Rant: Is Dentistry Going Backwards?

Let'sgoflying! said:
As much as I want to defend the dentists, it's there turn!
Nice to see some other profession.....which works very hard every day, with great integrity, to help the public, while struggling to keep a business afloat amid the plethora of burdensome regulations and under constant worry of malpractice & challenge to licenses, while struggling to pay off enormous education loans....get lumped on by those few on POA! Have seen doctors, lawyers, veterinarians :) you name it, all get their turn here! Who is next?
Click to expand...
Don't forget airline pilots, and bizjet pilots. ;)
 
It's been a long time since I've heard the term "jawbreaker". I call my guy "doc".

Crowns vs implants. I don't have either and don't know much about either. Are there times where one is preferred over the other? Or are they apples and oranges?
 
Let'sgoflying! said:
As much as I want to defend the dentists, it's there turn!
Nice to see some other profession.....which works very hard every day, with great integrity, to help the public, while struggling to keep a business afloat amid the plethora of burdensome regulations and under constant worry of malpractice & challenge to licenses, while struggling to pay off enormous education loans....get lumped on by those few on POA! Have seen doctors, lawyers, veterinarians :) you name it, all get their turn here! Who is next?
Click to expand...

Dude! You can't lump dentists in with lawyers!! Haven't you read your Shakespeare back before dentists when barbers often pulled teeth and did minor surgery, and even he didn't complain about the "dental barbers."
 
Matthew said:
It's been a long time since I've heard the term "jawbreaker". I call my guy "doc".

Crowns vs implants. I don't have either and don't know much about either. Are there times where one is preferred over the other? Or are they apples and oranges?
Click to expand...
Implants are the metal post placed in the jawbone. It can be used to support a crown but also bridges and dentures. IMO an implant is the most ideal and most predictable tooth replacement option. There are times when esthetics or anatomy can make other options better in a particular situation, but implants are my first choice for most patients.
 
I see a periodontist once in a while, he took over from my previous perio. She had been Navy and claimed that all her work was a "geographic success". She'd work on new Marines, they'd ship out and she'd never see them again.
 
paflyer said:
Right, I have both. I was replying specifically to the apples and oranges question.
Click to expand...
Yeah, I realize now I didn't word the question properly. Crowns attach to something, either an implant or some part of a tooth. And the correct answer is probably, "that depends".
 
Their prices haven't gone backwards, nor insurance deducts.
 
mscard88 said:
Their prices haven't gone backwards, nor insurance deducts.
Click to expand...

when I graduated dental school in 1995, I had $45k debt and that was just dental school. It increased to $78k after my 3 year residency (got married and had a kid, lol). I had lunch with a fairly recent grad, and my same alma mater is sending dentists out with 150+k debt, and it's rapidly closing in on 200k. That's for a state run dental school. Some of the private institutions are going to be much higher.
 
I have been a Dental Technician for 45 years and have seen the evolution of dental materials firsthand. My industry is rapidly going away from the fine hand craftsman to computer generated milled crown and bridge. A lot of the new materials are more aesthetic but don't last near as long as the traditional porcelain to gold or gold crowns. Amalgam will last a lot longer than the modern composites. For posterior teeth there is nothing better than gold crowns or inlays but that is rarely the choice anymore as the public has been brainwashed that they need "white" teeth. I have gold crowns and inlays in my mouth that are 50 years old and will probably last the rest of my life. Dental implants are one of the best treatments to come along and have been my specialty since 1981. I equate modern dentistry to shopping for new kitchen cabinetry. You can go to the big box store and get some pretty nice stuff that is done with mediocre materials and will look pretty good or you can hire a fine finish carpenter and get a job that is a much higher fit and finish and will last generations. The problem with dentistry and the medical field as a whole is it is no longer about patient health but making as much money as possible. I continue to slowly phase out of the lab business and more into my aircraft rebuilding. Don
 
