece. Even my SIL let's them have a bit from his glass.

On the other hand, when I am babysitting, I try to remember to tell them to floss (I sometimes forget). They have all been flossing since they were two.

[davebo]

I am pretty happy that my Dentist office has 2 main dentists (that started the practice), one that is a tad younger (also a partner), and a couple younger dentists. I'm not sure if it's totally accurate, but I would assume they would only hire dentists that share the same philosophy and skills. I kinda make it a point to schedule an appointment here and there with the different dentists in the practice from time to time.

I know my dentist has a problem with the newer breed of dentists that use technology to identify cavities quicker. He said that patients go in there for the first time and need 10 fillings and 3 root canals and it's not necessary. He maintains that if you can't spot it with the magnifying glass on top of his head, then there is no need to work on it.

[tuckeverlasting]

My experience at my local School of Dentistry has been highly satisfactory. They are my dentist for life!

[dm200]

The big scam is that you have to see a dentist in order to use the services of a dental hygenist. The fact is that it does not take much to be a general dentist. Its like being a pediatrician. You would be better off getting your teeth cleaned by a hygenist and seeing a dentist only when you have a problem. Dentists get laws passed to prevent hygenists from working independently. They have the hygenist do the work then mark up their services.

I thought that this was not allowed, in most (if not all) states. I also think I saw a related fight over non-dentist practiticioners being allowed to whiten teeth. Apparantly, that is not allowed in most (or all) states outside of a dentist's practice/office.

[reggiesimpson]

The big scam is that you have to see a dentist in order to use the services of a dental hygenist. The fact is that it does not take much to be a general dentist. Its like being a pediatrician. You would be better off getting your teeth cleaned by a hygenist and seeing a dentist only when you have a problem. Dentists get laws passed to prevent hygenists from working independently. They have the hygenist do the work then mark up their services.

I thought that this was not allowed, in most (if not all) states. I also think I saw a related fight over non-dentist practiticioners being allowed to whiten teeth. Apparantly, that is not allowed in most (or all) states outside of a dentist's practice/office.

Look for a dental hygienist program at a local college. They do a terrific job for a fraction of the cost and the work is checked by the dentist faculty.

[lindisfarne]

The big scam is that you have to see a dentist in order to use the services of a dental hygenist. The fact is that it does not take much to be a general dentist. Its like being a pediatrician. You would be better off getting your teeth cleaned by a hygenist and seeing a dentist only when you have a problem. Dentists get laws passed to prevent hygenists from working independently. They have the hygenist do the work then mark up their services.

You could try saying when you make the appointment that you just want a cleaning; no x-rays or exam. Try calling around - I'm sure some offices will be fine with that. I did this once when I was new to an area & had seen a dentist about 6 months earlier. They may do it expecting that on the next visit you'll want x-rays & exam.

[Fallible]

Perfect teeth are an American cultural phenomenon forced on the rest of the world.



Victoria

Perfect teeth, dead patient.

Or how about this W.C. Fields classic, "The Dentist."

http://www.youtube.com/watch?v=Bhb0Xy26eys

[Atilla]

This is what we did: get your x-rays and first dentist's recommendations sent to a different dentist for a second opinion. Made a huge difference in total cost and amount of work done for my wife.

If it don't feel right - get a second opinion.

I have discovered there is a large gap between dentists who tell you what to get done when it needs to get done - and in the most economical way possible - vs other dentists who want to go whole hog with lots of very expensive stuff right away.

[dm200]

Seinfeld had several "Dentist" bits in his show over the years.

[stlrick]

1. You can't count on referrals from periodontists, orthodontists, etc. They get their referrals from general dentists, and some may recommend just to return the favor.

2. There is no way a patient can judge, regardless of the number of years they have seen their dentist.

3. The absolutely best way to find a good dentist is to find a dentist that other dentists send their families to.

4. Second best, find a dentist in private practice who teaches part-time, usually one day per week, as clinical faculty at the local dental school.

5. If you are going to use students, use students in the General Practice Residency of a hospital, not dental students studying for their DMD or DDS (there is, by the way, absolutely no difference between these degrees).

