What Makes a Good Dentist?

Like all of you, I receive a lot of mail each day.  Last week one of these mail pieces caught my eye.  It was from some dental organization that I had never heard of.  Upon opening the letter and reading the contents, I discovered that I am a leading dentist, one of the best in the country.

“That’s interesting,” I thought.  “I wonder what kind of criteria they are using.”

As I read further, I learned that, for a small fee, I could obtain a commemorative plaque to display in my office for all to see how great I am.  Very curious.  For a price, I can pay someone else to declare that I am the proverbial, “cat’s meow” of dentistry.  Someone who doesn’t know me has no idea what kind of technical skills I possess, and likely has no association with any of my patients.

I began thinking, what actually does make a good dentist?  This is both a subjective and an objective question.  The objective perspective is one that most people do not think much about.  These are the things to which a patient responds, “You’re the expert, whatever you say.”

When most people think of dental work, they think of fillings and crowns – the repair of damaged teeth.  A good dentist will consider what is best for the long-term health of the tooth – is the damage minimal enough that a filling will adequately restore the tooth?  Or, is the damage extensive enough that a full coverage restoration will better protect the structural integrity of the tooth?  What kinds of mechanical forces (compressive, sheer, a combination) are exerted on this tooth and what adjustments need to be made to the preparation design to best address these forces?  What kind of restorative material will be best suited the restoration?  If the restoration is a crown, etc., etc., etc.  The list of technical considerations goes on.

The dental consumer trusts the dentist to be skilled in the diagnosis and treatment planning process so that the final product is a long lasting, good-looking, and properly functioning restoration.

The dental consumer, in most cases, is interested much more in the subjective considerations involved in dental care and trusts the dentist to pay attention to the technical details.

What are the subjective considerations?  Generally speaking, they can be summed up by the following questions:

1.  Did it hurt?

2.  Was the front office easy to work with?

3.  Did the work last a long time?

And, while each of these subjective items are very important to the overall dental experience, they simply do not provide a reliable measurement for whether or not a dentist has any technical expertise.  For example, a crown may be made and delivered to a patient’s tooth and last a very long time.  However, the crown may have an “overhang” on the edge of it that creates a periodontal problem.  So, while the tooth is doing fine and the sub-standard crown is actually protecting the tooth, bone loss is occurring because of the chronic irritation created by the overhanging crown margin.

Using the same example of an overhanging crown margin, hopefully the dentist would identify this at a subsequent exam and recommend replacement of her or his work at no charge.  This is a conscientious dentist taking responsibility.  That is a quality of a good dentist.

So how do you know if your dentist is “one of the best”?  Certainly not from a plaque or a title that has been bought.  Look for characteristics such as conscientiousness, patience with patients (is the dentist willing to listen until s/he understands the needs and concerns of the patient?), how does the dentist treat his/her employees?  What kind of dental laboratory does the dentist use?  Is the dentist willing to take extra time to make sure everything is right?  No one is perfect.  When imperfections arise, does the dentist do what s/he can to correct their shortcoming?

These are just a few of the things to be thinking about when selecting a dental team to help you maintain your optimum oral health.  There are many others, but that will get you starting in thinking about things.  Best Wishes to you all :^)