How to Choose a Good Dentist

Our mouth is one of the most tender parts of our bodies, and we feel vulnerable letting someone touch it. The mouth is a mixed bag because it is a source of both great pleasure and if infected, extreme pain. Therefore, confidence and trust are musts in your dentist for patients to feel comfortable and accept treatment. But how does one determine if a dentist is a good clinician?

First, let’s open the communication lines. Talk to your dentist and ask questions of him or her and their staff. Get a feel for what their practice philosophy is and see if it matches your own. Dentists are not like medical doctors. They usually are more personable because they have greater time allotted for each patient, so get to know yours. Patients in my office usually see me first for an initial consultation before they even reach my hygienist. They get an office tour, meet my staff, radiographs are taken, an initial periodontal screening is done, an oral cancer Velscope exam is completed, and a treatment sequence is planned. Dentistry is a highly reimbursed field so look for quality of service and a staff that takes its time.

Look for a clean office. Ask about sterilization techniques and make sure that they meet OSHA requirements. Remember that dentistry always has new and evolving technology, so check to see if your doc uses such equipment. Consider dental radiography, which even in the traditional form has far less radiation than any medical scans. A full mouth series or FMX has eighteen xrays but contains 56,000X less radiation than an upper GI, 800X less radiation than a chest xray, and 40X less exposure than what a person is exposed to throughout his day. Digital radiography has an 80% reduction in radiation exposure on top of the figures I listed above, and I believe it to be a must in a modern practice. Digital xrays produce an instantaneous image without the use of processing chemicals and enable far superior diagnostics for the clinician. Infection is diagnosed in its beginning stages, and treatment can often be kept conservative saving the patient money, time, and pain.

Another important diagnostic tool to look for is the presence of a thorough periodontal screening system to diagnose gum and periodontal disease. Remember that bleeding gums during flossing and brushing is not normal and are signs of infection. The bacteria in gum and periodontal disease can enter your bloodstream through damaged vessels in your gums. This bacteria produces toxins that increase a patient’s risk for stroke, cardiovascular disease, insullin resistance, lung disease, and stomach ulcers. Your mouth’s health is very much linked to the rest of your body’s overall well being,  and so your dental hygienist should be probing six surfaces around each of your teeth to check for pockets and inflammation during your check-ups.

Oral cancer is another concern. It is important to have a complete oral cancer screening performed once a year. Your dentist will check your head, face, neck, and mouth for any lumps, bumps, or unusual sores that do not disappear within two weeks. Current statistics from the American Cancer Society state that 25% of oral cancer sufferers neither smoke nor drink and their five year survival rate is about half. Those are scary numbers. Therefore no dental exam is complete without a yearly oral cancer evaluation. In our office we use the Velscope Oral Cancer Screening System. This machine emits a safe flourescent light that penetrates the tissue through the epithelium to the basement membrane, the area where most oral cancers start. Abnormal tissue does not flouresce and appears dark. Normal tissue flouresces green.  While the Velscope does not diagnose cancer, it is an excellent tool that aids in identifying premalignant change. Its light reaches where your eye cannot. So if there is dysplasia present, we no longer  have to wait for it to spread through the epithelium and into the mouth to detect it with loops. The Velscope will detect these changes in its earliest stages when treatment can be most successful.

Also important are your dentist’s cosmetic skills. There are many beautiful and lifelike restorations available for patient care. These include porcelain crowns and veneers, cerinate veneers, all porcelain bridges, implants for tooth replacement, cosmetic bonding, invisable braces, and deep tooth whitening.   

Other excellent dental equipment to look for in a well equipped office include a diagnodent early caries laser detector, an intraoral camera that shows patients what clinicians see, and a CadCam Cerec unit. The Cerec stands for Chairside Economical Restoration of Esthetic Ceramics and is manufactured by Sirona Dental in Germany. It is truly an awesome technology that provides same day porcelain  restorations. That means no 2-3 weeks in a temporary, no impression, and no return visit. The cavity preparation is scanned with an intraoral camera and stored as a 3D digital model in the unit. The doctor then refines the model using 3D CAD software and then a milling unit actually carves the exact restoration from a solid block of porcelain. Crowns, onlays, and inlays are made this way and are then cemented into a tooth. I have been using this machine since 2005 and I am still in awe of it, as our my patients. They love to watch the design and artistryof it, and many of them say that the enlarged images look like clouds, mountains, and toes. Use your imagination.

So to summarize, look for a clean and technologically advanced dental office. The doctor and staff should be current with changing dental technology which indicates that they strive to excell, educate themselves, and provide high end service to their patients.  Find a clinician who you connect with, who you are comfortable with, and who you trust. After all a good patient-dentist relationship will last decades, and you will likely bring those you hold dearest to them.

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