Time to leave our dentist??

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crazyapple11
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Time to leave our dentist??

Post by crazyapple11 » Sun Aug 06, 2017 10:00 pm

My wife and I went to our dentist's office 3 years ago. The doctor asks every patient to do two bite-wing X-rays on each side of the mouth annually. The first year was fine since we had dental insurance, though we volunteerlly asked for the deep cleaning service. The second year, we did not have dental insurance and the doctor opened a new office. Then she did two fillings for my wife and one filling for me because she said she saw cavities through the x-ray. I was kind of doubt about the true reason is that she needs to pay off the new office. I heard the doctor talked to a visiting representative from some medical companies admitting the new office did not have enough clients. Total $600 for 3 fillings.

When we visited her office this year, she said she found cavities through the x-ray again, and each of us needs to do one filling. However, she significant raised the price for the filling. Total around $600 for 2 fillings.

I also found out the discounted cash price we paid was much more than the price she charged under the insurance contact, through the front desk told me on our first visit, the cash price is a better deal for us.

I feel really tried of doing filling every year and wondered whether it's a scam. For disclosure, we follow every instruction the doctor told us to keep our teeth clean and drink only water most of the time. Any inputs would be greatly appreciated. Thank you.

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celia
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Re: Time to leave our dentist??

Post by celia » Sun Aug 06, 2017 10:28 pm

If you don't have confidence in that dental practice, don't go back. But don't tell them that. Instead, ask for a copy of your last two x-rays (for your medical records history you keep at home, should they ask) and take them to a different dentist next year and ask for a second opinion.

runner3081
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Re: Time to leave our dentist??

Post by runner3081 » Sun Aug 06, 2017 10:57 pm

crazyapple11 wrote:Then she did two fillings for my wife and one filling for me because she said she saw cavities through the x-ray. I was kind of doubt about the true reason is that she needs to pay off the new office.

I also found out the discounted cash price we paid was much more than the price she charged under the insurance contact, through the front desk told me on our first visit, the cash price is a better deal for us.

I feel really tried of doing filling every year and wondered whether it's a scam. For disclosure, we follow every instruction the doctor told us to keep our teeth clean and drink only water most of the time. Any inputs would be greatly appreciated. Thank you.
Could always ask to see the x-rays to show the defect before filling.

I have been to a number of dentists over the past 15 years, though it makes no sense, it is very common, in my experience, for the cash pay rates to exceed contracted rates for cleanings and work. Discounts are hard to come by in the dental world, especially if they are good at their trade.

Also, some people don't have good teeth genetically, regardless of what they do to them.

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whodidntante
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Re: Time to leave our dentist??

Post by whodidntante » Sun Aug 06, 2017 11:50 pm

I had a dentist tell me I needed two fillings. That seemed odd because I don't have a history of needing fillings and keep up with my dental care. So I went to another dentist for a checkup without any mention of what the other dentist said. That dentist didn't mention a need for fillings. I never went back to my old dentist.

z91
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Re: Time to leave our dentist??

Post by z91 » Mon Aug 07, 2017 6:10 am

I had a dentist that was like a used car salesman. Would always need some kind of filling done and would always offer random things like braces. I believed him at first, but then heard him talking to literally every patient about getting braces. I cancelled all my appointments with him and love my new dentist. Trust goes a long way.

Grt2bOutdoors
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Re: Time to leave our dentist??

Post by Grt2bOutdoors » Mon Aug 07, 2017 6:33 am

Time to find a new dentist. A filling should not cost $300. Dentistry has become the new cash cow. Things in general can break, especially on cars, however if you have done the preventive maintenance along the way, risk of failure is low. I would have and have asked to see the xrays in the past and twice after a second consult found the diagnosis to be off - either dentist needs pair of new glasses or their bank account needs to be refilled. It's like a few car mechanics i've run across from time to time, eventually people catch on to them and they lose their business.

The latest craze is the offering of a "free" laser tooth whitening but before that they tell you about the need for a tooth cleaning and a filling or two that should be done. Of course, the latter items are not free.
Last edited by Grt2bOutdoors on Mon Aug 07, 2017 6:38 am, edited 1 time in total.
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Muri
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Re: Time to leave our dentist??

Post by Muri » Mon Aug 07, 2017 6:36 am

Definitely go to another dentist. Our daughter has gone to our local, very conservative dentist her entire life. She got a job in another city after college. The dentist she saw there told her she had 4 cavities that needed filling. I talked to the dentist here, and he said definitely get a second opinion. She saw a different dentist in her new city who said she has natural dips in her teeth, but they don't need to be filled. She had dental insurance, so I don't know that having or not having dental insurance affects this. Obviously some dentists just need $$.

Swansea
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Re: Time to leave our dentist??

Post by Swansea » Mon Aug 07, 2017 6:54 am

On the issue of annual x-rays, if you have no recent history of tooth decay and are past a certain age...say 60, I would ask if they are necessary.
I was 65 when I asked my dentist. He said every two years would be fine given my history.

crazyapple11
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Re: Time to leave our dentist??

Post by crazyapple11 » Mon Aug 07, 2017 8:28 am

Thank you so much for all your input. We are around 30s and have no dental problem for 30 years until we moved into this area. The current doctor is our second dentist. The first dentist I found in this area did a total of 11 fillings plus recommended deep cleaning on us in one year. Anyway, since I lose confidence on our dentist, I think it's time to leave.

A quick question, how can we get a second opinion with our x-ray? Just made an appointment with another dentist? I have never done this before. Thank you.

open_circuit
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Re: Time to leave our dentist??

Post by open_circuit » Mon Aug 07, 2017 8:51 am

Remember that half of the professionals you will meet in the world are worse than average. Numbers are funny that way.

