I was a little curious, so last week I posed a question on my personal Facebook page for my non-dental friends to answer.

Should dentists tell you everything the first time you meet?

This is a question I asked on Facebook recently about dentistry.

Why did I ask this question? It’s easy to be someone’s first dentist, or only dentist, but complications can arise when patients transfer from another office to ours. Patients come to see us for a variety of reasons: move to a different city, previous dentist retires/don’t “like” the “new dentist” in the office, poor customer service…the list goes on. What has seemed a constant for us is the patient who adored their previous dentist mostly because “he never found anything wrong!” Many dentists who were trained a long time ago without the benefit of good-quality continuing education learned to “watch-and-wait.” This treatment philosophy was born in a time when the solutions for dental problems were “drill and fill” or “pull it out”, but we have MUCH better options available to us now and the ability to treat teeth more conservatively as well as keep teeth longer. In fact, since we are living longer lives, the importance of keeping our own teeth for a lifetime becomes that much greater.

I will often meet a patient for the first time whose teeth look like this picture below:

Do these teeth look healthy?

Photo of a new patient’s teeth

This patient is 55 years years old, and has been regularly attending a dental office for many years, every 9 months. Each time she leaves, the dentist says “those fillings are getting a bit worn, so we will keep an eye on them for next time.” There has never been a next time. Eventually, this dentist retired and closed his office and she became my patient. I’m sure even those of you reading this without the benefit of a dental education can see…problems. The patient didn’t “like” the staining, but couldn’t see it when she smiled. She didn’t “like” the silver fillings, but they didn’t hurt. And really…she didn’t “want” to spend any money on her teeth. She had other things to spend money on…a car, a pool in the backyard, vacations. And I don’t mean to be crass…her dentist NEVER TOLD HER about the DISEASE present in her mouth. Not once. Now she is my patient. I told her lots of things I see, and we even looked at this photograph together. We talked about the bone and gum loss, about the staining of the roots of her teeth, about the corroded old silver amalgam fillings with cavities underneath, about the tipping and shifting  of her back teeth due to the early loss of a molar. Just like I would talk to every patient about what I see, and what the possible consequences could be, what I’ve seen based on more than 22 years of experience as a dentist. I can tell you from experience that some patients are frightened when they learn of previously undiagnosed dental conditions, and some even think I am making things up!

Now read some of the responses I received to my Facebook question below:

Patients want to know everything about dental health.

Some of the answers I received to the questions asked about sharing everything I notice at the first visit.

The interesting thing you can’t see about all of the Facebook responses is that they often continue with “tell me everything you see and I will do what I need to do.” I can tell you, based on lots of years of diagnosing that this isn’t the case! Often “need” to a patient is also related to “what my insurance will cover” or fixing something that hurts or fixing a tooth that is broken. I understand that finances can be a concern, and that dentistry is “expensive”. What can unfortunately be more expensive is…watching and waiting. Waiting for it to break. Waiting for it to hurt. Waiting to lose that tooth…and then another one…the beauty of modern dentistry is that there is so much that can be done conservatively to manage disease and maintain teeth for a lifetime! So the next time you visit your dentist, ask her to show you anything she sees that may be not healthy in your mouth, and get serious about taking care of the problem. If necessary treatment costs more than you expect, most dental offices will work with you on the plan that makes the most sense to achieve your best dental health.

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 drandreastevens.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.