Rant: Is Dentistry Going Backwards?

[RJM62]

Tomorrow I'm going to the dentist to have a crown re-attached for the second time in as many weeks. The dentist bonded it with some sort of light-cured resin the first time. That lasted a day. Then he cemented it. That lasted about a week. What he plans to do tomorrow, I have no idea.
I'm thinking about bringing along a can of Bondo. It holds up on cars pretty well, so why not teeth?

The thing that I don't get is that I have fillings that my then-dentist put in when I was 9 years old that are still going strong, but most of the composite fillings that I've have done in the past 10 years or so have fallen out at least once, and sometimes twice, and have had to be redone.

In talking about this with family and friends, I've learned that I'm not alone in my frustration. My father will be 78 next month. The dental work he had done in the Army is still going strong, but the work he's had done in the past few years is coming apart. My mother also told me that the crowns she had done 50 years ago when we lived in Brooklyn are still intact, but the ones done in the past few years with the high-tech materials have fallen off. And my younger brother had an implant done less than a year ago whose crown has already fallen off twice.

I really don't get it. Every other area of medicine has advanced, but dentistry seems to be going backwards, at least in terms of durability of the materials.

It also seems to me that there's altogether too much emphasis on how teeth look versus how they work nowadays. Practically every dentist and hygienist I've seen in the past 10 years has tried to sell me on tooth-whitening. My teeth have never been pure white and I've never cared. Frankly, I couldn't care less if they were hot pink. But it would be nice to be able to eat an egg sandwich without having to worry about swallowing a crown that was just re-cemented last week.

That's what I was eating this morning when the crown came loose again -- an egg sandwich. If the cement can't even hold up to chewing scrambled eggs, what the hell good is it?

As far as I can tell, the crown fits okay. It doesn't hurt and it doesn't wiggle. But it comes straight down from the suction of the food and would fall out if the two adjacent teeth weren't there to catch it. The dentist seems competent enough and isn't rushed for time. He's a solo-practice rural dentist with 30+ years of experience who seems to take his work seriously. So I don't think he's the problem.

The only thing I can think of is that whatever kind of glue, or cement, or resin, or whatever else they glue crowns on with these days, simply doesn't work. I must admit, however, that my disappointment with the durability of modern dental materials contributes to that speculation.

Bondo is looking better and better.

Rich

 

[Chip Sylverne]

Can't really comment on your problem, but as far as daily dental care goes, I bought one of those Sonicare brushes. Man, what a difference. Seriously, my teeth feel as clean afterward as they do after a dental tech works on them. It's like a little personal ultrasonic cleaner for your teeth.

I don't usually rave over consumer products, but this one is worth the $.

 

[DaleB]

Can't really comment on your problem, but as far as daily dental care goes, I bought one of those Sonicare brushes. Man, what a difference. Seriously, my teeth feel as clean afterward as they do after a dental tech works on them. It's like a little personal ultrasonic cleaner for your teeth.

I don't usually rave over consumer products, but this one is worth the $.

Amen. I have an appointment today to get my teeth checked and cleaned. I'll bet I'm out of there in 15 minutes tops. The dental techs have almost nothing to do any more.

Rich, I share your frustration. I have a crown I've had to have re-glued twice now, and I'm SURE it will take a third time soon. The last time I had a filling (90s maybe) they said their new wonder material would last at least 15-20 years. I asked, why so short? I have some I got in junior high that I'll be buried with.

Whatever they were using to attach crowns in the early 70s -- THAT'S what I want.

 

[PaulS]

Sounds like operator error to me. My dentist did this to me with a temp crown, he just put a dab of glue on the temp and it fell off that night, I bit it and ended up with a root canal on another tooth. I used to deal with epoxies in critical situations and nine time out of ten the issue was one of a few: improper ratios of hardner to resin, this would happen at the packager, the next was improper mixing, generally not combining the materials together which would cause incomplete curing, finally expired shelf life. Might be time for a new dentist.