[gd]

I was always more impressed by the size of the needle.

The dentist that I criticized as incompetent in a previous post had one curious good point-- he used a device to inject anesthetic slowly-- like for 30-60 seconds. Sounds horrific, but it was always utterly painless. He claimed that rapid fluid injection was the thing that caused pain. I had an intensely painful injection as a child, have cringed from them ever since, and this was really different. Good thing, since the fillings always fell out the next week...

[beachplum]

I know my dentist is good based on the fact that I continue to go to him. I was traumatized as a child of the 60s from my dentist experience and went through periods during my adult life when I would go years without seeing one. Now I'm back on track thanks to this young man who doesn't recommend doing anything that isn't absolutely necessary. Sometimes I find drs/dentists based on referrals, sometimes on what I've read and then I go see them and see what I think. I also like to read as much as possible about any procedure/ condition I have and what the latest recommendations/options are so I go in with some knowledge.

I hear what you are saying and I realize that you are comfortable with your decision. But, if you really think you know that your dentist is 'good' you are just rationalizing and fooling yourself.

I have all my teeth, no tooth aches, and I've gone for second opinions when needed. Not sure how that equates to fooling myself/rationalizing.

[pennstater2005]

I know my dentist is good based on the fact that I continue to go to him. I was traumatized as a child of the 60s from my dentist experience and went through periods during my adult life when I would go years without seeing one. Now I'm back on track thanks to this young man who doesn't recommend doing anything that isn't absolutely necessary. Sometimes I find drs/dentists based on referrals, sometimes on what I've read and then I go see them and see what I think. I also like to read as much as possible about any procedure/ condition I have and what the latest recommendations/options are so I go in with some knowledge.

I hear what you are saying and I realize that you are comfortable with your decision. But, if you really think you know that your dentist is 'good' you are just rationalizing and fooling yourself.

So then your patients are rationalizing and fooling themselves when they tell others you are a good dentist, right?

[Saving$]

I've decided my dentist is probably one of the good ones, although over the years I have had my doubts. I have four indications

1. I went to another dentist about 20 years ago who recommended all sorts of things, replace all sorts of fillings, railed on about how I was not flossing (not true) and had gum disease, etc. etc. and charged extra to clean one area. So 6 months later I went to my current dentist, recommended by a friend who used to work in their front office. After the cleaning and the exam by the dentist, he recommended to keep an eye on one particular filling, and gave me a special brush and floss thing to get behind my back tooth, and recommended that once a day I use those for the back area to avoid plaque build up. He said the hygienist had to scrape extra there. There was no charge for the extra scraping, no railing on about anything, and no list of work that I needed any particular appointment for. He said he hoped to see me in 6 months. I got out the list from the other dentist and asked; he checked all those things and said nothing was wrong, stop worrying, I did not have any gum disease and we would just watch the items on the list if I wanted.

2. Current dentist has never tried to upsell me. No special treatments, no whiteners, etc. They have a display of whiteners you can ask about, and he once mentioned a new product, but no hard sell. I was going to buy a whitening system from him once, and he suggested I instead buy a milder system at the drugstore due to some sensitivity I have at one tooth.

3. Once I needed a root canal. Regular dentist recommended a root canal dentist down the street. I asked who he would go to if he needed one. He gave me the name of a fellow 30+ miles away, warned me he did not have much of a personality, the only other patient he had sent there had left, but said that is where he went for his own 2 root canals and where he sent his wife and dad. At the root canal dentist, the patient before me was talking all sorts of technical stuff with the dentist. I remarked that was certainly a knowledgeable patient, and the assistant said the patient was another dentist, and said about 1/3 of their patients are dentists. It was inaccurate to state the root canal dentist did not have much of a personality. He had a TERRIBLE one. I actually wondered if he is a bit autistic. On the 2nd root canal appointment, I asked what he thought of my dentist. He said he was not the best. I was taken aback. After a few more questions, I found out "the best" is a guy about 70 miles away. If I did not want to drive more than 30 miles (and I'm in one of the 10 biggest cities in the country) he thought my dentist might be in the top 10 or at least close. If you had met this fellow, you would know this is a resounding endorsement.

