I’ve been acting like a dental pick for a couple of years now doing some serious digging in the world of professionals that care for teeth.
There appears to be an illness in the dental industry. This disease in the oral care world has turned a regular dental office into a potentially dirty business.
It has everything to do with marketing, need and even some greed. But wait, there’s more! A brazenness has swept the land and entitlement is leading the way.
As Americans, we are told we can do anything, right? We’ll get back to that one later.
We need to start at the beginning to understand how far the world of dentistry has come.
Notice how in every commercial aircraft there are flight magazines and in almost every magazine there are at least one or two full page ads from dentists, promoting themselves as being “the best” in their city.
Did you know that years ago, it used to be ILLEGAL for any dentist to ADVERTISE their practice?
It was not only illegal, but considered completely inappropriate, unprofessional, unethical and even immoral (back when being moral was a thing to be) to fish for patients via any type of media (which was extremely limited back in the day). The only type of ad a dentist was allowed to run was a small ad in the Yellow Pages, which stated the name, address and phone number of the dentist. That was it. And even the size of the letters in a Yellow Pages ad had restrictions.
There certainly was not a dentist on every block back in the day, and a dentist could graduate from dental school and begin to practice, having a nice income shortly thereafter. No dentists were getting ultra wealthy, but a dentist was basically guaranteed a comfortable living after graduation, whether he was a good dentist or not.
Fast forward several decades to a world of overwhelming student loan debt and a society of people who are more concerned with displaying a particular ‘lifestyle’ and taking trips, eating in fancy restaurants and making their Instagram flashy for all to see. Tuition in dental school and other expenses leaves a majority of new dentists with $200-$300K worth of debt the day they graduate. And that’s assuming they don’t already have significant debt from college, which many of them do.
Many of the dentists come out of dental school and immediately not just want, but actually NEED to make big money right away so they can make their massive monthly student loan payment.
There is only so much money in filling cavities and pulling teeth. The big money is in procedures. The procedures that specialists do, not dentists, are the big ticket items. Think dental implant surgery.
I won’t get into the politics behind this latest movement, but what is happening now and is most frightening, is that main stream dentists, with little or incomplete training (not even having any experience seeing patients after surgery), are performing surgical procedures that traditionally only specialists/surgeons performed. And it’s happening because these dentists are desperate and legitimately need money.
The current politics allow for any untrained dentist to perform surgical procedures without the appropriate experience, and the patients have no clue. They trust the dentist and never think to ask about their experience in a specific procedure. What most patients think is, “Why would a dentist perform a procedure they are not proficient in?”
There are numerous dentists actually performing surgeries and placing dental implants who should not be. It’s quite scary because once a dental procedure goes wrong, it seems like it will never end. Ask anyone who has had bad dental work done. As one dental specialist put it, “They [dentists] graduate having never even seen a surgical post-op, let alone having performed a surgery, learning the ins and outs.”
A top periodontist in the US told me that when he attended a WEEKEND continuing education course a few years ago to refine his skills, almost 100% of the participants in the course were general dentists. This continuing education course was for SPECIALISTS. It was a refresher course, you know, to brush up on their surgical skills. But the general dentists were there learning about implant procedures, for ONE weekend, and then going back to their practices and performing the procedures. Learn along the way and use patients as guinea pigs must be the thought process here. Or maybe, I can do anything you can do better (even though I’m not trained).
It’s a terrible situation. I understand the stress of having to make money to pay bills, but I also know that in ANY business, there are the long grinding out hours and starting a new practice means working for a smaller paycheck for a few years. This is not appealing to an instant generation. They want it all now. They really need it all now because of the debt. Dentists need these high ticket procedures to make more money.
New dentists and all dentists for that matter (competition has become fierce), are in a desperate situation when it comes to generating revenue. The millennial generation is drawn toward group practices where everything is ‘in house’. This means they can keep all of the dollars in their practice.
Why refer to a specialist who is an expert at a particular procedure when dentists can ‘wing it’ and bag the cash themselves?
The only thing that can be done now is educating the public about this unfortunate reality. No dentist should be performing specialist procedures unless they are in fact a specialist and have trained for it. Remember, a specialist goes to school full-time for a minimum of 3 years AFTER graduating from dental school. If a general dentist wants to go back to school for another 3 years to become a specialist, that’s great. They will get the necessary experience and perform the procedure correctly. What you don’t want is a general dentist performing a procedure they learned in a weekend course rather than in a full-time, multi-year specialty program.
When getting work on your teeth, you have to do your due diligence and ask questions. Do not be intimidated! If they don’t like your questions, then maybe you don’t want to be treated by a dentist who can’t handle questions about their experience. There is another dentist around the corner now.
Your teeth are meant to last a lifetime, but if teeth or gums get into problems, consider the permanence of any dental work, good or bad. Once a tooth has been violated, there’s no turning back. It is absolutely a forever thing. Protect your teeth. You get only one permanent set!