yakdriver said:
I have been a Dental Technician for 45 years and have seen the evolution of dental materials firsthand. My industry is rapidly going away from the fine hand craftsman to computer generated milled crown and bridge. A lot of the new materials are more aesthetic but don't last near as long as the traditional porcelain to gold or gold crowns. Amalgam will last a lot longer than the modern composites. For posterior teeth there is nothing better than gold crowns or inlays but that is rarely the choice anymore as the public has been brainwashed that they need "white" teeth. I have gold crowns and inlays in my mouth that are 50 years old and will probably last the rest of my life. Dental implants are one of the best treatments to come along and have been my specialty since 1981. I equate modern dentistry to shopping for new kitchen cabinetry. You can go to the big box store and get some pretty nice stuff that is done with mediocre materials and will look pretty good or you can hire a fine finish carpenter and get a job that is a much higher fit and finish and will last generations. The problem with dentistry and the medical field as a whole is it is no longer about patient health but making as much money as possible. I continue to slowly phase out of the lab business and more into my aircraft rebuilding. Don
Click to expand...


BINGO! I'd rather have a set of store-bought choppers than continue to contribute to the wealth of the medicine men.
 
Dentistry has become all about marketing. When I first started attending Dental Conventions in the early 70's most of the programs were geared to continuing education and a small percentage to practice management. Now it is over half are about how to market your services and sell the patient on things they don't need. They have taken tooth whitening way too far and it now looks really artificial. How many times have your Dentist tried to sell you teeth whitening or want to re build your smile by crowning all of your front teeth. Finding a good conservative Dentist is getting harder and harder. Don
 
DFH65 said:
<<<------ 51 never had a cavity, tooth pulled, shot of novocaine in my mouth. Still have my wisdom teeth and never had braces and have pretty straight teeth. So far have been very blessed in that area for sure.
Click to expand...

I'm one of those also, but only 44 at the moment.

painless said:
It's people like you that prevent me from being able to afford to retire!
Click to expand...

Hahaha. By far not. My old dentist who retired (and I miss, he kept up on *everyrhing* and was one of the first around here to do laser gum surgery -- although that's not something I need and hope to never need) said it has to do with mouth chemistry and Ph levels. Acidic mouths tend to create cavities and deteriorate teeth, and base mouths tend to not have problems with teeth and cavities but instead with tartar buildup and gum disease. I build tartar like there's no tomorrow.

Another fan of Sonicare here and even an old school water pick. If I don't use those I'm having "deep cleaning" done nearly on a three month schedule and if there's one thing I absolutely hate it's when the hygienist has to scrape below the gumline. Oh damn that hurts if they miss a little. If it weren't for sonicare and the waterpick I would spend 1/3 of my life with sore gums after cleanings and recovery time. Hate hate hate it.

It kept me away from dentists for years in fact. Until I found the old guy who's hygienists were absolutely top notch and extremely careful.

Everskyward said:
My dentist charges more that the insurance pays, but there is simple solution to that. I pay the difference.

When I go out on my own, insurance-wise, I won't opt for dental. Right now it's covered, such as it is, by work.
Click to expand...

Same here. All dentists I've used that I like don't charge anywhere near as low as what dental insurance of any sort that I've had will actually pay. They'd submit whatever they could and then send a bill for the difference. Worth every damn penny when you find a good one too.

The only time I ever did a "generic" oral surgeon was the mass removal of my wisdom teeth many moons ago. And they both didn't listen to me when I said I have a naturally high tolerance to anesthesia, so I woke up while he was banging on my face with a hammer and chisel busting out my tooth, and also I got the "joy" of the antibiotic cocktail killing off everything useful in my intestines and ending up in an ER a week later with an intestinal infection.

I have an aversion to dentists from all of this. Unfortunately with my guy retiring, I'm shopping for another one I can trust. I'll drive a long way across town to the one that appears to have their **** together versus looking by proximity to home. Big time.
 
