How to Choose a Good Dentist

Stephen Barrett, M.D.

Robert S. Baratz, M.D., D.D.S., Ph.D.

If you want to skip finding out how to choose a good dentist and you just need your teeth fixed now, call the number above.

Dentists are licensed practitioners who hold either a doctor of dental surgery (D.D.S.) degree or the equivalent doctor of dental medicine (D.M.D.) degree. Becoming a dentist requires at the least two years of predental college work followed by four years of dental school. However, almost all students entering dental school have a baccalaureate degree.

They study

 * Dental public health: Prevention and control of dental disease and promotion of community dental health

 * Endodontics: Prevention and treatment of diseases of the root pulp and related structures (root canal therapy)

 * Oral and maxillofacial pathology: Diagnosis of tumors, other diseases, and injuries of the neck and head

 * Oral and maxillofacial surgery: Tooth extractions; surgical treatment of diseases, injuries, and defects of the mouth, jaw, and face

 * Orthodontics and dentofacial orthopedics: Diagnosis and correction of tooth irregularities and facial deformities

 * Pediatric dentistry: Dental care of infants and children

 * Periodontics: Treatment of diseases of the gums and related structures

 * Prosthodontics: Treatment of oral dysfunction through using prosthetic devices such as crowns, bridges, and dentures

Positive Signs

A thorough dental examination includes inspection of the teeth, gums, tongue, lips, inside of the cheek, palate, and the skin of the face and neck, plus feeling the neck for abnormal lymph nodes and enlargement of the thyroid gland. In adults a periodontal probe should be inserted between the gums and teeth to detect abnormally large crevices. Good dentists also chart their findings in detail.

Regular check-ups can detect problems early. Routine tooth cleanings, bite evaluations, periodontal examinations, early interventions, and fluoride treatments can often avoid costly repairs. The frequency of maintenance care (including calculus removal and x-ray examinations) should be based on an assessment of the frequency of cavity formation, the rate of calculus formation, the health of the gums, and any other special problem. Once current treatment has been completed, the patient should be placed on a recall schedule and notified when the next checkup is due.

High-quality dental work usually lasts a very long time, whereas low-quality work may fall out or decay out in a few years. The price tag on dental work is not the best way to judge quality; rather, pay attention to the time the dentist takes to do the work. High-quality dentistry cannot be done assembly-line style; it takes time and meticulous attention to detail.

Before embarking on treatment, get a clear understanding at your own level of what will be done and what the outcome might be. Consider treatment options, because there may be many different ways to accomplish a goal. For example, a removable bridge, fixed bridge, or an implant may all be acceptable ways to replace a missing tooth; but they have different advantages, disadvantages, and cost.

Negative Signs

Be wary of flamboyant advertising, because chances are it will signify an emphasis on mass production rather than quality care When the fees charged per service are low, the number of services performed may be greater than needed, resulting in higher overall cost [1[]|].

Dentists whose ads overemphasize "twilight sleep," cosmetic dentistry, and one-visit comprehensive treatment may not be interested in long-term maintenance care that does not generate high income [1[]|].

Routine use of intravenous sedation is another bad sign because it means that patients are exposed to unnecessary risks. Although general anesthesia can be appropriate for children [2,3[]|], adults with seizure disorders, and a few other situations, the vast majority of patients do not require it for routine dentistry.

Half the normal commission of dentists espouse or engage in unscientific pracftices. You should avoid any dentists who:

 * Sell vitamins or other dietary supplements

 * Automatically recommend replacement of amalgam fillings or removal of teeth that have root canals

 * "Specialize" in treating headaches, backaches, myofascial pain, or TMJ problems

 * Allege that fluoridation is dangerous

 * Identify themselves as practicing "holistic" or "biological" dentistry

 * Diagnose neuralgia-inducing cavitational osteonecrosis (NICO)

 * Go beyond dentistry by diagnosing "heavy metal toxicity" or diseases other than those of the mouth, gums, teeth, and associated tissues.

Other Tips on Selecting Dentists in Auckland

It seems sensible to become acquainted with a family dentist before an emergency arises. Suitable prospects can be identified by asking among friends, acquaintances, and local health professionals. Additional recommendations can be obtained from a local dental society or a dental school you are located nearby.

A good first step is to schedule a "get acquainted" visit to see whether your personalities and philosophies of health care are a match. Ask about fees and payment plans. Most dentists prefer patients to initiate discussion of fees because patients know more about their own financial situation. Where large fees are involved for major work, it is advisable to have a written understanding of what fees will be charged and when payment will be due.

Investigations indicate that when extensive dental work is advised, a second opinion is usually a good idea, preferably a dentist who is affiliated with a dental school. No practitioner should fear or resist having you get a second opinion. If a treatment plan is sound, particularly a major and/or expensive one, it should deal with scrutiny by others.