My Patient's Can Tell My Story

In 1977, the Supreme Court approved advertising by Professionals. Many dentists of that era have always disapproved of advertising by their peers but thankfully, the old school dentists are retiring and everyone practicing will have grown up during the time that dentists could advertise.

I do a significant amount of advertising and I never give it a second thought about the possibility that it was once considered 'unprofessional.'

What I do know is that compliments and comments by my patients are of far greater value than the advertising that I pay for.

I received the following email from a patient that I saw the day of the drawing for the $580 million dollar Powerball drawing:

Well I didn't hit the Powerball, so my blue corvette will have to wait. I am
always a little nervous when I have this work done but I don't know why I
should be with you. I got in the car and took a look in my mouth and had to
take a moment of amazement. You are a true artist it would be very difficult
if even possible to the eye to tell that there is even a restoration there.
I even showed it to someone at work because they made a comment about me
driving all the way to Saratoga for my dentist once. Well she took one look
and said she now understands. I just laughed, I thought you would appreciate
that. Wish you the best on your surgery see you in January.

I was thrilled to receive this email from my patient and it confirms to me that there ARE patients that will select excellence if it is made available to them.

I thank everyone of my patients for trusting me and my staff to take care of you. It is an absolute honor and privilege to be your dentist.

Insurance Companies are the Payer and NOT the Decider

It is my opinion that the role of medical or dental insurance companies is to pay for treatment. It was never intended that insurance companies would actually decide on which treatment is necessary. Unfortunately, insurance companies and not the doctor and patient decide what treatment  you should have.

Any discussion that begins with "My insurance company...." is no longer a discussion about our dental health or the right treatment or what is the best treatment for you but rather who will decide what treatment that you will have.

A relatively small percentage of patients have NO choice but to have treatment that insurance companies will pay for. A fairly large number of people have the ability to decide for themselves what treatment is in their best interest and do not let the insurance company make an important decision about their dental health. Unfortunately, many patients financially able or not often begin our conversations with "My insurance company..."

No one would listen to an insurance company tell them which house, car or coat to buy but often rely on the insurance company to make the decision about health care.

Does this make any sense?

People Believe What Makes Them Comfortable

I met my best friend and dental school classmate in Manhattan last weekend and the discussion turned to what takes to be a world class performer. My friend believes that we are born with talent and if we are lucky, then we would have the opportunity to be world class at whatever task that we wanted to be.

I on the other hand, I quoted the literature that says that if you want to become the best at chess, the violin, sports or dentistry, it takes passion, hard work and the ability to practice things that we are not good at.

How can my friend and I be so far apart in our thinking? 

If you believe, as my friend does that a person is BORN with talent, intelligence or a skill, then you only have to have the good fortune to be discovered. To me, that is like saying if you play the violin in your basement then a violin teacher might walk past your house, hear you play the violin,discover you and you will become rich and famous. This absolves humans from having any responsibility in becoming very successful.

I believe, like most experts on the subject that some  talent is necessary but that endless practice combined with a true PASSION for your subject will most likely result in a person becoming world class and recognized by other experts for their talent.

I was a dentist for 15 years before I  started taking large amounts of continuing education. After 7 years of taking 200 hours of education a year, I felt that I was competent in certain dental areas of treatment and I entered the American Academy of Cosmetic Dentistry Smile Contest, the most prestigious clinical contest in the world. I was most fortunate to win the contest in my division which gave me a significant amount of recognition and respect among my peers. Ten years after starting to study endlessly with the best in the world, I started posting my work in dental forums and my colleagues wondered who this 'new dentist' is that is showing his beautiful work.

It does not matter if you are Tiger Woods, Michael Jordan, Neil Leifer (the famed sports photographer), Frank Spear (one of the top 10 dentists in the world) or my good friend and world class endodontist, Francisco Banchs...each of these people have devoted themselves to EXCELLENCE and EXCEPTIONALISM at the task that they love and are passionate about.

Becoming world class has very little to do with exceptional talent and luck and everything to do with  PASSION, DEDICATION AND HARD WORK.

"It Was Harder for Me to Find You than for Me to Find My World Class Urologist"

A new patient presented for a consultation last week and told me that it was next to impossible to have found me. She told me that her world class urologist in Boston was much easier to find than the great dentist that she was looking for.

After speaking with my patient and performing a cursory clinical evaluation I had pretty much learned why the patient was unhappy. She recently lost a lateral incisor and then had an implant and crown placed. What bothered her the most was that the shade of her natural teeth did not come anywhere close to the implant supported crown. When I discussed this with her, the patient said that she had rejected the previous two crowns because neither one matched her own teeth.