Get a second opinion on fillings. Look in there, probe around. If its not soft and you can see it, get a second opinion on filings.
 
Well, my dentist mixed up a batch of what seems to be Some Other Kind Of Dental Cement and cemented the crown back on. At least I think it was Some Other Kind Of Dental Cement because it took him much longer to mix it, and this time he gave me gauze to bite on for an hour until it sets up. I am biting as I speak. Or write, actually. If I were speaking, I would be saying something like IHH SUNNNDF FURRY BECAUFH I HAFF THSS GAGGHE IMM MAH MOUFF.

In any case, either it's Different Stuff or he wants me to believe it's Different Stuff. Hopefully whatever stuff it is will work this time. It's almost an hour's drive to his office. It's getting tedious.

Rich
 
"I don't need no stinking dentist"

063da605daaa908b5b1c60a5e0f010fa.jpg
 
Well, I'm happy to say that I didn't do any bogus fillings today.

Comments have been made about marketing being emphasized in dentistry.

Totally agree.

My advice to anyone looking for a dentist. Ask your friends, family, coworkers who they go to. When you start hearing the same good things about one, make an appointment. I have always stressed to my staff that internal marketing, that is, how we treat our patients and presenting an atmosphere that makes our patients willingly recommend us to others is so very important. I get marketing seminar announcements by supposed experts in the mail all the time. Circular file they go. I've never had a period in my 34 years of practice when I was ever worried about having enough work to do. Quite the opposite, and quite frankly, I'm beginning to get burned out!
 
I just remembered of an endodontist I knew. Amazing stories of what she dealt with, and had to correct. Most of it patient neglect. They can do elaborate stuff. So much of it was pro bono work, and not all voluntary. My hat is off to anyone working in the public's mouths all day long.
 
You could class me in with the anti-dentite crowd. Miserable places to visit and as far as I am concerned, dentists are sadists!
Seriously though, could you have a section for men who hate the visit? You know with bar stools and rock music, frosty beverages, live bands, peanuts, bacon cheeseburgers and maybe a golf practice net we could knock some balls into? That would be swell, thanks.
 
Acrodustertoo said:
You could class me in with the anti-dentite crowd. Miserable places to visit and as far as I am concerned, dentists are sadists!
Seriously though, could you have a section for men who hate the visit? You know with bar stools and rock music, frosty beverages, live bands, peanuts, bacon cheeseburgers and maybe a golf practice net we could knock some balls into? That would be swell, thanks.
Click to expand...

I can't seem to find that dentist, but my old one had awesome picture windows into a park behind his building and they'd hung bird feeders and what-not out there. I tell ya, it's a lot nicer to stare outside at birds messing around on a feeder (or squirrels) and the weather and some trees and stuff, than at a freaking 30 year old drop-ceiling tile.

BTW. I noticed at my FAA Medical that the doc had a picture of some Norwegian fjords thumbtacked into one of those ceiling tiles for the time period where you lie flat on your back on the exam table. I chuckled when I saw it. You never notice it up there until you lie down. Then you can't forget it's up there. And it's still better than a stupid blank ceiling tile!

But the window to the world was great. Nothing worse than staring at a wall or worse, all the out of date dentistry gear that apparently all dentists keep and store in their exam rooms. Haha.
 
denverpilot said:
I can't seem to find that dentist, but my old one had awesome picture windows into a park behind his building and they'd hung bird feeders and what-not out there. I tell ya, it's a lot nicer to stare outside at birds messing around on a feeder (or squirrels) and the weather and some trees and stuff, than at a freaking 30 year old drop-ceiling tile.

BTW. I noticed at my FAA Medical that the doc had a picture of some Norwegian fjords thumbtacked into one of those ceiling tiles for the time period where you lie flat on your back on the exam table. I chuckled when I saw it. You never notice it up there until you lie down. Then you can't forget it's up there. And it's still better than a stupid blank ceiling tile!