4. Once I was out of town and a tooth cracked. Went to a friends dentist, who remarked that whoever had done my recent fillings (my long time dentist) did "really nice work." I don't know what that means, but it gave me a boost in confidence in my dentist.

[david99]

Last June I went to a dentist that said that I had a cavity --- and this was without an x ray. She also said that other work had to be done. She set up an appointment to have the tooth fixed and do the other work but I didn't go back. So today I went to a different dentist that took x rays and found nothing wrong --- no cavities and he didn't recommend any other procedures.

I wouldn't go to a dentist that is part of chain or franchise ---- I think that management puts pressure on their dentists to find work.

[Cyclone]

With my dentist I got lucky. He taught at a dental school part time. He was moving out-of-state to work full time at another teaching hospital and he sold his practice to a recent graduate, so I am pretty sure he picked out someone good. By the way the new guy's name is "Doctor Payne", so there is a humor factor as well.

[dm200]

The comment about going to a dentist who had 4-5 years experience was interesting. Many years ago, I had a college classmate who went to dental school, and went into the military after graduating to get a few years of "hands on" experience before setting up his own practice.

[DouglasDoug]

As I have a deep suspicion of Financial Advisors, I have deeper suspicions of doctors. So much at stake and a magnet for scammers to be sure. I hate doctor shopping and think consumers are basically unprotected. Good luck!

[VictoriaF]

As I have a deep suspicion of Financial Advisors, I have deeper suspicions of doctors. So much at stake and a magnet for scammers to be sure. I hate doctor shopping and think consumers are basically unprotected. Good luck!

You can avoid financial advisers by using mutual funds, particularly, index funds. What would be a medical equivalent? Who would be Jack's counterpart?

Victoria

[HardKnocker]

Bad dentist = Seems to always find something that needs fixing and then wants to fix it. Over-zealous.

Good dentist = Is not over-zealous about finding and fixing.

Had a dentist once that everytime I went for a checkup had some new gizmo designed to find cavities. And he did. He also seemed to buy a new motorcycle and new car quite often.

My current dentist tells me I have great teeth and hardly ever finds a cavity.

[leo383]

Seinfeld had several "Dentist" bits in his show over the years.

Louis CK has a dentist episode on his show, too. Extremely uncomfortable.

[dm200]

As I have a deep suspicion of Financial Advisors, I have deeper suspicions of doctors. So much at stake and a magnet for scammers to be sure. I hate doctor shopping and think consumers are basically unprotected. Good luck!

Although no organization or system is a 100% guarantee of anything about medical providers, my opinion (based on my experiences) is that my HMO (Kaiser) reduces the probability of my being seen by an incompetent medical provider. Also, I am a strong believer that being a VERY informed patient also increases the probability of good medical treatment and reduces the probability of bad outcomes.

[Polar_Ice]

A dentist that has been a dentist in the military is a good sign. They get a lot of practice early on in the military over a wide range of issues. Stay away from the dentists that focus their practice towards cosmetic dentistry. Find a good family dentist that doesn't sounds like a salesman pushing you into changing your grill out with veneers. Also never use a coupon for dental work or laser eye surgery for that matter.

[pennstater2005]

Seinfeld had several "Dentist" bits in his show over the years.

Louis CK has a dentist episode on his show, too. Extremely uncomfortable.

The end of that dentist visit is awful!

[ejvyas]

Why in the world did I read this thread I did not learn how to evaluate a dentist but it sure does make me nervous as I have an appointment coming up

[reggiesimpson]

Why in the world did I read this thread I did not learn how to evaluate a dentist but it sure does make me nervous as I have an appointment coming up

+1

[mmaguy]

If you have to ask, they probably aren't...

[Jerilynn]

Thanks for the commentary Jerilynn, it is informative.
I've never had a dentist use a microscope while doing any kind of filling.

You don't know what you are missing.