 

[RJM62]

Sounds like operator error to me. My dentist did this to me with a temp crown, he just put a dab of glue on the temp and it fell off that night, I bit it and ended up with a root canal on another tooth. I used to deal with epoxies in critical situations and nine time out of ten the issue was one of a few: improper ratios of hardner to resin, this would happen at the packager, the next was improper mixing, generally not combining the materials together which would cause incomplete curing, finally expired shelf life. Might be time for a new dentist.

I would think that in more than three decades of practice, a dentist would learn how to properly mix resins. But hey, you never know. I do know that all the other work he did, including the other crown, seem up to par. But it hasn't been very long, so even that's uncertain.

Rich

 

[RJM62]

Amen. I have an appointment today to get my teeth checked and cleaned. I'll bet I'm out of there in 15 minutes tops. The dental techs have almost nothing to do any more.

Rich, I share your frustration. I have a crown I've had to have re-glued twice now, and I'm SURE it will take a third time soon. The last time I had a filling (90s maybe) they said their new wonder material would last at least 15-20 years. I asked, why so short? I have some I got in junior high that I'll be buried with.

Whatever they were using to attach crowns in the early 70s -- THAT'S what I want.

That's exactly what I'm saying. Maybe there were some toxicology concerns or something along those lines, but whatever they were using to patch teeth together in the 60's and 70's seemed to work a lot better than whatever they're using today.

Rich

 

[Van Johnston]

Like in many facets of life, experience makes a difference. Worst dental experiences I had was with the kid right out of school. As teeth in general get healthier, there's fewer bad teeth that need fixing, which exacerbates the experience problem. That's my unsubstantiated hypothesis anyway.

That being said, my wife and I go to the same dentist, and she has had similar experiences to you, and I have not. We've both had crowns in the last couple of years.

 

[Matthew]

+1 on Sonicare.

And I think some of the new materials are more "green" and might not work as well as some of the old stuff that many of us still have in our heads.

 

[painless]

The primary way that crowns are stabilized and keep from coming off teeth is the shape that the tooth is prepared. An extreme example is the difference in retention between a short, conical shape vs a taller trapezoidal shape. There is more friction and height to stabilize things. Because this basic crown preparation guideline is followed whenever possible, I have had instances where it is difficult to get the crown back off a tooth after checking it's fit prior to cementation.

There are times, often when a tooth needs a crown after years of being restored with bigger and bigger fillings and subsequent loss of tooth structure, where there is limited amount of tooth to shape it in the desired manner. When this happens, a core, or base material is bonded to the tooth which is then shaped to accept the crown. This works fine so long as there is adequate sound tooth structure at the gum line of the tooth. Relying on this core alone to stabilize a crown often fails.

The newer crown materials and especially the bonding cements have been marketed to dentists with the emphasis that cores may not be needed and that crowns can be bonded onto short preparations. In theory and based on the chemistry, this is true, to an extent. Where a major problem arises, IMHO, is ensuring that a dry field is maintained throughout the cementation process. Contamination with moisture can severely decrease the efficiency of the cement. I'm afraid that some dentists are relying too heavily on new technology rather than basic design parameters of tooth preparation for crowns. Some cases, however, are very difficult to achieve the proper shape, especially height due to limited room. This is very true in the back molars.

As to fillings not lasting as long, there are so many variables with each situation that it is difficult to comment. One thing that I have noted that patients get frustrated with and don't take into consideration is that often times when I have to replace a filling due to new decay or fracture, I'm not working with the same amount of tooth that Doc X had to work with in the first place. The larger a filling is, the higher chance there is that it will fail, or more commonly that a chunk of tooth will fracture from it.

Just for reference, DDS with 34 yrs experience.

Sorry to hear you are having trouble.

 

[Everskyward]

I had the opposite problem. All the old fillings I had when I was a kid deteriorated and were gradually replaced with crowns, mostly 5-10 years ago. I have had no problems with the new crowns.

 

[DFH65]

<<<------ 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.

 

[RJM62]

The primary way that crowns are stabilized and keep from coming off teeth is the shape that the tooth is prepared. An extreme example is the difference in retention between a short, conical shape vs a taller trapezoidal shape. There is more friction and height to stabilize things. Because this basic crown preparation guideline is followed whenever possible, I have had instances where it is difficult to get the crown back off a tooth after checking it's fit prior to cementation.

