I received a bad review this week on Google+. Well, not a terrible review, but certainly not a positive one. And yes, it bothered me as a business owner whose team works really hard every day at providing the best possible service to our patients. What did the review say?

“Expensive. That’s all!”– demn demnovich

So why would I highlight a bad review in this blog? Wouldn’t it make more sense to try to bury it with other, glowing reviews? Let me explain…

 Expensive. Dentistry is expensive. Yes, I suppose that’s true. Why is it so expensive? Let’s take, for example, one crown (what you may call a “cap”.) In our office, we currently charge $1500 for a crown on a back tooth. Here’s how that breaks down: I typically remove any old filling material in a tooth to ensure no cavity or bacterial leakage is underneath, unless I placed that filling myself recently. Then I replace some of that material with new, freshly-bonded material, and the fee for that part is $320. There is a fee for me to prepare the tooth to receive the crown: I freeze the tooth with a computer-assisted dental freezing called The Wand, I take a pre-impression of the tooth so I have a guide for a temporary crown, I change the shape of the tooth to make room for the ceramic material, I manage any gum bleeding with special medications, I make an impression of the changes I’ve made as well as of the opposite jaw and the way the top and bottom teeth meet so the final crown will chew properly, I record the color of the existing tooth as well as the color of the desired crown to match the surrounding teeth, I place a temporary crown and assure it fits properly in the bite. The fee for all of those actions is $845. The high-quality dental lab we use charges us $335 for a non-metal highly-esthetic crown. We usually reserve 1.5 hours for the first appointment, and 30 minutes for the second appointment to remove the temporary crown, try-in the final crown and check for fit on the tooth, fit between the teeth and in the bite, and color matching. If we are all satisfied with those, I bond the crown in place using a series of chemicals made especially for this treatment.

Are you exhausted just reading all of that? It describes every single day of my practice! So essentially, for a total of two hours of my time, a patient pays me $1165. Out of that amount, I pay my fantastic chairside assistants a salary, I buy the anesthetic, the disposable device to deliver it, the two different types of bonding materials, the two or more different kinds of filling materials, the three or more chemicals I use to make everything work. There are impression materials and the disposable tips to mix them. Don’t forget all the other bits and pieces I use which are disposable and need to be tossed out, and even some of the items which can be sterilized, but only a certain number of times. I also pay someone to answer the phones while we are doing this, submit everything I’ve done to your insurance, and fight with your insurance when needed to help you get some kind of rebate for this healthcare. Then we have rent, heat/air conditioning, water, wear and tear on the big equipment we use. I also had 8 years of formal education after high school to do this work, and I pay for approximately 200 hours of continuing education each year to update and upgrade that knowledge, and my team also participates in about 75% of that continuing education on my dime. Most dental offices work at between 60-70% overhead, which means after I pay for all of those things…I earn $349.50-$466 for two hours of work which is both mentally and physically demanding. Is it still “too expensive” for the value?

So here’s the biggest personal kicker from that online review. That patient didn’t see the value in the service I provided, and didn’t give me feedback so I could improve. He or she even left an anonymous review so we can’t follow up and see where we went wrong in his or her eyes. Maybe this particular patient doesn’t see value in dentistry altogether, which is why he doesn’t have value for what we attempted to provide. Maybe we miscommunicated something, didn’t follow up on something. We will never know. If I have a bad experience somewhere (doctor, restaurant, anywhere) I will often contact a manager or owner to let them know of my concerns. You can always tell the best businesses by the type of reaction to this contact…the excellent ones are grateful and usually willing to do what they can to remedy the problem and encourage me to return, give it another try. And when I can, and it seems appropriate…I do. My other practice is to give online kudos freely to any business I use as often as possible; if I’m satisfied, each business owner should know, and so should others looking for that type of service.

If you are a patient of our practice, I would encourage you to leave reviews that are specific to what you love about our practice on Facebook, Google, or other online sites. This helps folks looking for a new dental home to find us! If you have concerns or constructive criticism, please contact us and show us how to improve. Please also do this for great restaurants, hairdressers, furniture stores…it helps us all.

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.