Drill'r
Toms River, NJ
Male, 63
I was in private general practice for 30 years, taught at UMDNJ and NYU College of Dentistry, and was a US Navy Reserve Dental Officer (Fleet Marine Force). Suffice it to say, I know a thing or two about teeth! Ask me anything.
My son is a physician and my MD friend/patient ENT told his son to become a dentist and he did. Seems like the " gums are always greener." I was at the same crossroad when I was considering a profession. I shadowed my physician cousin (who worked much harder than my dentist) and then our family dentist to see what they actually did all day. The dental field seemed to suit me and I was in practice quite awhile before my college classmates finished their medical residencies and fellowships. Medicine in the past was much more lucrative, but now there is some closer financial parity. Incidentally my son left patient care and now works for "Big Pharma", where he is much happier. One major factor is that physicians are held in higher esteem in society than dentists -- no one "likes" going to the dentist.
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Over 90% of the population has some form of dental disease -- miniscule to major. Of those, approximately 50% will seek treatment. I understand your skepticism with all of the marketing and advertising now in dentistry, but the longer you stay away the "fatter" our wallets get. Routine 6-month check-ups (some people with periodontal/gum disease must go more frequently) can prevent or catch a problem and be less costly in the long run. For patients who have stayed away and need extensive and sometimes costly treatment, the regular check-up protects your investment. The cost of dentistry amortized over the the life of the restorations and treatment is not that great when you consider your upper and lower teeth come together between two to three thousand times per days (eating, swallowing, talking, etc).
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I don't know for sure ??BUT........... some hygienists I've had in my employ and have taught think they are Dentists and their egos may become bruised if you question their authoriy .. only a guess. In the military a Dental Hygienist is a recruit trained to clean teeth, this training and skill is useless in the private sector when discharged, but they do a great job. With a little bit of common sense and training , if she will train you, cleaning your own teeth as you described can be a valuable adjunct to her procedues. Be very careful not to cut or srape the gums and alway floss daily . I din't know if you have ever had a dog , but my vet. bills to have my dog's teeth cleaned is 3 -4 times what I charged so I do my best to "scrape"away the "tartar" to extend intervals between cleanings.
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I'll answer your last question first. A good "chairside/bedside manner" usually indicates the treating dentist is more secure in his/her knowledge and abilities. To put patients at ease, I was a bit of a dinosaur, in that I would greet my patients in the reception area, walk them to the treatment area, and walk them back out to the reception desk post-treatment. My staff told me it was a waste of treatment time, but I never had an empty chair. Also, I never had an answering machine; I put call-forwarding to my home, telling the patients they could reach me there. In addition, I took a call-sheet home with me and called patients who had overgone restorative treatment. Mind you, I did not have the "little country practice" -- I had 5 operatories, a large staff, and 4 generations of patients in some families. If you're not happy with your treatment, keep looking, though unfortunately with dental insurance sometime you limit your options. One important thing I neglected with regard to putting patients at ease was Nitrous Oxide Analgesia (laughing gas). As I mentioned in another response, it's very safe and has no after effects. As opposed to systemic sedation we sometimes prescribe.
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You answered your own question, it's a marketing ploy. I'm glad to see a thoughtful consumer. Dentists are able to prescribe anti-anxiety drugs, but I would suggest a dentist who uses Nitrous Oxide Analgesia (Laughing Gas). It has a relaxing and calming effect, no after-effects, and leaves your system within minutes after breathing room air again. No one really "likes" going to the dentist -- I've even had many dentists as patients over the years who could be classified as "chickens." The oral cavity is very sensitive inutero and infants put things in their mouths for identification because it is our most acute, tactile sense at birth. Add to this nurturing, affection, aggression, and communication and you can begin to imagine the psychological impact along with physical impact when we invade this area with necessary treatment. Hence, "chickens." Dentistry, with its prevention programs (e.g. flouride, 6-month check-ups), is slowly negating the need for our routine services. Therefore more advertising and marketing has found its way into the profession.
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Unfortunatey ,as you said, some people need do need dental check-ups more frequently. The 6-month interval is an average and if you have dental ins. you have to have a 6 month plus 1 day interval to be covered. Ins. coverage for shorter intervals has to be documented , but if done so properly, is still covered. Diet can be a factor , but very difficult to detemine. Plaque is soft and removed by routine brushing. The best time is before you go to bed and in the morning, forget after or between meals, everyone else does, but not as critical When plaque "solidifies" into calculus(tartar) it is impossible to remove and that is what the hygienist is doing. Most people have the most accumulation behind the lower anterior teeth and the cheek side of the upper molars, this can be from brushing technique. For the lower anteriors hold the brush vertically, not horizontal and always use a flat tip SOFT nylon brush and change it every month. The soft doesn't seem as abrasive but the bristles flex into every crevice without hurting the "gums", Hold the brush horizontal for the posteriors and aim for the crevice betweeen the tooth and the gingiva(gums). don't waste your money on electronic or high tech toothbrushes, a marketing ploy.
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My opinion -no I don't think mecahnical/electricl toothbrushes do a better job. The best way to avoid plaque build-up is to brush before you go to bed and when you wake in the morning. Plaque buils up mostly while you are sleeping. Scrubbing your teeth with a washcloth if you lose your or forget your brush does a pretty good job ( the furthest you can get from mechanical), but I've been recommending a SOFT FLAT NYLON BRUSH AND CHANGING IT EVERY MONTH for 39 years and have seen great results. Use a circular motion with the tip of the bristles aimed at the crevice where the gums(gingiva) and teeth meet. Also brush your tongue as far back as you can(without gagging) and you entire gum and palate.
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