I had a (brand new, out of school) dentist buy the practice I used to go to. In 30+ years, I've never had a cavity, but suddenly the new dentist "found" 3 on the xray. Went to a new practice with more experienced staff and confirmed no cavities and no problems. I'm unsure if the dentist who found the phantom cavities lacked scruples or experience. To me, though, the result is the same: finding a new practice I can trust.

To get a second opinion, I called another local practice and explained what I was looking for. They agreed to provide a free inspection and opinion. In my previous area of residence, dental practices frequently offer first visit free promotions to attract new business. If your area is like this, and you receive these offers in the mail from time to time, you will probably have success finding an established practice that will provide a free inspection and opinion.

tidelandp
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Re: Time to leave our dentist??

Post by tidelandp » Mon Aug 07, 2017 8:56 am

crazyapple11 wrote:Thank you so much for all your input. We are around 30s and have no dental problem for 30 years until we moved into this area. The current doctor is our second dentist. The first dentist I found in this area did a total of 11 fillings plus recommended deep cleaning on us in one year. Anyway, since I lose confidence on our dentist, I think it's time to leave.

A quick question, how can we get a second opinion with our x-ray? Just made an appointment with another dentist? I have never done this before. Thank you.
Since I have my teeth cleaned twice a year, I'd just offer current x-rays to new dentist at time of next cleaning, without mentioning previously detected-but-unfilled cavity. Don't be surprised if new dentist pays little attention to them. In my experience, they like to do their own x-rays, in which case you can decide if you want them more frequently than once a year. I don't. If cavity is big, dentist should find it at cleaning, even without x-rays.

You did not mention if x-rays were digital. If possible, ask for them in electronic format.
Last edited by tidelandp on Mon Aug 07, 2017 9:02 am, edited 1 time in total.

ponyboy
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Re: Time to leave our dentist??

Post by ponyboy » Mon Aug 07, 2017 8:59 am

Get a 2nd opinion.

Runner01
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Re: Time to leave our dentist??

Post by Runner01 » Mon Aug 07, 2017 9:33 am

Last time my dentist found a cavity in an X-ray he showed me the X-ray and explained how he determined it's a cavity. Not sure if that is common practice among dentists.

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Pajamas
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Re: Time to leave our dentist??

Post by Pajamas » Mon Aug 07, 2017 9:51 am

If the cash rates were generally lower than the contracted rates, no one would bother to contract. It would be even more rare that your portion of a contracted rate for health care would be lower than the full cash rate. The only exception that I have run across is that the occasional cash cost of a common generic medication is lower than the fixed copayment. You might also be responsible for the full contracted amount if you have not met your annual deductible or if for some reason the procedure isn't covered but that should still be less than the contracted amount.

I had several private dentists before going to a dental school because of a weekend emergency. I have been more satisfied with the quality of care and certainly with the cost. The few negatives are greatly outweighed by the benefits for me. The profit motive is largely absent, at least on an individual scale, although the dental school clinics act as a huge source of revenue for the university.

If you have really lost confidence in your dentist, go to another one.
Last edited by Pajamas on Mon Aug 07, 2017 9:56 am, edited 2 times in total.

Dottie57
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Re: Time to leave our dentist??

Post by Dottie57 » Mon Aug 07, 2017 9:52 am

Runner01 wrote:Last time my dentist found a cavity in an X-ray he showed me the X-ray and explained how he determined it's a cavity. Not sure if that is common practice among dentists.
My dentist too shows thex-ray. Also when the sharp tool sticks.

In fact I am shown he x-rays each time. If there is a somewhst suspicious area, I am told to brush extra carefully.

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Pajamas
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Re: Time to leave our dentist??

Post by Pajamas » Mon Aug 07, 2017 9:55 am

Dottie57 wrote: Also when the sharp tool sticks.
Current best practice is not to probe for cavities because it damages the enamel and can even create a cavity where one does not currently exist. You should question your dentist if he or she relies on that to any large degree. None of the faculty or students where I go ever come close to probing like my childhood dentist did.

YoungDentist
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Re: Time to leave our dentist??

Post by YoungDentist » Mon Aug 07, 2017 12:43 pm

I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a new office off. Sure, there are a few dentists out there who may practice this way. The VAST majority have invested in better technology (digital radiographs with good software can detect cavities at earlier stages/better accuracy than old school films) and are in fact watching out for your own good.

Would you rather spend $200 on a filling now, or spend $4000 on a root canal/crown or implant? It all depends if you want to be proactive in your dental care or reactive to a problem that may occur. If the patient is fine "watching" a cavity grow and with the possibility of needing a root canal/crown in future, then they absolutely have that right - but the dentist is not doing his/her job by not diagnosing the initial cavity.

One poster said something to the tune "I was told I had two cavities by one dentist and the other didn't say anything, so I kept going to the latter...". Would you want to me told you have a disease? Or rather the doctor/dentist sweep it under the rug? I can tell you that not all dentists treat the same "types" of cavities. Some may watch something, while another may treat. Either way, wouldn't you as a patient want to know what was going on?

Some simple advice: we show our patients an intraoral photo of each tooth, all the radiographs, and smile images on a LCD screen no more than 3 feet from them so they can understand what we are looking at. In my mind, each patient needs to understand what is going on. ASK TO SEE THESE THINGS, and if your dentist isnt doing these things or taking the time to explain, then maybe seek another opinion.

daveydoo
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Re: Time to leave our dentist??

Post by daveydoo » Mon Aug 07, 2017 12:56 pm

YoungDentist wrote:I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a new office off.
I hear you and it certainly hurts to hear one's profession maligned. A relative who was a dentist (back in the day when even advertising was considered unethical) was well aware of the spectrum of, shall we say, aggressiveness among members of his profession. He was famous for a watch-and-wait approach. Clearly there are extremes -- the "60 Minutes"-featured dentists who give kids a mouthful of fillings in deciduous teeth. Some are flat-out unethical and place their needs above those of their patients. Most, I suspect, reflect the spectrum of aggressiveness of care. But caries isn't like cancer, imo; you don't need to excise with a wide margin the instant it's detected. (well, you don't need to do that with a lot of cancers, either, but anyway...).