<< I'm sure that guidelines have to be based on the reality that even dentists have human foibles & may take shortcuts or not follow instructions quite perfectly, rather than the ideal dentist.>>

There are no 'guidelines' in dentistry. Practitioners in every State must conform to the 'standard of care' (SOC). SOC is the MINIMUM level of acceptable care within a community at a given point in time by responsible practitioners. It's determined on a case by case basis. It often times involves attorneys, state boards of dentistry, malpractice companies, patients and practitioners.

In my opinion there is nothing wrong with docs that practice at the SOC (as long as the patient knows it's a MINIMUM level). Personally, I practiced at a level several rungs higher than SOC, which of course includes the SOM.

<< I'm sure a lot of dentists are convinced that they do everything correct,>>

It they are, they are just fooling themselves.

but in reality, for most, it's not actually true (lots of research suggests humans are overconfident of their ability in many areas.) If the evidence suggests the average amalgam is going to last longer in certain teeth (even if it's due to the factors you mention), that's probably what the guidelines are going to recommend because that's what the result of the average dentist is.

+1 for the most part.

It is my contention that "average" dental Tx in the USA is "crummy". It may conform to the SOC, but I wouldn't want it in my mouth.

Now, I'm not saying that everyone can AFFORD dental care that is beyond SOC, so there is a place for that minimum level. And this gets back to my answer to the OP where I stated that lay people CANT tell which is which.

Now if I had a way of being sure I had found that ideal dentist, I'd be a whole lot happier ... and that's the topic of this thread. Maybe the thing to do is talk to some endodontists in the area! I'd rather pay more for an excellent dentist, than have future problems resulting from poor dentistry.

Talk to ALL the endodontists (and periodontists and oral surgeons). If the same name keeps coming up for a good GP, it's probably accurate.

[lindisfarne]

I just talked to a faculty dentist at a local university to get a 2nd opinion on some work that was recommended in Dec by a local dentist (was trying local dentist for the first time).
Tooth 1
First dentist: Crown was recommended on the back molar because of a "crack" in the tooth & he said current filling weakens the tooth too much to do anything other than a crown
2nd opinion: didn't see any reason to do anything with the tooth; didn't think there was any kind of a crack. He didn't think there was any debate.
Tooth 2
First dentist: need a small composite filling on another tooth
2nd opinion: there is decay but it's tiny & best to do nothing & see if it remineralizes as it's only in the enamel.

This is the 2nd dentist I've tried locally who has recommended at least one crown (a previous dentist recommended 2 - on different teeth) & another dental school also disagreed. In that first case, they said a case for a crown could have been made, but they felt replacing the existing amalgam would work fine.

I think I've found my new dentist. Going to the faculty dental clinic will mean about a 45 min drive (outside of rush hour) & parking headaches, but I'd rather have a competent dentist.

[Jerilynn]

Disclaimer: My fiancee is graduating with a dental hygiene degree. She has worked in dental offices as an assistant (in the US) and as more-than-an-assistant (in Central American/Caribbean volunteer trips, assisting surgeries and pulling teeth). Most of my knowledge comes from her first-hand experience in dental hygiene school alongside dental students and on various dental/dental hygiene trips.

Grats! Only 6 more years and she too can be an endodontist and rake in the BIG BUCKS!

From knowing many of the dental hygienist students in her class over the past two years (she already had an undergrad, so it's a 2-year program), they all agree that they would not use a dentist who has been practicing for less than 4-5 years.

Not a bad rule of thumb, but as like anything else there are exceptions. Also, just because someone has 4-5 yrs of experience that doesn't mean they are worth a damn.

My fiancee also had the privilege of working for an experienced dentist (>35 years in his own practice)

This can be either good or bad. If the guy is keeping up with both his knowledge, techniques and equipment AND his physical skills havent diminished, experience is wonderful.
If he is still doing things like he did 35 years ago... RUN!
Also, most dentists don't 'keep up' because of the time involved. Sure they take the necessary CE, but that just won't cut it if the doc wants to be more than SOC.

I used to spend 2-3hrs A DAY 'keeping up' via on-line international dental and endodontic discussion groups. I knew a lot more about general dentistry than some (most?) of the general dentists because of this. Sad, but true.

This reinforced her personal belief that you should not necessarily trust a newly commissioned dentist.

