|
Home > Archive > Dentistry > June 2006 > The average US dentist is barely average
You are viewing an archived Text-only version of the thread.
To view this thread in it's original format and/or if you want to reply to
this thread please [click here]
| Author |
The average US dentist is barely average
|
|
|
| "The average dentist is barely average."
A few decades ago when the late, great Dr. Saul Schluger uttered these words
at a professional meeting he was castigated by the attending group for
making such a bold statement. Dr Schluger was one of the founding fathers
of periodontics. As man of great physical stature and intellect, he
commanded respect and admiration. Why then were his words so controversial?
Dr Schluger had broken the unwritten "vow of silence". Any dentist who has
practiced as a specialist for any period of time knows the unwritten rule.
No matter how poor the dentist or the quality of his work, the patient is to
be kept in the dark at all costs. Can there be any greater conflict of
interest?
I have practiced as a periodontist for over a decade and have worked with
over 200 different dentists during that time. Based on what I have seen, I
truly feel that Dr Schluger's words are more accurate and appropriate than
ever. The profession I cherish and love so dearly is in peril.
Denistry is now more a business than a profession. The mantra, "First do no
harm" has been ignored. What I see on a daily basis are dentists performing
procedures that are in their own best interests, not the patients. In the
quest for the almighty dollar, accurate diagnosis and treatment planning
have all but been ignored. Demtists tend to treatment plan the high ticket
items first, followed by conditions that cause pain. Painless but
progressive periodontal disease and asymptomatic periapical lesions are
generally overlooked. I have only met few dentists who perform a thorough
evaluation of the patient - ranging from detailed medical and dental
histroy, thru full extra- and intra-oral examinations. I have never seen a
dentist formulate a diagnosis-and-etiology-based treatment plan. This is
clearly why dentistry fails prematurely and why fail our patients.
It has been my experience that the problem is not just limited to general
dentists. Many specialists fall into this category as well. However the
general dentists tend to be the biggest culprits as they are quick to jump
on any bandwagon that promises quick monetary gain for little or no effort.
The 2 current examples of this worrisome trend are Invisalign and surgical
placement of implants by general dentists.
Invisalign - The whole concept of out-sourcing the diagnosis and treatment
planning to a 3rd party and allowing the dentist to be the deliverer of an
appliance in which they made no meaningful input, is completely unethical.
A weekend course to "certify" a dentist as an Invisalign member hardly
compares to the commitment, dedication and sacrifice required to complete a
2-3 year post-graduate program in orthodontics. How would proponents of
using Invisalign in this way feel if Wal-Mart openend a department where
impressions were taken by techicians and the applaicne delivered at the
check out? (I know that currently this could not be accomplished without
legislative changes - but the point I'm trying to make is that these same
dentists would be the first to jump and shout foul!)
Implants - Most general dentists have a hard time diagnosing caries and
fabricating well-fitting restorations. These are tasks they were supposedly
taught at dental school and for which they received years of training.
Implant comapnies, in their hunger for profit have aggressively pursued
general dentists in the hope that if they place their own implants, they
will sell more implants. This logic is flawed on so many levels it almost
impossible to know where to begin. Most dentists have not been placing
implants because they don't know how, but rather because they are terrified
by the restorative process itself. Proper surgical placement requires an
understanding of surgical technique and wound healing and is magnitudes more
complicated that drilling a hole in a piece of wood and screwing in a screw.
This over-simplification will result in immeasurable harm to our patients,
as dentists will not take the time to diagnose and treatment plan correctly.
The future of periodontists and oral surgeons will parallel those of
endodontists. Fixing the huge mistakes made by general dentists. And what
has become of the specialty of endodontics? It's on its way out because
"weekend courses for general dentists" means "no need" for the expert
training of endodontists. In response the endodontists have climbed in on
the implant band wagon themselves. As they start to expereince a busy-ness
problem, they're started to place their own implants. I guess if you can't
beat them, join them.
All we can hope for is that the numerous lawyers we have trained,w ill come
to our aid. What we need are some large lawsuits directed not only at the
dentists performing these prcoedures without adequate diagnosis, preparation
and training, but more importantly huge awards against the unscrupulous
companies that place profits ahead of our patient's welfare.
| |
| Steven Bornfeld 2006-06-05, 2:24 am |
|
SeattleGumDoc@hotmail.com wrote:
> "The average dentist is barely average."