I do think a profession needs to own its irresponsible members. You're clearly not one, but I think it's important to recognize that there are bad apples out there. Plus, it's been shown over and over that objectivity wanes when there is a financial incentive. That's why I'm not allowed to accept a pen or Subway sandwich from a potential "influencer" in my field. Folks here post often about how Edward Jones (et al) reps seem to think they really are helping people.
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themesrob
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Re: Time to leave our dentist??

Post by themesrob » Mon Aug 07, 2017 1:18 pm

I had a very nice, "conservative" dentist growing up, who gave me zero fillings for the first 22 years of my life, and who always told me I took very good care of my teeth. When I moved to another area for my first post-college job, I was shocked when my new dentist told me that I had four cavities -- I had never had cavities in my life, and four all of a sudden? when my teeth are so strong?

I went back to my old dentist who said "no no! that's not true at all, you have great teeth, no cavities. your surface grooves are just deep in a couple places, here, let me smooth this one down for you."

Back in my new home state, after six months I went to a new dentist recommended by a co-worker. She took x-rays and immediately diagnosed four cavities in the exact same teeth the other guy had said, plus another two danger spots. She also said "did someone try to smooth out the surface of one of your teeth? what idiot would do that??"

all that to say...if you're suspicious of a new dentist's diagnoses, by all means get the details and go get a second opinion. But my experience sure did teach me a lesson.

Bigbonds
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Re: Time to leave our dentist??

Post by Bigbonds » Mon Aug 07, 2017 2:20 pm

YoungDentist wrote:I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a new office off. Sure, there are a few dentists out there who may practice this way. The VAST majority have invested in better technology (digital radiographs with good software can detect cavities at earlier stages/better accuracy than old school films) and are in fact watching out for your own good.

Would you rather spend $200 on a filling now, or spend $4000 on a root canal/crown or implant? It all depends if you want to be proactive in your dental care or reactive to a problem that may occur. If the patient is fine "watching" a cavity grow and with the possibility of needing a root canal/crown in future, then they absolutely have that right - but the dentist is not doing his/her job by not diagnosing the initial cavity.

One poster said something to the tune "I was told I had two cavities by one dentist and the other didn't say anything, so I kept going to the latter...". Would you want to me told you have a disease? Or rather the doctor/dentist sweep it under the rug? I can tell you that not all dentists treat the same "types" of cavities. Some may watch something, while another may treat. Either way, wouldn't you as a patient want to know what was going on?

Some simple advice: we show our patients an intraoral photo of each tooth, all the radiographs, and smile images on a LCD screen no more than 3 feet from them so they can understand what we are looking at. In my mind, each patient needs to understand what is going on. ASK TO SEE THESE THINGS, and if your dentist isnt doing these things or taking the time to explain, then maybe seek another opinion.
Are you denying that dentist have a obvious financial incentive to be more aggressive when treating "different types of cavities" or just not bring it up? Before I get a cavity filled I want it to be confirmed by a separate dentist, if two don't agree then in my opinion it's not bad enough to get filled. It doesn't mean it will lead to a mouth full of root canals.

Grt2bOutdoors
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Re: Time to leave our dentist??

Post by Grt2bOutdoors » Mon Aug 07, 2017 3:22 pm

YoungDentist wrote:I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a new office off. Sure, there are a few dentists out there who may practice this way. The VAST majority have invested in better technology (digital radiographs with good software can detect cavities at earlier stages/better accuracy than old school films) and are in fact watching out for your own good.

Would you rather spend $200 on a filling now, or spend $4000 on a root canal/crown or implant? It all depends if you want to be proactive in your dental care or reactive to a problem that may occur. If the patient is fine "watching" a cavity grow and with the possibility of needing a root canal/crown in future, then they absolutely have that right - but the dentist is not doing his/her job by not diagnosing the initial cavity.
Depends on what is in the driveway of the dentist's office - my guy drives an old minivan and has plenty of clients. I'm going to miss him when he eventually retires. My dentist also takes a wait and see approach because sometimes those potential problems resolve themselves. The new guy near my home is driving a benz or beemer depending on day of week, bought a house and converted it to commercial space. Figure the monthly upkeep for place is $5-10K especially if they are leasing everything from equipment to the cars in the driveway, that's alot of fillings. My dentist friend who works for a practice tells me of the pressure from the owner to turn over the chair often and drill. I'd say there are more than just a "few". The Fed says that inflation is low to non existent, however given the prices you are throwing out maybe they should revisit that assumption. I had a root canal/crown installed six years ago - given the price you tossed out that would indicate dental inflation of over 8% per year. My root canal was handled by services of endo and primary dentist - they both did a great job.
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Nowizard
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Re: Time to leave our dentist??

Post by Nowizard » Mon Aug 07, 2017 3:38 pm

Leave, quickly. In a similar experience, a dentist told me that a specific tooth had a dark spot that would become a cavity. It was a tooth with a gold inlay that would have been big bucks to replace. I said I would wait. Have a new dentist, it is 12 years later, and there is no cavity according to the new dentist.

Tim

YoungDentist
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Re: Time to leave our dentist??

