Oh what a difference a dentist can make! Those faithful readers who have followed my discontent with "little shop of horrors" dentistry (see back in the land of the living...), will be pleased to learn that I went to see a shiny, friendly, new dentist this morning. I am so glad to make the change.
The "little shop of horrors" dentist (heretofore known as Dentist 1.0) that I used to see in the "dental Winnego of love" had several complaints about my teeth. For one thing, he seemed to dislike silver amalgam fillings and wished to replace all of mine with cosmetic composite fillings. For another, he told me that I ground my teeth too much and wanted to fit me with a "night tray". Finally, his predecessor in the "little shop of horrors" (Dentist 0.9a) claimed that I had some gum problems around my back molars that might require attention.
New recommended-by-Fiancee S. dentist (Dentist 2.0) has a somewhat happier story to tell. He carefully explained the relative merits of amalgam and composite fillings to me, but, did not seem to want to replace any existing fillings with anything new. Dentist 2.0 also didn't seem to spot signs of excessive wear due to teeth grinding, and therefore is not looking to fit a night tray. Finally, he explained carefully that the problems with my gums around my back molars are not really problems, but are more likely simply variances caused by the physionomy of my mouth.
Now, I suppose that the relevant question to ask is why should I trust Dentist 2.0 more than Dentist 1.0 or Dentist 0.9a? I've talked to some friends who (seem to) know something about the dental trade. They all tell me an answer can be found in the economics involved in the question "what kind of dentist likely has the time or inclination to practice out of an office in a Winnebego run by a dental HMO?"
Winnebego dentists tend to be newly minted dentists that don't have good office practices built up yet and who are willing to accept aggressive (though ethical) diagnosis guidelines. Dentists with solid office practices, or so the theory says, want to preserve those practices by developing good long term relationships with their patients in order to maintain good patient retention (and therefore a stable cash flow to pay office bills) and have good "word of mouth" advertising to attract additional patients. Dentists working out of Winnebegos are a bit more mercenary, counting on the convenience of the Winnebego in the parking lot next the building where you work to bring you back, not the quality of care. Winnebego dentists also have HMO-style accountants and lawyers pouring over their records to make sure that a correct and profitable balance of funds is transferred from your employer-provided dental insurance to "Winnebego Dentists, Inc." as frequently as is ethically possible.
I don't know if this is absolutely true or not, but, I see the effects. When I started seeing Dentist 0.9a, several cavities needed to be filled (some of which were later not deemed as ready for filling by another dentist) and some teeth needed to be sealed despite previous regular dental care. Likewise, when the dental HMO gods decided that Dentist 0.9a should be replaced by Dentist 1.0 without my knowledge or consent, Dentist 1.0 suddenly had a signficant laundry list of things that had to be fixed in my mouth, even though I had been seeing Dentist 0.9a at least 3 times a year (3 cleanings, plus the occasional filling) for the previous two years. I also received little continuity of care between Dentist 0.9a and Dentist 1.0; as soon as Dentist 1.0 moved in, all previously established trust and (more importantly) courses of treatment were thrown out the window. Can you see why I came to dread visiting the "little shop of horrors" dental Winnebego?
I contrast this with Dentist 2.0 that says that my mouth seems relatively healthy and little to no additional work is required. He also is willing to see me only twice a year to start. I also found him very patient and logical when it came to answering my questions.
Going to see Dentist 2.0 just felt SOOO nice, after seeing Dentists 0.9a and 1.0 for so long. I think I'll keep him around for a while.
on 2003-10-14 at 12:42 p.m.
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