There are times, often when a tooth needs a crown after years of being restored with bigger and bigger fillings and subsequent loss of tooth structure, where there is limited amount of tooth to shape it in the desired manner. When this happens, a core, or base material is bonded to the tooth which is then shaped to accept the crown. This works fine so long as there is adequate sound tooth structure at the gum line of the tooth. Relying on this core alone to stabilize a crown often fails.

The newer crown materials and especially the bonding cements have been marketed to dentists with the emphasis that cores may not be needed and that crowns can be bonded onto short preparations. In theory and based on the chemistry, this is true, to an extent. Where a major problem arises, IMHO, is ensuring that a dry field is maintained throughout the cementation process. Contamination with moisture can severely decrease the efficiency of the cement. I'm afraid that some dentists are relying too heavily on new technology rather than basic design parameters of tooth preparation for crowns. Some cases, however, are very difficult to achieve the proper shape, especially height due to limited room. This is very true in the back molars.

As to fillings not lasting as long, there are so many variables with each situation that it is difficult to comment. One thing that I have noted that patients get frustrated with and don't take into consideration is that often times when I have to replace a filling due to new decay or fracture, I'm not working with the same amount of tooth that Doc X had to work with in the first place. The larger a filling is, the higher chance there is that it will fail, or more commonly that a chunk of tooth will fracture from it.

Just for reference, DDS with 34 yrs experience.

Sorry to hear you are having trouble.

Thank you for the detailed explanation.

Do you have any openings this afternoon?

Rich

 

[painless]

<<<------ 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.

It's people like you that prevent me from being able to afford to retire!

 

[painless]

Thank you for the detailed explanation.

Do you have any openings this afternoon?

Rich

Sorry....day off.

 

[BigBadLou]

Heh, the common (conspiracy) theory says that if they make it last, you're not likely to come back and thus they will "lose" profit. Just like other services or manufacturers, they want you coming back so they provide shoddy service/merchandise. It makes perfect business sense if you think about it.

 

[RJM62]

Heh, the common (conspiracy) theory says that if they make it last, you're not likely to come back and thus they will "lose" profit. Just like other services or manufacturers, they want you coming back so they provide shoddy service/merchandise. It makes perfect business sense if you think about it.

I don't think that's the case. In my experience, dentists are the only health care professionals who give warranties (albeit informal, unwritten ones) on their work. On those occasions when some restoration didn't last as long as expected and I was able to get back to the same dentist who did it, I've never been charged for the work. I've met a few dentists whose skills I was unsure about, but none I thought were crooks.

Rich

 

[N747JB]

I've had the same dentist since 1969, his hygienist is the only one I ever remember cleaning my teeth and I have had no issues with the two crowns I have gotten from him. He is OLD school, if it needs fixing, he fixes it, but he doesn't do anything before it's time to do it. The other doctor in the practice, a younger guy around 40, checked me after my cleaning and said I had a soft filling that needed to be replaced. I set up an appointment with my dentist and when I got there he looked at it, tapped it etc and asked the hygienist one word, "Lightner" the other docs name. She nodded and he said he would do it, but it would be fine for another couple years. He replaced it two years later!

 

[rbridges]

Hard to say without seeing the tooth. No matter which cement you use, it requires axial wall height for rentention. The smaller the degree of taper, the better the retention, also. The newer cements are technique sensitive, and blood/saliva can compromise the result.

I went to a seminar this past winter, and the speaker said newer composites can last 10-15 years if bonded properly and maintained by the patients. Although that may appear short, it's better than the 3-5 year range we were seeing with the original tooth colored restorations. Keep in mind that longevity is dependent upon patient compliance, too.