Post by YoungDentist » Mon Aug 07, 2017 6:02 pm

In response to a few comments:

"Depends on what car he drives"
"Office upkeep of 5-10k"


By all means choose the dentist that you feel the most comfortable with. A dentist with the latest and greatest technology and services does not fit every personality, nor should it. Realize though that the dentist is investing in YOU when he/she invests in digital X-rays, 3D cone beam, 3D printing, same day crowns, and the list goes on and on. Just this past week we had two hand pieces and an X-ray sensor go down, the cost? 20k to fix. Does that mean I'm going to "find more cavities", absolutely not. Did I fix these things to give my patients the best service? Yes. Our office spent 30k last year alone to take extended learning courses for our docs/assistants/hygienists. It allows them to give you a better product. There are many hidden costs that a patient does not realize. It's not all cash flow at the dentist folks.

Just because a dentist is profitable and is successful, they shouldn't drive a nice car? I could make the argument that the dentist driving the nice car has simply worked more hours and built a dedicated patient base through trust and sound dental work. Or maybe they just invested in TSLA?!?! Either way, the car in the driveway is by no means in correlation to if the dentistry is done correctly.

"Are you saying there are no unethical dentists"

Absolutely not. There are certainly those in the dental field who over diagnose, as well as under diagnose. What seems to be pointed out on this forum are those that believe we all over diagnose. I think both over and under should be under the same scrutiny. It certainly is difficult to always be right - it's not an exact science.

Thank you all for commenting on this post. It truly allows me to know how most of my patients truly feel and how I can properly address a diagnoses.

Grt2bOutdoors
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Re: Time to leave our dentist??

Post by Grt2bOutdoors » Mon Aug 07, 2017 6:18 pm

YoungDentist wrote:In response to a few comments:

"Depends on what car he drives"
"Office upkeep of 5-10k"


By all means choose the dentist that you feel the most comfortable with. A dentist with the latest and greatest technology and services does not fit every personality, nor should it. Realize though that the dentist is investing in YOU when he/she invests in digital X-rays, 3D cone beam, 3D printing, same day crowns, and the list goes on and on. Just this past week we had two hand pieces and an X-ray sensor go down, the cost? 20k to fix. Does that mean I'm going to "find more cavities", absolutely not. Did I fix these things to give my patients the best service? Yes. Our office spent 30k last year alone to take extended learning courses for our docs/assistants/hygienists. It allows them to give you a better product. There are many hidden costs that a patient does not realize. It's not all cash flow at the dentist folks.

Just because a dentist is profitable and is successful, they shouldn't drive a nice car? I could make the argument that the dentist driving the nice car has simply worked more hours and built a dedicated patient base through trust and sound dental work. Or maybe they just invested in TSLA?!?! Either way, the car in the driveway is by no means in correlation to if the dentistry is done correctly.

Thank you all for commenting on this post. It truly allows me to know how most of my patients truly feel and how I can properly address a diagnoses.
Or maybe the dentist is loaded in debt up to eyeballs? You know, fake it until you make it. The point is there are ethical folks and unethical folks. The largest issue the field of dentistry is going to find itself in, if it hasn't yet, is once you lose clients trust, you don't have a business and all the latest greatest technology from Schein or XRAY along with training isnt going to matter a hill of beans. Same day crown?, unheard of, i am willing to use a temporary crown if it will save me a grand or even a couple of hundred. Overnight mail to/from lab is cost effective. Playing the market on TSLA, come on now, that isn't a very Boglehead thing to do! Buy VBR, it's on sale!
Last edited by Grt2bOutdoors on Mon Aug 07, 2017 6:23 pm, edited 1 time in total.
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2015
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Re: Time to leave our dentist??

Post by 2015 » Mon Aug 07, 2017 6:19 pm

YoungDentist wrote:In response to a few comments:

"Depends on what car he drives"
"Office upkeep of 5-10k"


By all means choose the dentist that you feel the most comfortable with. A dentist with the latest and greatest technology and services does not fit every personality, nor should it. Realize though that the dentist is investing in YOU when he/she invests in digital X-rays, 3D cone beam, 3D printing, same day crowns, and the list goes on and on. Just this past week we had two hand pieces and an X-ray sensor go down, the cost? 20k to fix. Does that mean I'm going to "find more cavities", absolutely not. Did I fix these things to give my patients the best service? Yes. Our office spent 30k last year alone to take extended learning courses for our docs/assistants/hygienists. It allows them to give you a better product. There are many hidden costs that a patient does not realize. It's not all cash flow at the dentist folks.

Just because a dentist is profitable and is successful, they shouldn't drive a nice car? I could make the argument that the dentist driving the nice car has simply worked more hours and built a dedicated patient base through trust and sound dental work. Or maybe they just invested in TSLA?!?! Either way, the car in the driveway is by no means in correlation to if the dentistry is done correctly.

"Are you saying there are no unethical dentists"

Absolutely not. There are certainly those in the dental field who over diagnose, as well as under diagnose. What seems to be pointed out on this forum are those that believe we all over diagnose. I think both over and under should be under the same scrutiny. It certainly is difficult to always be right - it's not an exact science.

Thank you all for commenting on this post. It truly allows me to know how most of my patients truly feel and how I can properly address a diagnoses.
Rest assured, some posts in this thread in no way indicate how most people feel about their dentist. My former Beverly Hills dentist moved into a new location and the artwork alone was probably worth an upscale foreign car or two. Do I care what kind of car he drives or the house he lives in? Absolutely not! IMO, he deserves everything the fruits of his success provides. He went to one of the best dental schools in the country and has walls of certification demonstrating continuing education. He literally saved my mouth, because at the time I first saw him I had neglected my teeth for years :oops: . He's responsible for not only helping save my teeth but in also showing me how to engage in best oral hygiene practices. Unfortunately, upon retirement and after my dental COBRA ended, I couldn't justify paying his cash prices. I was with him for over a decade and will miss going to him twice yearly knowing my teeth were in skilled hands.

Grt2bOutdoors
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Re: Time to leave our dentist??