> (snip)
Sounds like Corollary 1 of the Lake Wobegone effect.
Wow, that's quite an attack of dyspepsia! I'm sure your referring
generalists would appreciate you posting your full name, so they can
know how highly you think of them.
Steve
| |
|
| So -- who died and made you God?
<SeattleGumDoc@hotmail.com> wrote in message
news:mNWdnWRoe5IaoR7ZRVn-tg@comcast.com...
> "The average dentist is barely average."
>
> A few decades ago when the late, great Dr. Saul Schluger uttered these
> words at a professional meeting he was castigated by the attending group
> for making such a bold statement. Dr Schluger was one of the founding
> fathers of periodontics. As man of great physical stature and intellect,
> he commanded respect and admiration. Why then were his words so
> controversial? Dr Schluger had broken the unwritten "vow of silence". Any
> dentist who has practiced as a specialist for any period of time knows the
> unwritten rule. No matter how poor the dentist or the quality of his work,
> the patient is to be kept in the dark at all costs. Can there be any
> greater conflict of interest?
>
> I have practiced as a periodontist for over a decade and have worked with
> over 200 different dentists during that time. Based on what I have seen,
> I truly feel that Dr Schluger's words are more accurate and appropriate
> than ever. The profession I cherish and love so dearly is in peril.
>
> Denistry is now more a business than a profession. The mantra, "First do
> no harm" has been ignored. What I see on a daily basis are dentists
> performing procedures that are in their own best interests, not the
> patients. In the quest for the almighty dollar, accurate diagnosis and
> treatment planning have all but been ignored. Demtists tend to treatment
> plan the high ticket items first, followed by conditions that cause pain.
> Painless but progressive periodontal disease and asymptomatic periapical
> lesions are generally overlooked. I have only met few dentists who
> perform a thorough evaluation of the patient - ranging from detailed
> medical and dental histroy, thru full extra- and intra-oral examinations.
> I have never seen a dentist formulate a diagnosis-and-etiology-based
> treatment plan. This is clearly why dentistry fails prematurely and why
> fail our patients.
>
> It has been my experience that the problem is not just limited to general
> dentists. Many specialists fall into this category as well. However the
> general dentists tend to be the biggest culprits as they are quick to jump
> on any bandwagon that promises quick monetary gain for little or no
> effort. The 2 current examples of this worrisome trend are Invisalign and
> surgical placement of implants by general dentists.
>
> Invisalign - The whole concept of out-sourcing the diagnosis and treatment
> planning to a 3rd party and allowing the dentist to be the deliverer of an
> appliance in which they made no meaningful input, is completely unethical.
> A weekend course to "certify" a dentist as an Invisalign member hardly
> compares to the commitment, dedication and sacrifice required to complete
> a 2-3 year post-graduate program in orthodontics. How would proponents of
> using Invisalign in this way feel if Wal-Mart openend a department where
> impressions were taken by techicians and the applaicne delivered at the
> check out? (I know that currently this could not be accomplished without
> legislative changes - but the point I'm trying to make is that these same
> dentists would be the first to jump and shout foul!)
>
> Implants - Most general dentists have a hard time diagnosing caries and
> fabricating well-fitting restorations. These are tasks they were
> supposedly taught at dental school and for which they received years of
> training. Implant comapnies, in their hunger for profit have aggressively
> pursued general dentists in the hope that if they place their own
> implants, they will sell more implants. This logic is flawed on so many
> levels it almost impossible to know where to begin. Most dentists have
> not been placing implants because they don't know how, but rather because
> they are terrified by the restorative process itself. Proper surgical
> placement requires an understanding of surgical technique and wound
> healing and is magnitudes more complicated that drilling a hole in a piece
> of wood and screwing in a screw. This over-simplification will result in
> immeasurable harm to our patients, as dentists will not take the time to
> diagnose and treatment plan correctly. The future of periodontists and
> oral surgeons will parallel those of endodontists. Fixing the huge
> mistakes made by general dentists. And what has become of the specialty
> of endodontics? It's on its way out because "weekend courses for general
> dentists" means "no need" for the expert training of endodontists. In
> response the endodontists have climbed in on the implant band wagon
> themselves. As they start to expereince a busy-ness problem, they're
> started to place their own implants. I guess if you can't beat them, join
> them.