I agree about the older restorations. I have several 30+ year old amalgams (silver fillings) in my mouth that are holding up very well. The rush to remove mercury fillings created a big shift in people wanting composites (white fillings). The older ones did not hold up well, especially on chewing surfaces in the back. They would typically fail after a few years. The irony is that mercury is bound in silver fillings, and amalgam restorations are safer than a lot of the chemicals present in the composites. There has been a huuuge shift toward cosmetics. When I was in dental school, porcelain fused to metal crowns were the standard for front teeth. Nowadays, they have really nice veneers and crowns that require no metal that look fantastic.

Unfortunately bad things happen. Whether or not it's bad dentistry, I don't know. You can always get a second opinion, but I've seen my fair share of crowns that come loose. Sometimes there's more to it, but it could be the fact that not much tooth structure is left, and they were trying to make it work.

 

[JoseCuervo]

I would think that in more than three decades of practice, a dentist would learn how to properly mix resins. But hey, you never know. I do know that all the other work he did, including the other crown, seem up to par. But it hasn't been very long, so even that's uncertain.

Rich

Dentistry, like many other fields, you don't want to find a grey-haired provider. Technology and science move forward, old people sometimes don't.

Go find a young dentist that has been trained on new techniques, new equipment, new solutions.

Good luck.

 

[TheGolfPilot]

Tomorrow I'm going to the dentist to have a crown re-attached for the second time in as many weeks. The dentist bonded it with some sort of light-cured resin the first time. That lasted a day. Then he cemented it. That lasted about a week. What he plans to do tomorrow, I have no idea.
I'm thinking about bringing along a can of Bondo. It holds up on cars pretty well, so why not teeth?

The thing that I don't get is that I have fillings that my then-dentist put in when I was 9 years old that are still going strong, but most of the composite fillings that I've have done in the past 10 years or so have fallen out at least once, and sometimes twice, and have had to be redone.

In talking about this with family and friends, I've learned that I'm not alone in my frustration. My father will be 78 next month. The dental work he had done in the Army is still going strong, but the work he's had done in the past few years is coming apart. My mother also told me that the crowns she had done 50 years ago when we lived in Brooklyn are still intact, but the ones done in the past few years with the high-tech materials have fallen off. And my younger brother had an implant done less than a year ago whose crown has already fallen off twice.

I really don't get it. Every other area of medicine has advanced, but dentistry seems to be going backwards, at least in terms of durability of the materials.

It also seems to me that there's altogether too much emphasis on how teeth look versus how they work nowadays. Practically every dentist and hygienist I've seen in the past 10 years has tried to sell me on tooth-whitening. My teeth have never been pure white and I've never cared. Frankly, I couldn't care less if they were hot pink. But it would be nice to be able to eat an egg sandwich without having to worry about swallowing a crown that was just re-cemented last week.

That's what I was eating this morning when the crown came loose again -- an egg sandwich. If the cement can't even hold up to chewing scrambled eggs, what the hell good is it?

As far as I can tell, the crown fits okay. It doesn't hurt and it doesn't wiggle. But it comes straight down from the suction of the food and would fall out if the two adjacent teeth weren't there to catch it. The dentist seems competent enough and isn't rushed for time. He's a solo-practice rural dentist with 30+ years of experience who seems to take his work seriously. So I don't think he's the problem.

The only thing I can think of is that whatever kind of glue, or cement, or resin, or whatever else they glue crowns on with these days, simply doesn't work. I must admit, however, that my disappointment with the durability of modern dental materials contributes to that speculation.

Bondo is looking better and better.

Rich

My girlfriend is a dentist. She loses money on insured patients because the insurance company only pays so much for certain work. She stated that some dentists use lower quality materials to match what they are paid. Others, like herself, are just taking the hit until she builds up a large enough client base to drop insured patients all together. Don't know if that applies to you. I have also heard that the schools these days do place an emphasis on the appearance. A simple "I don't care how ugly it is, i want it to last, may give you a longer lasting crown.

 

[PaulS]

I certainly had my eureka moment many years ago concerning my teeth, I am now a flossing and brushing good doobee. My gums are healthy, my breath don't stink and my teeth look pretty good. Most importantly no pain. I go to the dentist every 6 months, and I insist on my next cleaning appointment before I leave. I've had a couple root canals that have held up well, one due to injury and two due to big fillings failing. I have several caps on back teeth that have been great. First sign of pain I go in, usually it's nothing but if you ever had a tooth ache you know enough not to mess around. Dentists have a tough job, many people dislike going to them and, from what I understand dentists have a higher rate of suicide than average. Not sure why, I thank my dentist every time I see him. Sometimes he apologizes when he has to do something that hurts, I tell him I'd rather a little pain now than a lot of pain later.