Post by Grt2bOutdoors » Mon Aug 07, 2017 6:26 pm

That's right, as i said it before, i really like my dentist!!
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sport
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Re: Time to leave our dentist??

Post by sport » Mon Aug 07, 2017 7:07 pm

When we needed to find a new dentist, we asked a periodontist for recommendations. He gave us 3 names. I selected one and Mrs. sport selected another. We have both been happy with our choices. Periodontists see the work of general dentists all the time. They can recognize good work when they see it.

I once had a dentist friend (not my dentist) tell me that when you go to a dentist for the first time, you will know within 5 minutes whether or not you like them. However, it will take you 5 years to determine if they are any good.

athan
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Re: Time to leave our dentist??

Post by athan » Mon Aug 07, 2017 7:47 pm

sport wrote:When we needed to find a new dentist, we asked a periodontist for recommendations. He gave us 3 names. I selected one and Mrs. sport selected another. We have both been happy with our choices. Periodontists see the work of general dentists all the time. They can recognize good work when they see it.

I once had a dentist friend (not my dentist) tell me that when you go to a dentist for the first time, you will know within 5 minutes whether or not you like them. However, it will take you 5 years to determine if they are any good.
Great advice. Dental specialists always know the good dentists in the area. Ask them who they trust their family members with.

Kennyt7
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Re: Time to leave our dentist??

Post by Kennyt7 » Mon Aug 07, 2017 8:31 pm

as a retired gp there is gross overtreatment in dentistry as well as medicine because of greed and the exorbitant tuitions to get your degree
adults should not be getting new cavities yearly but fillings do break down
not much in dentistry is permanent
excessive xrays are also pretty common
get a second opinion and if you are getting ripped off tell the world

texaspapas
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Re: Time to leave our dentist??

Post by texaspapas » Mon Aug 07, 2017 8:57 pm

YoungDentist wrote:I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a....
You might very well be a good, ethical dentist, but there are many who are not. Don't take my word for it, the CBC did a short expose segment on it:
http://www.cbc.ca/marketplace/episodes/ ... ntal-fraud

And I'm sure the same thing happens here in the U.S. Outside of my own experience with wildly discordant recommendations from different practitioners, I also once overheard a faculty dentist at dental school talking about how dental clinics "run up the bill." And formerly as a medical student, I have on at least three separate occasions, with no introduction of the topic of finance whatsoever on my part, heard young dentists delightfully boast that essentially they "can make so much money with so little work...", which is not the kind of sentiment that someone with ethical work practices espouses.

Youngdentist, keep up the good work, but many of your colleagues have been damaging the reputation of dentistry for decades. It's rampant and very obvious to myself and many others that a large proportion of dentists practice unethically. Watch the piece above if you have any doubt.

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3wood
Posts: 72
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Re: Time to leave our dentist??

Post by 3wood » Mon Aug 07, 2017 9:21 pm

I have read through the responses here and hope that no-one reading this uses ANY of the information in the comments to make a decision about their dental health (except for YoungDentist, good job). There is so much misinformation and ignorance it is mind blowing.
First off, to the op, no-one, not even a dentist reading this, can diagnose your dental condition and if your dentist did appropriate work. It sounds like what happened was a failure in communication and a lack of trust. You shouldn't be seeing someone you don't trust.
The fact is you are not trained or experienced enough as a patient to diagnose, so staring at X-rays and waiting for an explorer 'stick' as proof is pretty ridiculous. Yes, sometimes it is that obvious but not always. I agree that pictures are probably the best way to communicate the problems we can see visually. Ultimately, though, it comes down to trust.
Dentists are different. Even great dentists are different. Some more conservative and others more aggressive. You need to find an office that suits your personality. The dentist I bought my practice from 18 years ago was very conservative. 'Watched' lots of stuff and never looked for gum disease. When he retired and I took over I saw mouthfuls of decay and periodontal disease that had been festering for years. The patients loved him, until the shit hit the fan and they realized being a 'conservative dentist' does not always equal a 'good dentist'.
My advice would be to trust your instincts. There are certainly some bad apples like any field. If your gut tells you something is amiss ask for more information. Don't stop until you are sure. If that doesn't work get a second opinion from an office you find based on word of mouth referral.

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JaneyLH
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Re: Time to leave our dentist??

Post by JaneyLH » Wed Aug 09, 2017 12:08 am

3wood wrote:I have read through the responses here and hope that no-one reading this uses ANY of the information in the comments to make a decision about their dental health (except for YoungDentist, good job). There is so much misinformation and ignorance it is mind blowing.
First off, to the op, no-one, not even a dentist reading this, can diagnose your dental condition and if your dentist did appropriate work. It sounds like what happened was a failure in communication and a lack of trust. You shouldn't be seeing someone you don't trust.
The fact is you are not trained or experienced enough as a patient to diagnose, so staring at X-rays and waiting for an explorer 'stick' as proof is pretty ridiculous. Yes, sometimes it is that obvious but not always. I agree that pictures are probably the best way to communicate the problems we can see visually. Ultimately, though, it comes down to trust.
Dentists are different. Even great dentists are different. Some more conservative and others more aggressive. You need to find an office that suits your personality. The dentist I bought my practice from 18 years ago was very conservative. 'Watched' lots of stuff and never looked for gum disease. When he retired and I took over I saw mouthfuls of decay and periodontal disease that had been festering for years. The patients loved him, until the shit hit the fan and they realized being a 'conservative dentist' does not always equal a 'good dentist'.
My advice would be to trust your instincts. There are certainly some bad apples like any field. If your gut tells you something is amiss ask for more information. Don't stop until you are sure. If that doesn't work get a second opinion from an office you find based on word of mouth referral.
Great post. Articulates many of the thoughts I had while reading through all the comments. I am just going through a transition from my retiring dentist who I trusted absolutely. When the young new dentist asked me if the former dentist ever mentioned my grinding my teeth, I was flummoxed. When he pointed out the evidence, it was clear. My old trusted dentist never said a word. On the other hand, first thing the new dentist said was that I needed a new crown. The temporary came off 3 times. Finally gave up and just waited for the permanent crown to show up. Never had an experience like this before, although I have a number of crowns. Don't really know what to doabout keeping this new dentist or finding another.

bampf
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Re: Time to leave our dentist??

