One of the things I hear often in dentistry is when a patient asks me, “Why didn’t my other dentist tell that?” Or, “I didn’t have any problems last year and all of a sudden I have three cavities?” Or, “Dr. <insert name> told me I should get my wisdom teeth out. You don’t think so?”

Certainly, it is frustrating when you’re told you need certain treatment done by one dentist, only to go to another to get a second opinion and now suddenly all of that has changed.  I once met a patient who came to me as her 5th – yes, FIFTH – opinion for a comprehensive treatment plan.  When I told her what my findings were, she shook her head and said, “You people all need to get together and decide what ya’ll agree on.”

Dentistry, just like our colleagues in the medical profession, are doctors.  Dentists are diagnosticians and become experts at recognizing all kinds of pathology and disease of the teeth, gums, jaws, and other structures of the mouth and neck.  This aspect should not vary from dentist to dentist as the diagnosis of a problem is fairly objective.  You either have gum disease or not.  Your tooth has signs of decay or not.  The  diagnosis of your mouth is generally black and white, definitely more so than the treatment plan options that are given to you on how to address those problems.

The difference between dentists and other doctors, however, is that dentistry is a procedure-based field.  What this means is that dentists are not only doctors, but they are engineers, mechanics, and artists.  We do all kinds of procedures to fix problems within the mouth like fillings, crowns, root canals, extractions, implants, making removable prosthesis like dentures.  As such, there are various techniques to accomplishing each treatment, and likewise dentists have their own preferences on how they like to complete a treatment based off experience on what works best in their hands.  Some dentists may make a set of dentures using a completely different technique than their neighbors just down the street from them.  Many of these reasons are simply based on how they were trained and where they went to school.

Dentists can also fall on both ends of the spectrum in how they treatment plan.  Some are aggressive in order to stop a problem before it begins, and some are very conservative to only treat things that are definitely a problem.  While neither side is incorrect, this can often be unsettling to patients when they meet two dentists that think very differently.  For example, one dentist may decide that the small cavity in your tooth will eventually reach a point where it will hurt you, so the best course of action is to treat it now and put in a filling.  Another dentist may believe that because it isn’t hurting you and it is so small, it may stay like that for a long time so it may be best to wait to fill it when it definitely needs it.

Sometimes you may see a dentist who you believe is treating a problem you don’t have.  It is very common to find that while a moderate sized cavity can bring lots of pain, a big cavity can also remain painless as well, especially if the nerve of your tooth is on its way to dying.  Many times, a tooth can be abscessed and you won’t feel a thing.  Gum disease, while detrimental to your overall health, is often painless.  Nevertheless, all these issues are such that need to be addressed and treated, even if you are not in pain.  It’s not easy to explain to patients why they may have a problem that they are unaware of, and trust me, delivering this kind of unexpected news is no fun for the dentist either.  But hopefully you can find a dentist who can explain his/her findings well enough that helps you understand what is going on, and that you agree with the treatment plan.

The best thing you can do for yourself in selecting a dentist is to find someone whose approach to dentistry is compatible with you.  This is so very important because your overall health depends on your oral health, and you need to partner with a dentist who understands your personal approach to your well-being.  Although dentists may have different ways of treating dental problems, they will agree with the fact that patients should get the best help they can.  Not sure if your dentist is the right one?  Ask for a second opinion.  Your dentist needs to be a good fit for you, and you and your smile deserve the best!

If you have any questions or comments, please leave them in the comments section below.

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