RJM62, I hope you get it straightened out.

 

[PaulS]

Dentistry, like many other fields, you don't want to find a grey-haired provider. Technology and science move forward, old people sometimes don't.

Go find a young dentist that has been trained on new techniques, new equipment, new solutions.

Good luck.

Horse puckey, I rather the seasoned guy who has done it a thousand times then the new guy who thinks he knows it all and has done it twice. The good ones stay up to date and sales reps bring the new technology around all the time. Find a good dentist and stick with him, read reviews and ask around if you are looking for one.

 

[Zeldman]

My girlfriend is a dentist. She loses money on insured patients because the insurance company only pays so much for certain work. She stated that some dentists use lower quality materials to match what they are paid. Others, like herself, are just taking the hit until she builds up a large enough client base to drop insured patients all together. Don't know if that applies to you. I have also heard that the schools these days do place an emphasis on the appearance. A simple "I don't care how ugly it is, i want it to last, may give you a longer lasting crown.

That makes sense to me. Dental insurance is a scam, so I would rather pay cash. I always ask for a cash discount and I get it because I pay cash right now. The dentist doesn't have to wait for payment.

 

[rbridges]

Dentistry, like many other fields, you don't want to find a grey-haired provider. Technology and science move forward, old people sometimes don't.

Go find a young dentist that has been trained on new techniques, new equipment, new solutions.

Good luck.

that's not quite fair. You can also get a younger guy with a ton of debt who will do anything to increase production. I'm a specialist, and I work with nearly every dentist in town. I see great work by some guys and shoddy work from others. Age has very little to do with it. You are right about keeping up with technology. I've purchased a few items in the last few years that weren't even available when I started practed.

 

[RJM62]

Hard to say without seeing the tooth. No matter which cement you use, it requires axial wall height for rentention. The smaller the degree of taper, the better the retention, also. The newer cements are technique sensitive, and blood/saliva can compromise the result.

I went to a seminar this past winter, and the speaker said newer composites can last 10-15 years if bonded properly and maintained by the patients. Although that may appear short, it's better than the 3-5 year range we were seeing with the original tooth colored restorations. Keep in mind that longevity is dependent upon patient compliance, too.

I agree about the older restorations. I have several 30+ year old amalgams (silver fillings) in my mouth that are holding up very well. The rush to remove mercury fillings created a big shift in people wanting composites (white fillings). The older ones did not hold up well, especially on chewing surfaces in the back. They would typically fail after a few years. The irony is that mercury is bound in silver fillings, and amalgam restorations are safer than a lot of the chemicals present in the composites. There has been a huuuge shift toward cosmetics. When I was in dental school, porcelain fused to metal crowns were the standard for front teeth. Nowadays, they have really nice veneers and crowns that require no metal that look fantastic.

Unfortunately bad things happen. Whether or not it's bad dentistry, I don't know. You can always get a second opinion, but I've seen my fair share of crowns that come loose. Sometimes there's more to it, but it could be the fact that not much tooth structure is left, and they were trying to make it work.

Thanks. If it doesn't work out this time, maybe I'll take a ride to Georgia. I have a client down there I need to visit, anyway.

Rich

 

[JoseCuervo]

that's not quite fair. You can also get a younger guy with a ton of debt who will do anything to increase production. I'm a specialist, and I work with nearly every dentist in town. I see great work by some guys and shoddy work from others. Age has very little to do with it. You are right about keeping up with technology. I've purchased a few items in the last few years that weren't even available when I started practed.

The new process where they make the crowns in the office, with the dentist sitting beside the patient, using a software program to build a virtual crown, then transmitting it to another room in the dentist office to have the permanent crown built in minutes, instead of days is an example of the technology.