Post by bampf » Wed Aug 09, 2017 12:45 am

https://www.dentistat.com/ReaderDigestArticle.pdf

Many many reasons to distrust dentists.

mouses
Posts: 3283
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Re: Time to leave our dentist??

Post by mouses » Wed Aug 09, 2017 7:02 am

Recollects when looking for a new dentist after dentist retired, the one who said "All the dental work in your mouth needs to be replaced." Patient slowly backs out door saying "I'll think about it."

jlcnuke
Posts: 434
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Re: Time to leave our dentist??

Post by jlcnuke » Wed Aug 09, 2017 7:19 am

As a person with dental problems, I can say with 100% certainty that "shopping around" is DEFINITELY in your best interest when it comes to dentists.

Right now, I need significant dental work (toothache, broken tooth that needs a root canal/crown). I also have a massive phobia regarding dentists/dental work so I won't be getting any of that done without being knocked out.

So, as I self-insure for dental, I called multiple dental practices to get price ranges for root canals, crowns, fillings, and IV sedation. About 1/3rd refused to even provide a price range unless I go get examined by them (and of course, these aren't the "new patient exam and xrays only $49!" places). Sorry, if you can't tell me what range your charges are without first charging me money and taking up my time then I can't trust you... so those went off the list.

Then, we get to see what "normal" prices are (around here, $700-900 for a root canal seems pretty much the "norm", $1000-1200 for a crown, ~$200 or so for fillings, ~$500 flat fee plus or minus for sedation). Then I get to see the dental practices that are apparently VERY proud of their work since their prices START at 40-100% higher than most practices (literally as much as double from some of the practices).

As a general rule, I've found that for the basics (exam/xray and sometimes cleanings) you could probably switch dentists every year and never pay more than $50/year as there's almost always multiple practices trying to get new patients by offering deals on those items. Even if you like your dentist, paying $0-$50 for an exam elsewhere to get a second opinion could be well worth it.

BHUser27
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Location: A Midwestern Town

Re: Time to leave our dentist??

Post by BHUser27 » Wed Aug 09, 2017 8:30 am

Ask to see, or get a copy of the x-rays.
Study this and decide for yourself...
https://www.animated-teeth.com/tooth_de ... vities.htm

david99
Posts: 607
Joined: Sat Mar 03, 2007 11:56 am

Re: Time to leave our dentist??

Post by david99 » Wed Aug 09, 2017 11:36 am

whodidntante wrote:I had a dentist tell me I needed two fillings. That seemed odd because I don't have a history of needing fillings and keep up with my dental care. So I went to another dentist for a checkup without any mention of what the other dentist said. That dentist didn't mention a need for fillings. I never went back to my old dentist.
I had the same happen to me. I've been to two other dentists and neither said that I have cavity.

texaspapas
Posts: 99
Joined: Tue Jul 15, 2014 7:03 pm

Re: Time to leave our dentist??

Post by texaspapas » Wed Aug 09, 2017 11:48 am

bampf wrote:https://www.dentistat.com/ReaderDigestArticle.pdf

Many many reasons to distrust dentists.
Great article. From $300 to $30,000 worth of problems on the same mouth?? It's obvious that unethical practices in dentistry are rampant, and might even be the norm. Comments that "it's an art and not a science" are absurd in the face of the 100 fold variance in costs found in these investigative journalist pieces, and to common sense.

What's not obvious to me is how to find an ethical one? Word of mouth and internet reviews are maybe a good place to start, but they seem far from foolproof. I guess really the only way is "trial and error". I wish there was some way to examine metrics of different dentist, for example, their average bill-out per patient, or average new patient bill-out. I bet if there were a wide range of data available it would be possible to get at least an idea of who was practicing more ethically.

SamB
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Re: Time to leave our dentist??

Post by SamB » Wed Aug 09, 2017 11:59 am

It might be time to shop around, but I hate to break the news to you. Your dental health is a direct function of what you eat and when you eat it. I am speaking of the dental decay problem.

Maybe you should start thinking about it, and look up Westin Price. I am not making any food recommendations, just pointing to a dentist that did a great deal of research on dental health.

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onthecusp
Posts: 403
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Re: Time to leave our dentist??

Post by onthecusp » Wed Aug 09, 2017 12:08 pm

Bigbonds wrote:
YoungDentist wrote:I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a new office off. Sure, there are a few dentists out there who may practice this way. The VAST majority have invested in better technology (digital radiographs with good software can detect cavities at earlier stages/better accuracy than old school films) and are in fact watching out for your own good.

Would you rather spend $200 on a filling now, or spend $4000 on a root canal/crown or implant? It all depends if you want to be proactive in your dental care or reactive to a problem that may occur. If the patient is fine "watching" a cavity grow and with the possibility of needing a root canal/crown in future, then they absolutely have that right - but the dentist is not doing his/her job by not diagnosing the initial cavity.

One poster said something to the tune "I was told I had two cavities by one dentist and the other didn't say anything, so I kept going to the latter...". Would you want to me told you have a disease? Or rather the doctor/dentist sweep it under the rug? I can tell you that not all dentists treat the same "types" of cavities. Some may watch something, while another may treat. Either way, wouldn't you as a patient want to know what was going on?