>
> All we can hope for is that the numerous lawyers we have trained,w ill
> come to our aid. What we need are some large lawsuits directed not only
> at the dentists performing these prcoedures without adequate diagnosis,
> preparation and training, but more importantly huge awards against the
> unscrupulous companies that place profits ahead of our patient's welfare.
>
>
>
>
>
| |
| JimSocal 2006-06-05, 8:23 am |
| On Sun, 4 Jun 2006 13:03:19 -0700, <SeattleGumDoc@hotmail.com> wrote:
>
>Denistry is now more a business than a profession. The mantra, "First do no
>harm" has been ignored. What I see on a daily basis are dentists performing
>procedures that are in their own best interests, not the patients. In the
>quest for the almighty dollar, accurate diagnosis and treatment planning
>have all but been ignored. Demtists tend to treatment plan the high ticket
>items first, followed by conditions that cause pain.
As a patient who has seen about 8 different dentists over the past 2
years, in trying to find a decent one, I can assure you that what I
quoted above is true in many cases (in all but 2 of the 8 dentists I
have seen, I declare!).
Certainly not likely among those kind and professional dentists who
post here, but in the general public, at least where I live, the
dentists I've seen have been akin to snake oil salesmen, con artists,
and incompetents, to boot!
Dentistry, as I have seen it, is in a sad state, indeed.
| |
| joesplink@aol.com 2006-06-05, 4:22 pm |
| I am inclined to agree with your post because my great dentist of many
years didn't mention that I have a nasty case of periodontal disease
...... and now I have 9-10 mm pockets .......x-rays show bone
loss........ the periodontist says 'surgery' .... and I just today saw
a another dentist who recommended using his new laser ... the only one
in SF .... but I'm not convinced .....
So, I have a question ..... is there an alternative to surgery? I
think I just have to 'buck up' and do it.....
TIA,
Joe
| |
| Tony Bad 2006-06-05, 9:22 pm |
|
<SeattleGumDoc@hotmail.com> wrote in message
news:mNWdnWRoe5IaoR7ZRVn-tg@comcast.com...
> "The average dentist is barely average."
>
There is a lot of truth to what you say, but I cannot help but wonder how
much of this was inspired your very own concern about others placing
implants, which had become a nice little profit center for periodontists.
I must add, at the risk of sounding defensive, that most specialists are
poorly equipped to deal with or assess many things a GP does or faces. I
have numerous cases where endodontists have "saved" teeth that were beyond
restoration, and send the patient back to me, making me the bad guy when I
tell them that tooth they just spent a lot of money on will need to be
removed. I have also had specialists who have sent a patient back to me with
a list of teeth that "need" treatment, when these teeth are fine. I have
also had many patients who have spent considerable time and expense at a
periodontist's office and have never been given even basic oral hygiene
instructions.
Lastly, I don't think your comment that most GP's are "terrified by the
(implant) restorative process itself" is reasonable. There are a host of
reasons, but I don't think fear is one of them. Restoring a well placed,
well planned implant is not that difficult.
Yes, there are lots of problems, but a fair and honest assessment of these
problems is the first step to solving them.
T
| |
| Steven Bornfeld 2006-06-05, 9:22 pm |
|
Tony Bad wrote:
> <SeattleGumDoc@hotmail.com> wrote in message
> news:mNWdnWRoe5IaoR7ZRVn-tg@comcast.com...
>
>
>
> There is a lot of truth to what you say, but I cannot help but wonder how
> much of this was inspired your very own concern about others placing
> implants, which had become a nice little profit center for periodontists.
>
> I must add, at the risk of sounding defensive, that most specialists are
> poorly equipped to deal with or assess many things a GP does or faces. I
> have numerous cases where endodontists have "saved" teeth that were beyond
> restoration, and send the patient back to me, making me the bad guy when I
> tell them that tooth they just spent a lot of money on will need to be
> removed. I have also had specialists who have sent a patient back to me with
> a list of teeth that "need" treatment, when these teeth are fine. I have
> also had many patients who have spent considerable time and expense at a
> periodontist's office and have never been given even basic oral hygiene
> instructions.