But the window to the world was great. Nothing worse than staring at a wall or worse, all the out of date dentistry gear that apparently all dentists keep and store in their exam rooms. Haha.
Click to expand...
My dentist has tv's installed on the ceiling and a bunch of crummy jokes, random facts sheets hung around the tv.
Every time I visit there is news or sports highlights on the tv. That makes it worse. I always ask for Casablanca or Maltese Falcon but no luck yet.
 
Acrodustertoo said:
Seriously though, could you have a section for men who hate the visit? You know with bar stools and rock music, frosty beverages, live bands, peanuts, bacon cheeseburgers and maybe a golf practice net we could knock some balls into? That would be swell, thanks.
Click to expand...

BOOBS! Don't forget the boobies!

dental.jpg
 
Well, the crown came loose again. I left a message on the dentist's voice mail stating that going back every few days to have it re-cemented is not a satisfactory solution for me, and to please get back to me with a better plan for a more permanent solution. I figure he deserves a chance to get it right before I go all Rambo on him, but I'm frankly at a point at which my confidence is marginal.

If he doesn't make it right, I'll have to ask MetLife to revoke the reimbursement so I can use the benefit elsewhere. I'm not sure how that's done, but I was told by someone there that it's a last-resort sort of option. Either that or I can just self-pay and file a small-claims suit if it turns out that the work he did was deficient in some way.

I've also sent an email to my old dentist in Queens. If I have to make a four-hour drive and pay him to re-do the tooth, then so be it. It's less time than I've wasted so far with it.

I'm finding that the availability and selection of dental care is another thing I miss about living in the city. The choices are pretty limited up here in the boonies.

Rich
 
If its a molar tell him you want it re done in full gold or porcelain fused to gold if it is an anterior. It also might be the prep design. If you want, have him send me the impression and I'll make you a perfect one. Don
 
yakdriver said:
If its a molar tell him you want it re done in full gold or porcelain fused to gold if it is an anterior. It also might be the prep design. If you want, have him send me the impression and I'll make you a perfect one. Don
Click to expand...

Okay, thanks.

It is a molar, and it's porcelain fused to something, as far as I know. For all the times it's fallen out, I haven't really looked at it. It doesn't really fall out so much as come loose a millimeter or so. It's prevented from coming completely out by being wedged between the two adjacent teeth. I could pull it out if I wanted to, but I haven't.

If the fit of the crown is the problem (and assuming that there's no warranty for such things), I'll have him send you the impressions and you can bill me directly. But if my old dentist gets back to me first, I want his opinion on whether the prep was done properly. If the prep wasn't done properly, then it's my understanding is that no amount of artistry on your part would make it work. Am I correct?

I am learning more about dentistry than I ever wanted to know. :(

Rich
 
Sounds like a prep problem. I'm not going to say "improper" because other factors can come into play.

FYI, in my office, if this were a recurring problem, the preparation/crown would be redone with no additional fee.
 
painless said:
Sounds like a prep problem. I'm not going to say "improper" because other factors can come into play.

FYI, in my office, if this were a recurring problem, the preparation/crown would be redone with no additional fee.
Click to expand...

Thanks. That's good to know.

For what it's worth, his office called me today and asked me to come in on Tuesday for new impressions. They didn't mention anything about money. I'm trying to think of a non-insulting way to bring up the subject of whether the prep was less-than-perfect. Any suggestions?

I believe in giving people a chance to make good. The day I become perfect, I'll start demanding perfection of others. But if whatever the doc does this time around doesn't fix the problem, I'm going to have to take a stand (and find another dentist, too). I think I've been pretty patient and polite so far, but as some point enough will be enough.

Rich
 
RJM62 said:
...

They didn't mention anything about money. I'm trying to think of a non-insulting way to bring up the subject of whether the prep was less-than-perfect. Any suggestions?

...
Click to expand...

My inclination would be two questions, "What's all this going to cost me?" and, "Why do you think it didn't take?"
 
You must log in or register to reply here.
Back
Top