I have found through my course of years being a dentist, that the best of technical (preventive, esthetic, functional) care can only occur within the confines of a sound relationship. I have never seen excellence in dental treatment from an HMO type or insurance panel practice. There is simply not time allotted towards the development of a relationship. Dental procedures many times are performed by different dentists – dentistry is seen more as “units of work” to repair the results of dental disease rather than a treatment plan looking at the bigger picture including preventive and excellence in esthetic, functional and restorative technology. When dentists sign up with these plans, they have to accept their scant benefits for most all dental procedures. This induces the dentist to work faster and use cheap laboratories to fabricate their repairs/and teeth replacements. A talented, passionate dentist may need to start out in this type setting, but s/he wouldn’t stay there long, as this type philosophy does not support excellence in preventive and clinical care.
A sound relationship involves trust. Trust usually takes time - time to get to know one another, and time to discover the cause of the needed/desired treatment. Also to prioritize the mutual responsibilities involved in an oral health plan that will be successful over time. Also, for this type of care to occur, the patient must have a high interest in having the job done correctly. I have found in dentistry, unlike a valve job on an automobile, that a proper equation must consist of the patient caring about this at least as much as me. Caring enough to desire knowledge about the reasons for the treatment need and how to prevent it from recurring in the future, which is imperative in sustaining the longevity of the treatment.