Yes, it is a generalization to warn against grey-haired dentists, but, like most technologies, old guys are reluctant to learn/embrace. Myself include on some things. Where I used to like buying technology, and programming devices and software, I now find that I hate it, and, will look to hire / find a younger kid that can do the stuff in 2 minutes that I would spend 2 days on.

I used to have a an old grey-haired dentist who retired and left the practice to his two sons. I was amazed at how much better they were using newer (less painful, less discomfort) techniques and technology than their Dad did, who was in the same office.

I know in my circle, I will use methods and technologies that my Dad would never embrace.

It happens.

 

[Gerhardt]

I love the Sonicare, but it doesn't touch my crowns. I use it on the real teeth, and use a regular brush on the crowns. I'm probably 100% wrong, but somehow in my mind I figure the super vibes from the Sonicare can't be good for the adhesive. I also don't eat anything harder than a sandwich with my front teeth (the crowned ones). My dentist has told me it's fine to eat apples, etc....but it's just not happening.

If I had any idea what a crown was at the time I'd have never let him do that. I almost passed out when he handed me the mirror before putting the temps in.

 

[DFH65]

It's people like you that prevent me from being able to afford to retire!

Kids have been lucky too no braces very straight teeth or cavities yet son is 23 and daughter turns 20 next week although the daughter is complaining about her wisdom teeth. We went to see the oral surgeon wants 2+ AMUs to pull her wisdom teeth with sedation. The two on the bottom are not in and seem to be blocked slightly by by bone so he says they probably wont come in all the way. There is one in on the top and I don't think the other will come in. The issue isn't alignment or anything it is mostly the top one mashing food on the lower gum which irritates it. Being the cheapskate that I am I am tempted to have him pull the top one with novocaine and see how it goes. You can always go back for more later. That would be equivalent of a few hours in the 172 a little more reasonable.

 

[rbridges]

The new process where they make the crowns in the office, with the dentist sitting beside the patient, using a software program to build a virtual crown, then transmitting it to another room in the dentist office to have the permanent crown built in minutes, instead of days is an example of the technology.

Yes, it is a generalization to warn against grey-haired dentists, but, like most technologies, old guys are reluctant to learn/embrace. Myself include on some things. Where I used to like buying technology, and programming devices and software, I now find that I hate it, and, will look to hire / find a younger kid that can do the stuff in 2 minutes that I would spend 2 days on.

I used to have a an old grey-haired dentist who retired and left the practice to his two sons. I was amazed at how much better they were using newer (less painful, less discomfort) techniques and technology than their Dad did, who was in the same office.

I know in my circle, I will use methods and technologies that my Dad would never embrace.

It happens.

You're not completely off base. I've seen older guys that didn't keep up with the latest research, and some of their philosophies and techniques were very dated, but not all "old" guys fall into that category. It does depend greatly on the individual.

 

[RJM62]

That makes sense to me. Dental insurance is a scam, so I would rather pay cash. I always ask for a cash discount and I get it because I pay cash right now. The dentist doesn't have to wait for payment.

I dunno... between my part and MetLife's, the dentist got just under $800.00 each for the crowns. Is that in the ballpark for what crowns should cost?

I have the MetLife PDP-Plus "High" plan through VADIP, and dentists seem to like it a lot. When I had one of Delta Dental's PDP plans, not so much. I also considered Cigna Dental through USAA once I decided to cancel Delta Dental; but every dentist I spoke to preferred MetLife over Cigna, so that's what I bought.

I do know that my experience with MetLife has been drama-free. They requested an additional X-Ray before they would approve one of the crowns (which they ultimately approved), but everything else has been approved and paid without any hassles at all. As insurance companies go, I really have nothing bad to say about them.

Rich

 

[Everskyward]

That makes sense to me. Dental insurance is a scam, so I would rather pay cash. I always ask for a cash discount and I get it because I pay cash right now. The dentist doesn't have to wait for payment.

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.

 

[rbridges]

I dunno... between my part and MetLife's, the dentist got just under $800.00 each for the crowns. Is that in the ballpark for what crowns should cost?