Some simple advice: we show our patients an intraoral photo of each tooth, all the radiographs, and smile images on a LCD screen no more than 3 feet from them so they can understand what we are looking at. In my mind, each patient needs to understand what is going on. ASK TO SEE THESE THINGS, and if your dentist isnt doing these things or taking the time to explain, then maybe seek another opinion.
Are you denying that dentist have a obvious financial incentive to be more aggressive when treating "different types of cavities" or just not bring it up? Before I get a cavity filled I want it to be confirmed by a separate dentist, if two don't agree then in my opinion it's not bad enough to get filled. It doesn't mean it will lead to a mouth full of root canals.
Speaking of root canals and complete tooth failures, I've had many and I blame them on an overly aggressive dentist back when I was a teen. We moved from one city to the next and suddenly the new dentist gave me 8-10 fillings in the space of a year. This was after years of good dental care and maybe 3-5 fillings in the previous years. IMHO those large and plentiful fillings weakened my molars. My current dentist makes plenty off me too, but I trust him because he listens and informs.

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Toons
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Location: Hills of Tennessee

Re: Time to leave our dentist??

Post by Toons » Wed Aug 09, 2017 12:11 pm

Vote with your feet. :happy
"One does not accumulate but eliminate. It is not daily increase but daily decrease. The height of cultivation always runs to simplicity" –Bruce Lee

diy60
Posts: 134
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Re: Time to leave our dentist??

Post by diy60 » Wed Aug 09, 2017 12:28 pm

I had great confidence in my dentist, who recently retired. He was very non-aggressive, to the point I had some concern over a couple of not treated areas. He retired and the new dentist who took over was appalled some of the areas were not corrected. I went through about 4 different visits to get the problem areas addressed, to the point I considered him as possibly churning work, but in the end he gained my trust.

OTOH, I worked with an individual whose spouse was finishing up dental school and spent their last $60K of student loans on a new car. When I questioned this the response was "they've worked hard, it's deserved". I wouldn't want to be his patient.

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DaftInvestor
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Re: Time to leave our dentist??

Post by DaftInvestor » Wed Aug 09, 2017 12:47 pm

SamB wrote:It might be time to shop around, but I hate to break the news to you. Your dental health is a direct function of what you eat and when you eat it. I am speaking of the dental decay problem.
.
Its actually only 40% related to what you eat and when. The other 60% is related to genetics. Quite simply - some people are far more prone to cavities than others.
I've read about this multiple times in multiple places - here's one summary:
http://www.cnn.com/2014/07/03/health/to ... index.html
YoungDentist wrote:.... It truly allows me to know how most of my patients truly feel and how I can properly address a diagnoses.
[/quote]

I trust my dentist 100% after years of going to him. I also don't fault him for driving a nice car - he is well educated, works hard, and deserves it.
My dentist doesn't price-gauge me but I also know he isn't the cheapest in my area. Just like when I hire a landscaper or contractor - I won't necessarily go with the cheapest bid (unless referrals, etc. indicate quality work) - I'd rather pay a few dollars more for someone who knows what they are doing.

Years ago - I too - went to a dentist with 70's-era wood-paneled walls and very dated equipment who would assume all his patients were equally frugal - he would be okay saying "well - you've got something forming here but we can probably let this one go". Cavities don't fill in by themselves - the "let this one go" only got bigger over time. I wish I switched dentists a bit sooner.

OP: For your case - I'd walk - not just for the questionable diagnosis but knowing that he is charging you more at a cash-price than he is charging his insurance patients.

Da5id
Posts: 2035
Joined: Fri Feb 26, 2016 8:20 am

Re: Time to leave our dentist??

Post by Da5id » Wed Aug 09, 2017 12:52 pm

Any professional, whether a dentist, a doctor, a car mechanic, or an accountant knows things you don't. You have to trust them and their judgement, which if they aren't honest lets them take advantage of you. If you find you can't trust them, you need to find one you can trust...

I love my dentist. He mentions potential issues, but unless they become real he generally suggests a wait and see attitude.

Wakefield1
Posts: 793
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Re: Time to leave our dentist??

Post by Wakefield1 » Wed Aug 09, 2017 12:54 pm

onthecusp wrote:
Bigbonds wrote:
YoungDentist wrote:I've posted numerous times on this forum every time I see a dental post. It amazes me at the number of people who are quick to suggest a dentist is diagnosing out of "need for money" or to pay a new office off. Sure, there are a few dentists out there who may practice this way. The VAST majority have invested in better technology (digital radiographs with good software can detect cavities at earlier stages/better accuracy than old school films) and are in fact watching out for your own good.

Would you rather spend $200 on a filling now, or spend $4000 on a root canal/crown or implant? It all depends if you want to be proactive in your dental care or reactive to a problem that may occur. If the patient is fine "watching" a cavity grow and with the possibility of needing a root canal/crown in future, then they absolutely have that right - but the dentist is not doing his/her job by not diagnosing the initial cavity.

One poster said something to the tune "I was told I had two cavities by one dentist and the other didn't say anything, so I kept going to the latter...". Would you want to me told you have a disease? Or rather the doctor/dentist sweep it under the rug? I can tell you that not all dentists treat the same "types" of cavities. Some may watch something, while another may treat. Either way, wouldn't you as a patient want to know what was going on?

