Are dentists like mechanics? How can you trust them?

As I just recently started my career in private practice with Dr. Craig Christiansen in Orem, Utah I am starting to understand first hand the great amount of responsibility that I have as a dentist.

I know the feeling that you get when you are told something is wrong which you cannot personally verify, and that needs to be fixed by the person telling you there is a problem for a large amount of money.  It feels like you are being taken advantage of.

I recently purchased an older car and took it to an auto mechanic for a safety and emissions inspection and was told I had to have $800 worth of repairs or it would not pass safety or emissions.  I felt more than a little annoyed.  When I bought the car the people I purchased it from said it passed safety and emissions just a few months ago.  Why does this happen? Differences in interpretation of the safety and emissions guidelines? Conflicts of interest encouraging more work than really needs to be done in order to make more money?

I'm sure these are questions that arise in the minds of patients who come to see me or other dentists after switching from another dentist and more cavities or work is found than by a previous dentist. Sometimes there are differences in what one dentist would recommend versus another.  Sometimes there are differences in diagnostic technologies allowing one dentist to see what another has not seen.  There are gray areas in dentistry just like everything else.  Cavities that appear to be borderline may be watched by one dentist or treated with a filling by another.

I try to think to myself every time I diagnose a patient with dental work to be done: "What would I do if it was my wife, son, or daughter in the chair? What would I want to have done with my mouth/teeth?" This helps me to keep in mind the best treatment possible independent of what the cost would be.   Treatment plans do need to be adjusted depending on the decay rate, finances, etc but I will always try to treatment plan with the following motto: "Do unto others as I would have them do unto me."

I feel like I am a fairly conservative dentist.  Whenever possible I like to not treat anything that does not need to be treated.  I would love it if more of my patients showed up for their exams with no cavities.  I don't get a thrill out of finding cavities or doing fillings. I am thrilled when I find someone with healthy teeth and gums that do not need treatment.  I do enjoy my job and I take great pride in the work I do but I would never wish cavities on anyone, and I don't need to practice doing fillings.  I actually really hope they put Fluoride in the water here in Utah County because it would help decrease cavities in kids and among people with less income who cannot afford dental care not to mention save everyone else a lot of money.

At least right now I am not paid by production but by the hour so I don't have a financial incentive to diagnose things that do not need to be done.  That will not always be the case however, so I will have to maintain a high level of professional integrity and always remember to treat everyone like it was my family.  So how can you know if you have an honest dentist?  Go to dental school.  :) Just like finding an honest mechanic you have to rely on the experience of others and hope that the dentist is honest with you too.

There are other things too which help keep even dentist who are not prone to honesty more honest such as insurance company's which review cases and make sure the work was needed,  professional societies and boards of dentistry help regulate dentists in the community.

Other things could be a sign that a dentist has your best interest in mind.  Do they help give you strategies on prevention; brushing, flossing, Xylitol, prescription toothpaste, etc?  Do they ever mark down small cavities to be watched rather than immediately treated? 

Something else that sets dentists apart from mechanics. We take an oath to do no harm and treat others with fairness and honesty.  I will do my part to live up to that oath.  In the meantime I will find a good honest mechanic.