Same advice pertains to dentists as to investment folks. TRUST NO ONE!

The biggest things she complained about were that the new dentists lacked the experience necessary to evaluate whether or not a patient needed a surgery/procedure, and that the new dentists were more concerned with the profit of the dental offices.. so they would default to recommending an expensive procedure if there was any doubt.

Can't argue with that. New dentists are ESPECIALLY helped by participating in *good* on-line dental discussion groups. If they will commit to spend the necessary time.
Problem is, after a long day of slinging lead (slang for placing many amalgam fillings), they don't want to have anything to do with dentistry once they get home. Well, maybe not ALL, but most.

They also weren't very skilled at performing many procedures, instead requesting oversight from their father (again, >35 years experience in his own practice). This brings to mind the old joke: what do you call the person with the lowest GPA who graduates from medical school? Doctor.

Yup.

Thing is, some of the folks with the LOWEST GPAs were the best dentists in my class. Also, keep in mind that there is quite a bit of artistic talent involved with certain dental procedures. Either you have it or you don't, it can't be taught. If you are doing many crowns/bridges/esthetic dentistry, you better have the talent of a sculptor. I had NONE of that type of talent. Fortunately for me, Endo was more of a precision skill and I had some of that talent.

Also, from my fiancee's experience, dentists aren't typically concerned with proper oral hygiene.**

Correct. No money in that.

*Disclaimer #2: I am in the military and have only had military dentists/hygienists for >10 years; however, I once had a civilian life.

The military has it's share of great dentists and slugs(slang for 'lousy dental operators').

And lastly, I definitely agree with the earlier recommendation regarding daily brushing, flossing, and fluoridated mouthwash. In most states, a fluoridated mouthwash isn't exactly necessary (Hawaii is one of the few states that doesn't have fluoridated tapwater, so a fluoridated mouthwash should strengthen your enamel, but using a toothepaste with fluorine would help just the same). Proper brushing of the teeth will reduce calculus (plaque) buildup and the reduce the risk of periodontal disease; however, flossing is what really minimizes caries (cavities) in many folks (genetics/tooth formation and diet play a large role too).

Depends on the individual patient. People with Xerostomia (dry mouth) have different needs than a normal healthy person. For these folks you may need high-Fl toothpaste with tri-calcium phosphate (Clinpro 5000. Rx only), Fl floss, Fl rinses and most importantly Fl varnish. (Vanish by 3M) http://solutions.3m.com/wps/portal/3M/e ... 800&rt=rud

Every patient is different.

I hope this helps you determine a "good one."

Wishful thinking, it doesn't.

[Jerilynn]

That said, there are extremely well trained dental professional that operate outside of the USA. The services, training, and the professionalism of these practitioners has been learned by these individuals.

100% true. I know several outstanding dentists in Mexico, Canada, Latin America, Europe and Australia.

These trained professionals can perform the exceptional care at a fraction of the cost if one is willing to cross borders.

I wouldn't say 'a fraction', but for the most part less. If anyone needs a good dentist in the Netherlands, I know of two world class individuals. They ain't cheap, however. I also knew superb docs from Mexico City, Sao Paulo, Caracas, etc.

As an example, I could have been prescribed for tooth issue that may require a Crown. The local USA dentist here in the US states that the Crown procedure will cost me $1200-$1500 to have the procedure done. If I decide to opt for an international trip accoss borders, that same procedure, care, and crown installation might cost to me around $400 for everything.

True, but you still run into the same issue. You have NO IDEA how good that dentist is.

If you decide on this option, every one of the US based medical praticioners and insurance based entity's will let you know that you are 'jeopardizing you safety, health, and standards of healthcare'. They may also proclaim that it is unsafe, sub-standard, and the conditions that you may be subjected to may well be threatening to you. (These are fear tactics) When you sign any US based agreement on services rendered, the same risks are being identified in that US derived healthcare disclosure.

Which of course is bull. Like I said there are many fine dentists in foreign countries, course there are also ones that fit the above description.

You as an individual will have to do the math and decide if the consideration is reasonable to go outside of the box, but it should be considered.