My first question to my  patient was, "Do you know if the implant was put in the right place?" Her immediate response was amazement and she responded ," No it was not but how did you know?"

I am not sure why patients have a difficult time finding a knowledgeable dentist. I have discussed this in a blog several years ago but it may be worth reviewing this topic.

If I was looking for a top notch restorative dentist, this is what I would look for:

• A dentist with at least 1500 hours of continuing education
• A well done website with many, many clinical cases
• A statement on the website that the cases shown are actually the work of the dentist
• Photos of the office which looks clean, modern has evidence that the dentist uses a technology
• Testimonial statements by patients  and other dentists commending the dentist for their work
• Photos that show that the dentist routinely uses a rubber dam during dental treatment
• Evidence that the dentist is a clinical professor at a dental school
• Evidence that the dentist has at least one publication in a peer reviewed journal
• Photos showing that the dentist and the staff have beautiful, well maintained teeth and smiles
• The dentist participates with no insurance plans or one or two at the most

If a dentist can meet many of the above criteria, then I believe that you could consider the dentist  as
one of the clinicians that you might select to provide your dental care.

I Just Don't Understand

One of the dentists on a previous dental forum that I used to participate with  posted the following note:

We just replaced a failing Peri Pro III to do our conventional films and pans. The unit we got is an Image Max. Got the OK from Marty and gave it a try. Staff loves it and the fact that it gives us dry pans is a welcome improvement from the tanks. Very happy with it and if any other old farts are looking for a processor I would give this a look. Maintenance is very easy…all the solutions move and the film stays put.

Old dentists discussing old and potentially dangerous technology. I was one of the first dentists in the country to purchase Digital Radiography in 1995. The beauty of this technology is that there is no pollution when disposing of old chemicals, there is less exposure to radiation and the information from the x-rays are more clearly visible and can be managed better ie no film x-rays on the floor to be lost for the patient forever.

Why are these dentists continuing to use ancient technology? CHEAP is the only answer.

When will patients rise up and demand excellence from the people that are supposedly taking care of them?

I would never be treated in a dental office that takes pride in using out dated techniques, materials or technology.

Don't say that you haven't been told.

Crowns Must be Treatment of Last Resort

I have written for many years about the unnecessary and abusive use of crowns to 'protect and strengthen' teeth.

Crowns destroy healthy tooth structure and weaken teeth. Today, I cut off two crowns that I placed 18 years ago and 23 yeras ago respectively. Years ago, we had few options but to remove large amounts of healthy tooth structure to help retain a tooth in the mouth.
Alas, this is no longer true as we have many restorative techniques to conserve irreplaceable tooth structure.

What was so bad about crowns that lasted a combined total of 43 years? All dentistry and all dental materials will FAIL given a sufficient amount of time and often when the dentistry fails, the tooth has been so weakened that it is truly not worth the effort or the cost to place a new crown. This means that we are making dental implants a certainty when we place crowns in 20-40 year old patients.

Many dentists have become so used to removing healthy tooth structure for crowns that they no longer even feel badly about doing it. Dr. Richard A Powell*, Associate Dean at SUNY/Buffalo Dental School told our class on the very first day of classes that tooth structure is living tissue and that everything possible must be done to preserve it. And yet every dentist measures their 'success' by how many crowns they place in a day, a week or a year.

This is, in my opinion, both unethical and indefensable. Your dentist must learn how do place fabulous direct bonded posterior resin restorations using a rubber dam that strengthens and protects natural tooth structure. When your dentist tells you that a tooth cannot be saved with a resin, then find a dentist who is informed enough and talented enough to place well done, tooth conserving direct resins. I am in my 20th year of placing these fillings and I can tell you with the highest degree of certainty that well done resins last a very long time.


*I was the first winner of the Richard A Powell award during graduation from Dental School.

VOTE

It has been said that our military has gone to war to protect and defend the American Way of Life. That is not completely accurate. Our military went to war to defend democracy in America and central to our democratic way is the right to vote.

When we fail to vote we dishonor the memory of every soldier that defended the American Way.

When we fail to vote we give up our right to criticize the government when things don't go as we want them to.

You may not like the candidates and you may have to hold your nose when you vote but vote nonetheless.

We cannot have a sustainable democracy without you and I.

Vote!!!!!!!!!!!!!!!!!!!!