I have the MetLife PDP-Plus "High" plan through VADIP, and dentists seem to like it a lot. When I had one of Delta Dental's PDP plans, not so much. I also considered Cigna Dental through USAA once I decided to cancel Delta Dental; but every dentist I spoke to preferred MetLife over Cigna, so that's what I bought.

I do know that my experience with MetLife has been drama-free. They requested an additional X-Ray before they would approve one of the crowns (which they ultimately approved), but everything else has been approved and paid without any hassles at all. As insurance companies go, I really have nothing bad to say about them.

Rich

it depends on the area, but around here, standard crown prices are over $1k. In some larger cities, I'm sure it's much higher.

 

[painless]

Dentistry, like many other fields, you don't want to find a grey-haired provider. Technology and science move forward, old people sometimes don't.

Go find a young dentist that has been trained on new techniques, new equipment, new solutions.

Good luck.

So what do you consider a "grey haired" dentist? 40? 50? 60?

You go for BFR's, right? In most states, dentists are required to get a certain number of hours of continuing education, here in Wisconsin it's 30, to be able to renew their license to practice. Having a dental license is similar to having a pilots license. It's a license to learn. The duty of a professional, no mater what career, is to be a perpetual student.

I'll venture that most "old dentists" stay abreast of new developements in dentistry. Having said that, this "old dentist" has also come to the conclusion, based on seminars I've attended and personal experience, that new doesn't necessarily mean better.

 

[Gary]

I dunno... between my part and MetLife's, the dentist got just under $800.00 each for the crowns. Is that in the ballpark for what crowns should cost?

I have the MetLife PDP-Plus "High" plan through VADIP, and dentists seem to like it a lot. When I had one of Delta Dental's PDP plans, not so much. I also considered Cigna Dental through USAA once I decided to cancel Delta Dental; but every dentist I spoke to preferred MetLife over Cigna, so that's what I bought.

I do know that my experience with MetLife has been drama-free. They requested an additional X-Ray before they would approve one of the crowns (which they ultimately approved), but everything else has been approved and paid without any hassles at all. As insurance companies go, I really have nothing bad to say about them.

Rich

Just got a second crown. Do have an "older" dentist, but he does seem to keep up with technology. He's actually pretty talkative when I ask about the how things are done and why things work the way they do. His big thing about crowns was the fit between the tooth and the crown. Better the fit, the longer it will last, he uses a local manufacturer and spends a fair bit of time doing the fit and what seemed to me, very fine adjustments to the new crown and the tooth. I'm pretty happy with him, I've yet to have a problem with his work. We've got Cigna, so far no problems with approvals or payment. The new crown was $1000, Cigna paid $500, I paid $500.

 

[paflyer]

Sorry....day off.

Say hello to Dish for us.

 

[iflyvfr]

The Philips Sonicare is expensive, but my wife & I are addicted to them and wouldn't consider anything else. Mfg is pretty good about warranty replacement too. I think my wife bought a reverse-engineered ripoff from eBAy and when it failed after 6 months, they replaced it no problem. I got the sense Philips was interested in seeing whatever it was we had bought.

I used to have a problem with pocketing of my gums (tobacco use) and I quit that, started on the Sonicare and my doc raves about my mouth health now.

 

[coloradobluesky]

What is bad are all the fillings. There are coatings that will prevent teens from getting cavities. NONE! A LOT of filings are bogus, no cavity. I know that is tragic but true.

Braces are a good thing. Straight teeth are worth it. 5k a kid.

Something needs to change. Too many bogus fillings and bad dentistry....

 

[painless]

What is bad are all the fillings. There are coatings that will prevent teens from getting cavities. NONE! A LOT of filings are bogus, no cavity. I know that is tragic but true.

Braces are a good thing. Straight teeth are worth it. 5k a kid.

Something needs to change. Too many bogus fillings and bad dentistry....

Wow.

Sounds like you need to find a new dentist.

 

[Let'sgoflying!]

As much as I want to defend the dentists, it's their 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?

 

[painless]

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?

Ha.

Just remember, I know where to hurt people. Real bad.