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Dear Dr. Hall
This started about five years ago when I wanted to get a single crown for my front tooth (#8). The crown ended up being bulky and the color was off. After that, I was referred to a very reputable dentist. The first crown he did was too gray. The second crown he did was closer, but didn’t fit into my mouth because of a protruding lower front tooth. At that point the dentist told me to get orthodontic work. When I did that, I ended up with a gap.
I’m now shopping around for a dentist I feel comfortable with, and I feel very uncertain about this. I am not 100% sure these dentists are going to follow through with getting it right. My last dentist has a really great reputation. He charged me enormous fees, paired me with a reputable ceramist, and it still didn’t work. Strangely, as I interview other dentists, when they hear his name, I am forced to defend myself. If they see the work, they back off, but everyone assumes the patient is at fault. As if I somehow caused the poor looking crown. Or am just being too picky?
– Melissa from Southern California
Yes, I’m very familiar with stories like yours. But it’s interesting—you say the dentist and ceramist had “great reputations.” Oh, there is such a difference between a dentist with a great “reputation” and a great cosmetic dentist, and likewise for ceramists.
If you do a lot of reading on my blog, you’ll learn that institutional dentistry—most dental schools, the American Dental Association, and the “reputable” dentists look down their noses at cosmetic dentists. They mock them, calling them “cosmetologists” and unprofessional. I was taught in dental school that, on issues of how the dental work should look, we should not listen to the patient but should use our professional judgment. To these academics and dental leaders, true cosmetic dentists are pandering to the patient and unworthy. Read the Wikipedia article about cosmetic dentistry, written by someone with this academic mindset, and you’ll get a flavor of this condescending attitude.
This goes to the heart of why I founded this referral service and this blog—to be the politically incorrect advocate for beautiful dentistry.
Here, read two of my blog posts that deal with this issue. In the first one, the patient didn’t like the result because the teeth looked too white and phony, but the dentist insisted that they were fine, basically telling the patient that her professional opinion should out-weigh the patient’s opinion.
In the second post, I answer a patient named Glen from Massachusetts who kept having reservations as his smile makeover proceeded. As he voiced those reservations, his dentist kept telling him, “trust me.” After the work was completed and Glen was still unhappy with it to the point where he was embarrassed to smile, the dentist sent him a certified letter where he relates his professional opinion combined with that of several colleagues that the work looks great. This contrasts with the attitude of great cosmetic dentists that they are treating the self-perception of the patient and if the patient has reservations about the appearance of the final result, the case is a failure.
This is what I see over and over again when someone gets a recommendation from a dentist in this institutional mindset for appearance-related dentistry. They get a great mechanical dentist who has a “great reputation” among his or her peers but is really psychologically unfit for appearance-related dentistry. True cosmetic dentists are outliers in the dental community.
If you can come to fully understand that and realize that you were victimized by this institutional mentality and referred to a dentist who had a great reputation with the wrong crowd, and now you are moving into a different world that plays by a different set of rules where everything depends on whether or not the patient likes the final result, you may find it in yourself to trust again.
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