Math is easy. A lay person trying to determine 'how good a dentist is' is virtually impossible.

[Jerilynn]

I had a dentist for 20 years I was very happy with,

I believe you. Just because a patient is 'happy with' their doc, doesn't mean the doc is good. Course, it doesn't mean the doc is a slug, either.

me figuring dentistry had pretty much become a commodity (like modern MD GPs, but that's another story...).

dont beat yourself up, MOST people figure that.

The new/old guy is more expensive, by the way, and I couldn't care less after experiencing the alternative.

Fees also aren't a good indicator of quality. Some of the WORST dentists I knew charged the most.

That said, almost ALL the docs that charge very low fees are terrible. [note I said almost] I knew a couple guys here locally that did superb work and charged at the low end. I kept telling them that their work was 10x better than guys charging 4x as much and they should raise their fees, but they didn't listen. Go figure.

[Jerilynn]

When did everybody switch from cavity to caries?

In Arkansas, we still haven't switched.

Seriously, it's just terminology. When talking to patients I used the term 'cavity' or 'decay'. When talking to other docs, I used 'caries' or 'decay'. 6 of one half dozen of the other.

[Jerilynn]

I was always more impressed by the size of the needle.

For the most part, bigger needle = better. I used 25g needles for blocks, you could reliably aspirate with those. Some guys used 30g, they were junk for blocks.
The lower the g the thicker the needle is.
One would think that the thicker needles would hurt more. (well up to a point) Studies proven that they didn't. go figure.

[Jerilynn]

The big scam is that you have to see a dentist in order to use the services of a dental hygenist. The fact is that it does not take much to be a general dentist. Its like being a pediatrician. You would be better off getting your teeth cleaned by a hygenist and seeing a dentist only when you have a problem. Dentists get laws passed to prevent hygenists from working independently. They have the hygenist do the work then mark up their services.

I wouldn't say it's a scam, per se, just some 'turf protection'. The dogma goes....."dentists are better trained to Dx medical issues, cancer, and other 'stuff' hygienists arent trained for. Total BS. Some hygienists know more about oral pathology than some dentists.

[Jerilynn]

The specialist was referred to me by his teacher in dental school, who has taken very good care of several of my friends and family members for many years. Luxury automobiles had nothing to do with it, although an additional factor in my choice was that he was a respectful individual with a professional manner, unlike some others.

Trust me, I taught in a dental school for a little while. There are some really good professors and some docs that are marginal at best. This also applies to specialists.

[momar]

Yelp reviews.

[Jerilynn]

Sometimes good enough is good enough, although no one likes to cut corners on health services. It's nice to hear a pro say the same thing about their own profession. Not that I wouldn't like to have the best dentist possible, but I too came to the conclusion that I couldn't tell the great from the average.

"good enough" is sometimes WONDERFUL, just so long as the patient knows they are gettting 'good enough' tx vs. optimal.

I now go to the dental school at OSU.

The thing I like about dental school Tx is that there are at least 2 pairs of eyes looking at the case. Even if you get a 'dud' student, the instructor makes sure they don't screw things up too badly. The care is CHEAP relatively. The down side is that it can be very time consuming and inconvenient. Here's a good example. Simple max pre-molar needs root canal (vital tooth, no apical findings). It will take a 3rd year student 2-3, 3 hr appointments to finish it. In private practice, maybe 1 45-90 min appt. (that's assuming it's done at the highest level). A typical 'cattle rustler'* can probably crank one out in 15 minutes.

*cattle rustler = practitioner who rushes the patients through the practice like cattle, trying to do the most amount of production in a give period of time.

In fact, I get the feeling that some of the dental students already think cleaning is beneath them. I could be wrong--just my impression.

[/quote]

It depends on the student. From what I hear from my pals that teach in dental schools, the 'quality' of the student has been decreasing steadily over the last 10 years. I believe that, but take it with a grain of salt. Back in the 70's -80's, the dental school profs said the same thing.

Also, keep in mind that there is a TREMENDOUS variation in the quality of dentists (especially in private practice).

[Jerilynn]

My experience at my local School of Dentistry has been highly satisfactory. They are my dentist for life!

