Dentists: stop specializing!

Nov. 1, 2004
This article is about specialization in dentistry. However, it's not about oral surgeons, endodontists, periodontists, pedodontists, and/or orthodontists.

Louis Malcmacher, DDS

This article is about specialization in dentistry. However, it's not about oral surgeons, endodontists, periodontists, pedodontists, and/or orthodontists. It's about the specialization movements that are growing in general dentistry today.

Each movement will point to its exclusivity and try to convince you that their group is the only one you need. What are some examples of the new movements in dentistry? Here are a few of the more well known:

The Comprehensive Examination Movement — Members of this movement claim every patient needs and wants a comprehensive examination before treatment. They also say every patient needs and wants a complete treatment plan for a full-mouth rehabilitation, and treatment should cost at least $20,000.

The CAD-CAM Movement — This movement believes that every patient needs and wants only one- appointment dentistry. Their followers say it is a sin to bring a patient back for a second appointment. They believe patients are fascinated with watching their own restorations being created in front of their eyes.

The Extreme Makeover Movement — This movement even has its own TV show! Members believe every patient needs and wants 28 veneers (even if they only have 10 teeth), rhinoplasty, liposuction, face lift, chin graft, high cheek bones, and surgery that changes other body parts so dramatically that no one notices the person's smile anyway.

The Laser Movement — This group believes that each patient needs and wants absolutely no local anesthesia, whether it is for flap-periodontal surgery, fillings, crown preps, or endodontic therapy.

The Holistic Movement — Followers of this movement say every patient needs and wants metal-free restorations, and certainly no amalgam should be in their mouths or within 100 yards of their bodies at all times. They sometimes pair up with members of the aesthetic movement, seeking to remove all traces of metal from patients' mouths. They then replace the metal with aesthetic composite materials. What they don't realize is that there are aluminum oxides in most composite resins, so that they are just taking out one metal and putting in another.

The Sedation Movement — This group believes every patient needs and wants to be sedated for their dentistry, which is probably not a bad idea.

You probably realized by now that I am exaggerating some of the statements about these movements. My point really is this: Let's not make assumptions about our patients' wants and needs. Rather, let's do something that will quickly, easily — and in a non-threatening way — find out what they need and want: Let's ask them! If they want a comprehensive examination, fine, we can do that. If they only want to talk about one tooth today and take care of the pain, we can do that, too. If painless dentistry is important to them — and it really is to most patients — then get yourself a hard-tissue and soft-tissue laser. If they are so fearful that they need to be sedated with conscious sedation or general anesthesia, we can make arrangements for that as well. If holistic dentistry is what they are requesting, that's not a problem either, because we can always refer them to someone else.

If you want to exclusively limit your practice to one of these movements, then that's great. What will really boost most dental practices, though, is incorporating the best of all of these movements into your practice, so you can offer more dental services to each and every patient. Spend the time to learn how to take advantage of the many modalities available in dentistry today.

My patients need and want a whole lot of different things. I never want to assume what they want, but I do want to be able to give them what they want, which is why we offer a number of different therapies in our office. Despite the hype, none of these movements in dentistry need to be exclusive of each other. However, they certainly can be very complementary, not only to each other, but also to success of your practice by offering the greatest range of benefit to your patients.

Dr. Louis Malcmacher is an international lecturer and author known for hiscomprehensive and entertaining style.An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired his audiences to truly enjoy practicing dentistry by providing the knowledge necessary for excellent clinical and practice-management skills. His group dental practice has maintained a 45 percent overhead since 1988.For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via email at [email protected].

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