Wow!

I just completed 40 full years as a dentist. Exactly 40 years ago today, May 29,1977, I graduated from the School of Dental Medicine, SUNY/Buffalo.

I gave Susan two presents on May 29, a gold snake neckless and a gold bracelet both of which she still has and wears. As I recall, the jewelry cost about $250 which was a fortune back then but I wanted to show Susan my appreciation for supporting me during my dental school career. About 25% of the marriages of dental students did not survive the four years and for good reason...it was a lonely 4 years for spouses.

I am thrilled to have been a dentist for 40 years and my interest has never wavered: Taking care of my patients in the best way possible.  How much longer will I be a dentist? Who knows but I am not ready to leave yet.

May 29, 1977...one of the best days of my life.

A Story That You Have Heard Before

To refresh your memory, I believe that the dental treatment that removes the least amount of natural tooth structure and yet lasts 15 + years is the best treatment for that tooth. That means that a well done direct bonded resin filling placed with a rubber dam is, in my opinion, THE BEST possible treatment especially when compared with a crown which removes ALL of the enamel and weakens the tooth dramatically.

Now remember that I have told you that in my office, a patient can have 3 1/2 resin bonded fillings for the cost of ONE crown. So if I was interested in earning the most amount of money, I would place CROWNS all day long...In reality, there are many days that all I do is well done resin bonded fillings.

Now the story:

We were in Charlotte over the Memorial Day Weekend and went to lunch with one of the other condo  owners. He is in his early 70s and retired so he enjoys spending a few hours with Susan and I. At lunch he related that he and his partner went to the ocean in South Carolina and while having lunch, he was chatting with the young waiter. "Where do you live?" my neighbor asks the young man. "Upstate NY," says the young man."  My neighbor tells the young man that he has a friend who is from  Upstate NY and asks him exactly where he lives. "Saratoga Springs" says the young man. What a coincidence my neighbor says  and asks, "Do you know Dr. Benjamin, a dentist in Saratoga Springs?"

"Oh yes, he is the dentist for wealthy people and I my family is middle class so we don't go to him."

I was shocked by the young man's response. I have probably taken care of more patients for 30+ years than any other dentist in the Capital District and NOT one of those patients could be described as wealthy. The overwhelming majority of my patients  throughout my career have ALWAYS been middle class.  Yes, the last few years I do have some very wealthy patients in my practice but that is the rare exception and not the rule.

Again, a dentist does not become very wealthy conserving natural tooth structure but does so by cutting down as many teeth for crowns as is possible  and ethical.

My goal is help you and  your family keep all of your teeth all of your life. It has never been about maximizing my income.  In fact, I have NEVER had a conversation with my staff about earning more money...It just doesn't interest me.

I feel bad that my reputation is that I only treat wealthy folks.

Dental Inequality

The Washington Post recently ran a story about inequality in America with dental care a strong indication of how separate and unequal our country has become. The full article can be read here:

http://theweek.com/articles/701396/lets-talk-about-dental-inequality-america

I have identified three things that the middle class had in common beginning in the late 1950s and extending to the early 1970s:

1. The middle class ate meat every day...Prior to the late 1950-60s only the wealthy ate meat everyday.
2. The middle class sent their kids to college, also available to only the wealthy.
3. The middle class started going to the dentist on a regular basis in order to maintain their teeth. Prior to this, many folks lost their teeth by their late 20s and early 30s. This was primarily due to the fact that unions had obtained dental insurance for their members. People were tired of seeing their middle age parents take out their teeth and place them in a glass.

There is no doubt that going to the dentist on a regular basis can be a luxury for many that find it hard to pay their bills. My parents sent my sister and I to the dentist every six months and we always had our cavities filled.

So what has happened in the intervening 40-50 years?
1. Dental insurance which used to pay for 8 1/2 crowns every year doesn't even pay for one crown a year...Blame employers who don't care whether their employees have teeth or not.
2. The middle class became less interested in taking care of their teeth and more interested in having larger homes and more than 5 TVs in their homes.
3. Young adults wanted to spend their money on cell phones, cars and vacations.

None of this is a good thing. The middle class must value its health including their teeth. Pulling teeth in children's mouths is a sin.

What is the answer?

A good start is making the very wealthy pay federal taxes. Our President is not the only billionaire who didn't pay federal taxes for 20 years. Every working citizen should pay taxes so that we can help everyone afford a minimum level of dental care.

What do you think?

False Equivalency

Most people assume that a physician is a physician and a dentist is a dentist. This is NOT in anyone's best interest and certainly not in the interest of someone that is desperate for good care.

I went to a fabulous small dinner party yesterday and met most of the people there for the first time. When the person sitting next to me realized that I was a dentist, she asked me my opinion about her cosmetic dentistry.

Am I a 'good' dentist? Am I 'good' at cosmetic dentistry? The person sitting next to me has no idea what quality of dentistry that I do and yet she feels that ANY ole dentist can offer a valid opinion about dentistry.

Why is this? You all know that I try to find the best physicians, surgeons and dentists to take care of ME. I would never ask a health professional an opinion unless I knew in advance that he or she was top notch in their area of treatment. I do not believe that a doctor is a doctor and never have.

YOU cannot get the best health care if you ask just anybody to take care of you. False equivalency  i.e. believing that all doctors are the same...can kill you.