Dental schools can be good for tx. Just remember some of those students are getting "F's" on their work while the guy in the next cubicle over may be getting an "A" for a similar procedure.

Now when I taught and a student did a really great job, I would praise them excessively in front of the patient. Something like, "Ms Patient, you hit the jackpot when you were assigned this student, she's clearly tops!" When they screwed up, I said nothing in front of the patient.


So, if the instructor comes over, evaluates the procedure and just kinda grunts and walks away, you now know what that means.

[Jerilynn]

I thought that this was not allowed, in most (if not all) states. I also think I saw a related fight over non-dentist practiticioners being allowed to whiten teeth. Apparantly, that is not allowed in most (or all) states outside of a dentist's practice/office.

Varies from state to state.

Look for a dental hygienist program at a local college. They do a terrific job for a fraction of the cost and the work is checked by the dentist faculty.

I taught at the local hygiene school, too. Same deal, there are A students and D students. And every once in a while a D student may get an A on a given day while the A student gets a D.

In my experience, the hygiene students were either GREAT or just 'pretty good'. Not too many slugs. At least at the place I taught.

[Jerilynn]

This is what we did: get your x-rays and first dentist's recommendations sent to a different dentist for a second opinion. Made a huge difference in total cost and amount of work done for my wife.

If it don't feel right - get a second opinion.

I have discovered there is a large gap between dentists who tell you what to get done when it needs to get done - and in the most economical way possible - vs other dentists who want to go whole hog with lots of very expensive stuff right away.

Better yet, get the first dentist to email you the images of the radiographs. Then you can email them to 100 dentists if you want. If you current dentist doesn't have digital x-rays, it MAY be ok. If they don't have the capability to email you the images, or accept the images emailed to them, find someone else.

[Jerilynn]

1. You can't count on referrals from periodontists, orthodontists, etc. They get their referrals from general dentists, and some may recommend just to return the favor.

That's why you want to talk to several perios, orthos etc. They dont all get referrals from the same dentists. The BEST recommendation you can get is when another practioner says something like this......"Dr. Jerilynn!?! Yes, I know her. WHAT AN A**HOLE! But, she does some pretty good work."

2. There is no way a patient can judge, regardless of the number of years they have seen their dentist.

+1 I think we have established this point pretty well.

3. The absolutely best way to find a good dentist is to find a dentist that other dentists send their families to.

Not a bad 'rule of thumb'.

4. Second best, find a dentist in private practice who teaches part-time, usually one day per week, as clinical faculty at the local dental school.

No. SOMETIMES that's true, but not always. There are slugs that teach part-time, too. Why do the schools hire them? Cuz, they need a warm body to cover clinic and they hardly have to pay them anything.
Most dentists that teach use their 'teaching credentials' as a practice development tool and PR. Hell, I did it. Nothing WRONG with that, but just because they 'teach', it doesn't mean they are practicing several rungs better than SOC.

5. If you are going to use students, use students in the General Practice Residency of a hospital,

Sometimes. GPRs have duds, also.

DMD or DDS (there is, by the way, absolutely no difference between these degrees).

Correct. It's just based on the school they went to. A while ago, some schools changed the degree from DDS to DMD because it sounded 'better and more modern'. But, the education was identical. Also, some of the schools that switched from DDS to DMD, switched back after a few years.

DDS=Doctor of Dental Surgery DMD=Doctor of Dental Medicine

[Jerilynn]

I was always more impressed by the size of the needle.

The dentist that I criticized as incompetent in a previous post had one curious good point-- he used a device to inject anesthetic slowly-- like for 30-60 seconds. Sounds horrific, but it was always utterly painless. He claimed that rapid fluid injection was the thing that caused pain. I had an intensely painful injection as a child, have cringed from them ever since, and this was really different. Good thing, since the fillings always fell out the next week...

It's called "The Wand", mostly a marketing gimmic. It works, sure. But, if a dentist used topical properly and injected slowly, he could accomplish the same thing. The device didn't catch on. I tried it, meh. I have one in a closet at the office, I'll sell it to you cheap!