Michael C. Goldman, DDS
How Honest Are                    ......Dentists?
response to......a 1997 Reader's Digest Article..or..

a Modern Dental Consumer's Choices
The Plot
In a February 1997expose in Reader's Digest (page 50), a Mr. Ecenbarger set out to do a story on what might happen if a patient were to go to awhole bunch of different dentists and ask each one, "Doc, what do I need .....?" In each case the dentist would know nothing of the other "consultations".  
What do you think happened - because Mr. Ecenarger did just that? In fact he went to 28 different dentists! Well, consider that question a moment. For many, if not most of us, the first reaction might easily be that all the dentists should have recommended about the same things, right? Well, guess again!
When this article first came out it ruffled a lot of feathers within - as well as outside of - the dental community. Mr. E was given treatment recommendations that ranged in complexity and in cost from the simplest - and least expensive - to the very complex , and, yes, you guessed it, that was spelled - m o s t e x p e n s i v e ...
Mr. E wrote about this set of experiences in a sensational and negative (to dentistry) manner. His suggestion was his "investigative reporting"   proved that dentists could not be trusted and that they were out to hoodwink the unsuspecting public out of their hard-earned dollars. After all, dentistry is about fixing things that are broken and diseased, right? And how could something be ok in one office and broken or diseased in another? It does seem a reasonable question.  Unfortunately the report was too shallow....
The Problem
The problem here, in my opinion, is that Mr. E was working with a paradigm of healthcare that was about two or more decades out of date  with reality. In the past, dentists did little else than fix up the rapidly advancing deterioration of decay and gum disease and neglect. That is, to use politically correct language of the 90's, they were primarily reactive.
In more recent times dentistry has advanced very far by comparison. Not only can we most often repair damage due to disease and wear-and-tear, but we can usually do a great many things to prevent breakdown that we associate with aging and disease. That is, we can be pro-active.  Not only can we largely prevent normal break-down, but we can often reverse it by using cosmetic dentistry techniques. Cosmetic dentistry not only repairs teeth and gums, it restores them. That is, it not only "fixes" the problems, it restores the more youthful structural strength and appearance to the teeth and gums.
Why did I head this part "The Problem"? Why would this be a "problem"? Well, it's a problem of sorts in that different dentists work with different paradigms. That is, some just do a basic "fix it if it's broke" kind of approach, while others "fix it and do a little preventive work". Still others not only try to "fix it" but try to reverse the ravages of time by using preventative and cosmetic dentistry techniques.
People vary widely in how they value dental health and appearance. You may think that to be a strange idea...you may be inclined to think everybody wants to be healthy and look good. Well to a degree that is correct, but just look around you. You will see many people -rich and poor - that have had a lot of dental treatment to try to stay healthy and youthful looking. You will undoubtedly also see many people - rich and poor - that are in obvious need of very basic dental care that they have avoided for a variety of reasons. True, sometimes it is lack of finances. But there are school clinics and other ways to get help if money is the problem. Most often these people talk about fear or lack of time or just not caring...what it comes down to is that these people just don't value dental health as highly.
Go into a low income home and you may find a lack of many things, but there will most likely be a big color TV there. Why? It's highly valued.
Dentists are just people, too. What they value is what they do. Dental practices after the first few years begin to take on a certain character. They begin to cater to the public at a certain very definable level, sometimes at the bottom or top, most often somewhere inbetween. After a while they seem to have attracted a certain slice of the public that is comfortable with that level of care. It may not be thought about consciously, but it does happen. In the same way, if someone comes to me and wants a "filling", and I tell him or her that I only do cosmetic fillings that have this and that advantage, but costs more than a "silver filling", that patient just may go elsewhere to get a less expensive silver filling. Over the years, however, I have attracted patients that value natural looking, high quality dentistry. The funny thing is that in early years when I did the lower cost "silver fillings" patients never said "Wow!" and "thank you" the way they most often do now. We share a value system
The Solution
The Reader's Digest article, as I said, upset a lot of dentists....but not me. I think it was unfortunate that the author chose to be shallow and go for shock - (shlock?) value. He could have really done the public - and himself
and dentistry - a real service. (You see, authors also vary in their value systems, just like dentists and the rest of us humans...). He could have done a little more research and shared that much of healthcare now is optional and is geared to improving the quality of life, not just maintaining life.
We no longer want to live to an old age in a wheelchair or nursing-home bed, but rather as active, and more fully alive independent people. Similarly most of us are no longer satisfied with the idea that false teeth are an automatic part of getting older. We know that doesn't have to happen, but it takes some work for many of us to prevent it from happening. All aspects of healthcare - medical, dental, traditional as well as alternative - have many skills and techniques to help us maintain not just life, but life at a more optimal quality.
That's why I try always to ask patients "what can I do for you?" I need to know what you want...what you value. Hopefully I can find the place where what I value in dentistry coincides with what you value.
The days of healthcare providers telling patients what must be done are over! Let's work together as a team!
Let's talk about it....!
This pamphlet was written in the hope that it will increase understanding about a topic that seems important from time to time. Obviously it is only a part of the whole story, so if you have questions after reading this please do not hesitate to ask or call. Also, if there is a topic that you think would be helpful, please suggest it.

Michael C. Goldman, DDS
General and Cosmetic Dentistry
3815 East-West Highway
Chevy Chase, Maryland 20815
Phone (301) 656-6171

      
More info about the following is available  if you select  "topics".
Holistic dentistry is an approach to dental treatment, primarily  caring for  patients' health and safety from both a conventional as well as  "alternative healthcare" point of view.   It is sometimes called "biological" dentistry or "biocompatible" dentistry.  In it's fullest sense, I believe it   acknowledges and deals with  the mind, body and spirit of the patient, not just his or her "teeth".  See Topics / Info.....
Cosmetic dentistry is about doing   quality , esthetic dentistry in a way that looks natural to begin with, and furthermore,   can even  improve  one's  attractiveness through techniques such as bonding, bleaching, veneers, caps, implants and more.  It can   be like "instant orthodontics" in correcting  crooked, twisted or misplaced teeth in many instances.  Dark or mis-shapen teeth can be restored.   Smiles that lack youthful vigor or beauty can be revitalized! See Topics / Info..
In holistic dentistry there is an effort  to find  biocompatible materials to use to reduce toxicity for  everyone, especially the chemically sensitive.  Amalgam use is avoided   in holistic dentistry (" amalgam free" or "mercury free") due to concern about possible toxicity problems.  Amalgam removal  and replacement with natural-looking bonded materials is a common holistic dentistry treatment as well as a common cosmetic dentistry  treatment.   Detoxification, especially of residual mercury deposits in body tissues from amalgams is often done.  Root canals are controversial  in holistic dentsitry and are discussed under topics.  And much more....
Bleaching, veneers, bonding, caps, bridges, and implants  are cosmetic dentistry treatments that are also  discussed in  Cosmetic Dentistry, and more...