Personally tailored dental treatment options

Dr Stevens discusses dental treatment options with each patient.

This week on Facebook, I read a post from a member of an online group of which I am a member. This was a post from a mom who had taken her daughter to a dentist for basic dental work.  During this appointment, there was some sort of malfunction of a piece of equipment used by the dentist, the daughter’s lip was slightly burned, and the mom turned to this Facebook group for advice on what to do.

I have done similar things myself…when something happens and I need help, or an opinion, I have been known to also turn to Facebook and other social media sites…as do many others! This mom’s call for an opinion wasn’t necessarily what this blog is about. It is more about some of the reactions of the other group members. “Contact the dental society and make a complaint” was said by a few. Now…some of those group members may be reading this, and my goal here isn’t offend anyone at all! However, this is a trend I see in so many aspects of our lives…the immediate desire to find blame and punish.

I can speak for all dentists and doctors for a moment. We all go to school for a long time and work throughout our careers to provide the best possible level of care to every single patient we see. I can say this without a doubt about the majority of people in medicine and dentistry. Are there some bad apples? Of course…that sadly happens in every single business and profession in the world. What I find the most frightening is this immediate knee-jerk reaction that “the evil money-sucking dentist” is looking to make a quick buck from each and every patient, and they should not be trusted!

So sad that this is where we’ve arrived in the field, in some part due to various bits of “investigative journalism” comparing treatment plans from 10 or 20 dentists, including “experts” from universities. In case you don’t know what I’m talking about, a journalist a few years ago from Reader’s Digest went to 50 dentists across the United States to see what types of treatment were recommended.  This treatment ranged from virtually no treatment at all to tens of thousands of dollars worth of treatment. Naturally, the dentist recommending no treatment was deemed “the most honest” and the others were denigrated in the article.

After more than 20 years in practice, I am fully aware that what every single patient coming into my office wants to hear is that they are perfectly healthy and need no treatment. I’m the same way when I see MY amazing dentist! And it’s only natural to be happy when “nothing is wrong” and distrust any recommendations, especially when we don’t arrive at the appointment believing we need treatment! There is an incorrect belief that if something is wrong in our mouths, we will have pain. In some respect, I wish this were true, because then at the slightest downturn of dental health, patients would run in for treatment that could be simple! In fact, most dental disease (early decay, sometimes moderate or severe decay, and gum disease) most often cause NO PAIN AT ALL, and therefore occur without a patient’s knowledge. Frankly, that’s a shame, because by the time there’s pain, the problem is often significant, and expensive, and may not even be able to be fixed.

Our diagnostic ability now is so much greater, and at the same time more involved, even then when I graduated from dental school more than 20 years ago. Digital X-rays are fast, easy, and each one has less radiation than eating 2 bananas (yes, there IS radiation in a banana!!), while a “full series’ of X-rays contains less radiation than a plane ride from east coast to west coast. Also during the last number of years, we now have lasers that can find a cavity just as it’s starting, before it shows up in an X-ray, before your dentist can feel it with an instrument in your mouth. We can then treat this cavity in its earliest stages, being more conservative. In our office, as in some others, we even use a laser to fix the cavity! Bleeding gums at any time are a sign of infection, don’t let anyone tell you it’s normal just because it’s common. We can use water-spraying instruments, lasers, and sometimes even little bits of antibiotics placed between your gum and teeth to clear this up. Bleeding should never be accepted as okay.

Do all dentists treat this proactively? No, they don’t…some don’t know about the technology available, some honestly don’t want to buy the equipment to do this type of treatment (all VERY expensive to own), and so they treat their patients the best they can with what they have and know. Are they bad dentists? NO! They are doing the best treatment they feel they can at that time. Does this mean that EVERY patient I see gets a $60K treatment plan from me (and yes, that’s a possibility!)? Absolutely not…and frankly, even if in my PROFESSIONAL opinion a patient would be best served by lots of dental treatment, in the end it’s a patient’s choice to make how they would like me to treat! However, whatever kind of plan for treatment I give a patient, the most important part is that each patient understands WHY I am recommending that treatment–this was the missing element, in my opinion, in that Reader’s Digest article.

Let’s get back to this mom and her daughter. Like many other problems when any kind of consumer pays any type of business for what they do…when something goes wrong (which does happen because we are all only human), the most important thing is good communication and a foundation of trust. If this situation had happened in my practice, I would hope that this mother would turn to me rather than social media. If this happened in my practice, I would be thinking about it, I would feel terrible that it happened, but I would feel worse if this patient didn’t feel she could trust me enough to talk with me about it.

Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!