>
> Lastly, I don't think your comment that most GP's are "terrified by the
> (implant) restorative process itself" is reasonable. There are a host of
> reasons, but I don't think fear is one of them. Restoring a well placed,
> well planned implant is not that difficult.
>
> Yes, there are lots of problems, but a fair and honest assessment of these
> problems is the first step to solving them.
>
> T
You are a paragon of restraint, Tony!
Steve
>
>
| |
| Tony Bad 2006-06-06, 4:23 pm |
|
"Steven Bornfeld" <dentaltwinmung@earthlink.net> wrote in message
news:4484E213.2040206@earthlink.net...
>
> You are a paragon of restraint, Tony!
>
> Steve
>
There is a first time for everything!
T
| |
| george1234 2006-06-14, 4:23 pm |
| On 5 Jun 2006 11:27:53 -0700, joesplink@aol.com wrote:
>I am inclined to agree with your post because my great dentist of many
>years didn't mention that I have a nasty case of periodontal disease
>..... and now I have 9-10 mm pockets .....
>So, I have a question ..... is there an alternative to surgery? I
>think I just have to 'buck up' and do it.....
I had a similar problem last year ( pockets up to 7 mm). I first had
the deep scaling, and just after the periodontist recomended 4
quadrant oseous surgery. I decided to wait and try better oral hygene
and see if it helped ( floss every day, brush with a sonicare tooth
brush at least twice a day, use a plastic toothpick, get teeth cleaned
by a dentist every three months ). Better care did help.. By last
March the average pocket depth was ~2. mm and the max was 3 mm
I'm sure that the response differs in different patients, but for me
better oral hygiene was the solution
| |
| Tony Bad 2006-06-15, 4:22 pm |
|
"george1234" <george1234pds@excite.com> wrote in message
news:cak09291jicvgdl8v2c48htkf3j2bjqdap@4ax.com...
> I had a similar problem last year ( pockets up to 7 mm). I first had
> the deep scaling, and just after the periodontist recomended 4
> quadrant oseous surgery. I decided to wait and try better oral hygene
> and see if it helped ( floss every day, brush with a sonicare tooth
> brush at least twice a day, use a plastic toothpick, get teeth cleaned
> by a dentist every three months ). Better care did help.. By last
> March the average pocket depth was ~2. mm and the max was 3 mm
>
> I'm sure that the response differs in different patients, but for me
> better oral hygiene was the solution
>
>
>
Better hygiene won't solve all cases, but it will help solve many, and
without a change in your hygiene habits, surgery is just finger in the dam
treatment. Glad to hear your improved habits helped. Before I send anyone to
a periodontist, I always stress the importance of improved hygiene.
T
| |
| canyonlakegirl 2006-06-16, 4:25 pm |
|
Tony Bad wrote:
> <SeattleGumDoc@hotmail.com> wrote in message
> news:mNWdnWRoe5IaoR7ZRVn-tg@comcast.com...
>
> There is a lot of truth to what you say, but I cannot help but wonder how
> much of this was inspired your very own concern about others placing
> implants, which had become a nice little profit center for periodontists.
>
> I must add, at the risk of sounding defensive, that most specialists are
> poorly equipped to deal with or assess many things a GP does or faces. I
> have numerous cases where endodontists have "saved" teeth that were beyond
> restoration, and send the patient back to me, making me the bad guy when I
> tell them that tooth they just spent a lot of money on will need to be
> removed. I have also had specialists who have sent a patient back to me with
> a list of teeth that "need" treatment, when these teeth are fine. I have
> also had many patients who have spent considerable time and expense at a
> periodontist's office and have never been given even basic oral hygiene
> instructions.
>
> Lastly, I don't think your comment that most GP's are "terrified by the
> (implant) restorative process itself" is reasonable. There are a host of
> reasons, but I don't think fear is one of them. Restoring a well placed,
> well planned implant is not that difficult.
>
> Yes, there are lots of problems, but a fair and honest assessment of these
> problems is the first step to solving them.
>
> T
| |
|
| |
|
|