Some simple advice: we show our patients an intraoral photo of each tooth, all the radiographs, and smile images on a LCD screen no more than 3 feet from them so they can understand what we are looking at. In my mind, each patient needs to understand what is going on. ASK TO SEE THESE THINGS, and if your dentist isnt doing these things or taking the time to explain, then maybe seek another opinion.
Are you denying that dentist have a obvious financial incentive to be more aggressive when treating "different types of cavities" or just not bring it up? Before I get a cavity filled I want it to be confirmed by a separate dentist, if two don't agree then in my opinion it's not bad enough to get filled. It doesn't mean it will lead to a mouth full of root canals.
Speaking of root canals and complete tooth failures, I've had many and I blame them on an overly aggressive dentist back when I was a teen. We moved from one city to the next and suddenly the new dentist gave me 8-10 fillings in the space of a year. This was after years of good dental care and maybe 3-5 fillings in the previous years. IMHO those large and plentiful fillings weakened my molars. My current dentist makes plenty off me too, but I trust him because he listens and informs.
This is probably why I now have a mouth full of gold and bridges,my parents thought they were doing the right thing in taking me every 6 months to a drill and fill guy in the 1950's,I was not taught how to floss or its importance,I was never given a fluoride treatment or the subject of fluoride treatments ever brought up by that dentist. (I assume that fluoride treatments were available back then,if not then apologies to the dentist).
With time,the filled and refilled molars (many had developed decay under fillings and also new decay from cavities that started between adjacent teeth) cracked and broke up.
I had various dentists over the years,the most recent one was able to crown or bridge some of the remaining stumps but she recently retired due to breast cancer. Interestingly and perhaps something that some would disagree with she crowned my 4 wisdom teeth but I have lost 3 of my first molars and the wisdom teeth are large and well developed.Being that one of the wisdom teeth actually had no fillings or cavities in it but its opposing tooth was crowned she said that it would wear excessively eventually unless crowned. She also had an examining room set up with a small camera to put in your mouth and t.v. display for showing the inside of your mouth,she also usually showed your X rays.

Wakefield1
Posts: 793
Joined: Mon Nov 14, 2016 10:10 pm

Re: Time to leave our dentist??

Post by Wakefield1 » Wed Aug 09, 2017 12:58 pm

Da5id wrote:Any professional, whether a dentist, a doctor, a car mechanic, or an accountant knows things you don't. You have to trust them and their judgement, which if they aren't honest lets them take advantage of you. If you find you can't trust them, you need to find one you can trust...

I love my dentist. He mentions potential issues, but unless they become real he generally suggests a wait and see attitude.
Finding a new dentist or a new car mechanic can be an intimidating proposition. It's worthwhile to follow a trusted mechanic to a new shop.

chabil
Posts: 508
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Location: North of Boston

Re: Time to leave our dentist??

Post by chabil » Wed Aug 09, 2017 1:09 pm

My husband and I went to a dentist for several years until he retired. At one point he took on a partner, a younger guy. A few years later they moved into a swank office, with sculptures in the waiting room. My son who was in college was visiting us and when my husband took him in the younger dentist saw him and immediately gave him 4 fillings. My husband, who has several dental issues, saw the younger dentist one time who informed him he needed several different procedures done. Alarmed he went back to the senior, regular dentist, who told him there is no need and, get this, he felt the younger dentist is simply in a hurry to make more money.

I don't usually have many problems with my teeth and after retirement when we were no longer covered for dental I just went in for cleaning. I declined to see the dentist (the younger one) for which there was an extra charge. After a while the office called me to say if I don't see the dentist I cannot be a patient anymore. I took my recent exrays to another dentist with a more modest office and very friendly staff. Yesterday at my check up I told him I feel a hollow space in my tooth and wondered if the filling is wearing out. He confirmed they are fine and suggested I should consider wearing a night guard. He said he could make one for me for $400 or I can go to the drug store and buy one for 20 bucks. He said he has tested several of these, they are fine, and I should get the RiteAid brand as they are cheaper and you get 2 for the price of one. He is my dentist forever.

deskjockey
Posts: 149
Joined: Sat Dec 03, 2016 11:15 am

Re: Time to leave our dentist??

Post by deskjockey » Wed Aug 09, 2017 2:50 pm

This is a timely thread for me. My old dentist retired a couple of months ago and last week I went to see one of the dentists who bought his practice. The new dentist said he saw a cavity that needed filling. Granted, I've been living in a city where the water is not fluoridated for the past year, but I've always been diligent about dental hygiene, use fluoride mouth wash, and have not had a cavity in 25 years (more than half my life). I was wondering what was up. I do think there are unscrupulous dentists out there pushing people to get needless work done so, just to make sure this new guy is not one of them, I'll ask for the x rays and get a second opinion from another dentist.

mouses
Posts: 3283
Joined: Sat Oct 24, 2015 12:24 am

Re: Time to leave our dentist??

Post by mouses » Wed Aug 09, 2017 4:09 pm

SamB wrote:It might be time to shop around, but I hate to break the news to you. Your dental health is a direct function of what you eat and when you eat it. I am speaking of the dental decay problem.

Maybe you should start thinking about it, and look up Westin Price. I am not making any food recommendations, just pointing to a dentist that did a great deal of research on dental health.
If that is the case, perhaps you can explain why, when we grew up at the time when people actually ate sit down meals at home, my mother and I had many fillings and my Dad and brother had almost none, same dentist.

SamB
Posts: 821
Joined: Mon Mar 12, 2007 3:17 pm

Re: Time to leave our dentist??

Post by SamB » Wed Aug 09, 2017 6:08 pm

mouses wrote:
SamB wrote:It might be time to shop around, but I hate to break the news to you. Your dental health is a direct function of what you eat and when you eat it. I am speaking of the dental decay problem.

Maybe you should start thinking about it, and look up Westin Price. I am not making any food recommendations, just pointing to a dentist that did a great deal of research on dental health.
If that is the case, perhaps you can explain why, when we grew up at the time when people actually ate sit down meals at home, my mother and I had many fillings and my Dad and brother had almost none, same dentist.
This is what Westin Price was trying to explain and that is why I mentioned him. One fellow above gives a percentage breakdown for environment versus genes. However, no matter your genes, they have to be expressed. Epigenetics, not known by Price, may have also played a role with the differences that you saw in your family. This is why identical twins are never really "identical" as they evolve in life.

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