I pride myself on being a perpetual student of the profession I’ve chosen and have grown to love. Upon graduation from dental school, I had no clue about the important influence of oral health on the entire bodily system, nor how an improper relationship between the teeth, jaws and their joints could be a significant factor in someone developing migraine headaches, vertigo and head/neck/facial discomfort. We spent years learning about human body structure through studying Gray’s anatomy and cadaver dissection of muscles, ligaments and nerves, but nothing about how they were all supposed to work together in harmony and what could happen if they didn’t. It took many years of seeking out the right educational opportunities and keeping abreast of the many advances within and outside of dentistry to come to fully understand these mouth-body relationships and to gear my practice towards offering effective treatments for these unique dental problems. These learning adventures have been instrumental in the development of my Dental Wellness Center, with its core mission of educating patients about the status of their entire oral system and its relationship with general health so that they can make informed decisions about their dental treatment (future?).
One of the most important components that came out of my continuing education, one that has become foundational to the premium care that the Wellness Center has to offer is the development of the co-diagnosis, or New Patient Interview* and clinical examination appointment. This unique co-learning process involves not only performing a thorough oral examination, but also taking the time to get to know my patients and listen to their dental concerns so that I may discover things about them that will influence their dental treatment plan and ensure its success. Another aspect of taking the time to get to know and learn about my new patients is that it allows for the development of trust,** an essential aspect of the dentist-patient relationship and critical to delivering the best quality dentistry to people over the long-haul.
One of the ironic things I discovered during my pursuit of continued education, is that the more I learned and the more time I gave to patients to provide education and individualized care, the more difficult it was to fit it into the mold of third party insurance companies. Unfortunately, the insurance companies do not acknowledge benefits for educational and customized dental services that serve the uniqueness of each patient, so I like many other dentists had to face many challenges relating to this, since it seemed to go directly against the goal of offering excellence in dentistry. The following is an overview of some of the big challenges that dentists are faced with from the very start based on my own past experience:
Through many of my new patient interviews, I hear repeatedly of an increasing distrust of the dental profession – more so than ever before. As I’ve written in previous newsletters, traditional dentistry is more about repairing the effects of dental disease such as teeth repair, their replacements and cosmetics. Our primary focus is on determining causes rather than effects. I am hearing almost daily from new patients about how their previous dentist(s) “seemed to be just looking for work to do,” or “dismissed my concern about receding gums.” Sadly, there are reasons for this that go all the way back to dental school. Although dental school has us learn about the various components of the human body via courses in dental and general anatomy, biochemistry, etc., the main thrust has to do with the development of our dexterity in teeth removal, repair, replacement, etc. Since these are the procedures that pay the bills, all dentists must contend with this after dental school because today they are faced with debts well over $200,000, not including the four years of lost income while in school. Adding to the mix is that especially nowadays, in order for the dental school graduate to acquire patients, they are very compelled to contract with dental “insurance”*** companies, which places them on a provider list from which they receive a much needed flow of new patients.
I did this right after graduation as it was "the thing to do.” This pattern remains true to this day, as I know of no dentist in or out of my area that has not contracted with insurance. In terms of providing excellent dental care, however, this is a problematic situation. It places the dentist in a position of turning away from this idea of customized care towards recommending contracted services that the insurance companies refer to as “LEAT,” or “least expensive alternate treatment.” This is a benefit payment schedule solely based upon the dentist’s zip code, not upon the uniqueness of each patient, the dentist’s innate ability, added expertise from training after graduation or personal ethics. And there are absolutely no benefits for the time-required measures such as patient relationship-building or preventive teaching and coaching. It is interesting that dental insurance started in the 1960’s and their annual benefit dollar amounts remain exactly the same as they were fifty years ago! This creates the frustrating reality of enticing many people to base their entire dental care upon the limited benefits offered by a dispassionate, uncaring 3rd party.
This also created a huge fork in the road for me as a young dentist, and it brings me back to the day I made one of the most important (personal and) professional decisions ever in my path of continuing education - that of rescinding my 3rd party insurance contracts early on. This was risky, and done at great financial peril not long after graduation when I was deeply in debt like most other dentists. I realized then that if I really wanted to treat my patients like family and offer premium preventive and treatment care, I couldn’t do so under the influence of a 3rd party that knows nothing about the uniqueness of each of my patients. I was actually willing to leave dentistry at one point over this dilemma, if I couldn’t make it work outside the reins of the dental insurance system.
Well fortunately the risk paid off, as over time I was able to develop a patient base of people seeking the kind of individualized care that my Dental Wellness Center offers. My practice is a good example of one that has managed to thrive in spite of the obstacles dentists are faced with today, because we have strived to protect our core values and keep the focus on our main priority - our valued patients and their unique needs. Although I didn't realize at first that the pursuit of continued education would have so many twists and turns, forcing me to make some big decisions along the way, it has been well worth it – (a sort of forced character building experience?). Thanks to the great number of patients that value what we have to offer, The Dental Wellness Center has evolved to its position today of growth by leaps and bounds, offering a rare combination of health-centered services. Time is valuable and we want to use it in a manner that supports our mission of learning alongside each of our patients and set a path that will allow them to have exactly the dental health and ongoing care that they would wish for.
* Access “New Patient Interview” in “New Patient Info Center” on our website
** Access “Trust” article “New Patient Info Center” on our website
*** Access “Dental Insurance Misnomer”