The Inside Story

Patients think that when they go to discount or Corporate owned dental offices (Example: Aspen) that they are getting the same EXACT quality of dental care that their local dentist provides but only cheaper.

Not even close.

The best dentists take care of their patients and are paid a commensurate fee for excellence. Corporate dental offices take care of profits by treating lots of people and performing the maximum amount of dentistry.

One way that Corporate dental practices keep their fees lower  is by mandating that the dentist only use certain labs that are also primarily concerned with profit rather than quality.

This article in the Dallas Morning News is about the closing of dental laboratories in Texas because Corporate and Insurance based dentists are forced to use overseas labs.

https://www.pressreader.com/usa/the-dallas-morning-news/20170511/282458528877540

If your insurance company doesn't care about quality...and it doesn't
And Corporate Dental Offices don't care about quality

Then who is going to care about YOU?

There is a fine line between maximizing profits and providing great care to your patient.

In our office taking care of our  patients is our primary concern.

115 Years is Nothing

This past February, I wrote a blog about about three patients that had been my patient for a total of 115 years. Well two weeks ago, we saw 9 patients in ONE DAY each of whom had been in our office a MINIMUM of 30 YEARS. All combined, the total time treating these patients was about 300 YEARS.

Also, last week, one of my patients told her physician that she had an up coming dental appointment. The doctor asked my patient who her dentist was and when my patient mentioned my name, she also said that I had taken care of her for 33 years. The doctor was stunned that a patient would stay with the same dentist for more than three decades.

I am so honored to have cared for thousands of patients for a very long time. It speaks volumes for both you and I. I care for you and you care about me.. We are both very lucky.

My Staff

Everyone knows that I believe that I have the best staff...The most knowledgeable, the most caring of our patients and the most loyal. I believe that it is my job to be the best  employer  that I can as well as trying to be the best clinician that I can (Please note Dental Societies: I did NOT say that I was the best dentist.)

We do our best to function as a well oiled machine. More importantly we do our best to be a family. This means that we have great concern for each other.  I care for my staff and they care for me; and we all care for our patients.

We saw two new patients this week that came to our office after they met Trish, our hygienist, while she was shopping in the stores where they worked. They were both impressed by how Trish enjoyed working in our office and how highly she spoke of the level of dentistry that we provide.

Both patients were truly excited to become one of our patients.

This is what our office strives for. We all LOVE what we do and we try to do the best dentistry when we take care of you.

Our office is not for every dental patient and we know that. Just as my staff and I believe that our office is special, we also believe that our patients are just as special. You all have an understanding that quality dentistry is important and that you will search, research and investigate until you find a dental practice that meets your needs and expectations.

My staff is a large part of providing excellence in order to meet your needs, wants and expectations.

You Don't have to Be a Dentist to See the Difference

A young man of 23 became our patient a few short months ago when he said that he heard good things about our office and recognized that his current dentist was not meeting his expectations.

I replaced all of defective fillings with beautiful bonded resins and he was thrilled. However, his main concern was replacing a porcelain fused to metal crown that was recently placed by one of the Corporate Dental places.

Yesterday, I removed the crown, which was ugly and  had already failed because the porcelain was chipping off the crown near the gum line. This is what I discovered:

So what happened to the rest of the tooth? Did the dentist break off the rest of the tooth when removing the temporary crown????  Or is this how the dentist found the tooth from the previous dentist? Oh yes...I was placing the THIRD crown on this tooth for a 23 years old.

When I finished preparing his tooth, this is what the tooth looked like:

I know that the majority of readers of my blogs are NOT dentists  but it must be clear to you that  how I prepared my patient's tooth is a beautiful work of art (That is what my eyes see). When I removed the crown, the gum tissues were purple and inflamed  because the metal in the crown was low noble or non noble so that the dentist can pay less to the dental lab for making the crown. Look how healthy the gum tissue is simply by removing the old crown

You don't need to be a dentist to see what quality dentistry looks like.

Cost, Value and Caring

I saw a patient today that has been in my practice since 1998 and between that year and 2004, I restored her entire mouth. This patient was working with the State at the time and used one of the "State" Dental Clinics in Albany for her dental care. She was used to having 'constant care' which means that a filling was put in last year and replaced again next year. And I remember that she thought that I was expense by what the "State"Dentist Clinic charged.
Over these past 20 years, my patient has developed an understanding of what our practice is about: Providing the best possible care that we can and have our work last for as long as it can.

Several months ago, I diagnosed a small, new cavity on the root surface of a tooth that was not related or connected to any of the restorative dentistry that I had provided to this patient. On the day of the appointment to place a new filling, my patient said:

"You know, this is the first time in 15 YEARS that you have done any work for me."

FIFTEEN YEARS!!!!!!

Some people believe that our practice is  expensive but I have to ask you, "How expensive can our office be when you only pay for treatment (other than cleanings, x-rays and exams) ONCE every 15 years?"

I hate replacing my own work even when the work has lasted more than two decades. I truly believe that the longevity of our work combined with our care and concern for our patients is truly a great value.

Given the fact that I have 100s of patients that I have cared for for more than 30 years, many of you must agree with my staff and I.

As always, we thank you for being our patient and trusting us.

(Aside: I told Laura that I would write a blog about her)