Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

July 3, 2018

Botched case by a very reputable dentist


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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

Melissa

Melissa,
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.

Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

October 30, 2015

The Tyranny of Oral Surgeons

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I wanted to give kudos to Jim Du Molin. He is the founder of Internet Dental Alliance, which is a direct competitor to my company, Infinity Dental Web. But I’m on the same side as he is in this dental political issue of oral sedation, which I believe is slated to be voted on at the annual meeting of the American Dental Association, November 5-10, in Washington, DC.

He sent me an email early this morning about this issue. I had heard about this issue through other sources, but he put it rather directly and I liked his style of not pulling any punches. He titled it “The Tyranny of Oral Surgeons.” I’d like to quote it here:

The rivalry between oral surgeons and general dentists has never been fiercer.

And it looks as if the oral surgeons have seized the upper hand.

Right now, a tiny group of oral surgeons in positions of influence at the ADA who are pushing forward a proposal – Resolution #77 – that will make it much harder and much more expensive for general dentists to continue serving their fearful and anxious patients using moderate enteral sedation.

In fact, if their proposal, Resolution #77, is approved at next month’s ADA annual meeting, it could well spell the beginning of the end of oral sedation.

The BIG problem is this: Most of the ADA House of Delegates members who will be asked to vote on Resolution #77 have no clue what’s behind the proposal or what a dramatic impact it will have on dentistry and patients. The oral surgeons are counting on their ignorance – and their blind trust that if the ADA is proposing changes, they must be for the better.

We know that millions of patients have been treated safely and effectively – without incident – by general dentists who adhere to the existing guidelines and their states’ associated regulations.

Yet, under the ruse of concern for public safety – and it is nothing more than a ruse! – oral surgeons are poised to rewrite the ADA’s oral sedation guidelines to conform to their selfish interests.

I am joining with concerned leaders in the general dentistry community in urging you to contact your ADA House of Delegates representatives immediately (there is no time to waste) to let them know you strongly oppose Resolution #77.

Calling or writing them will only take a few minutes of your time, but it could make the difference for sedation dentistry and the millions of our patients who rely on it.

Thank You,

Jim Du Molin

On mynewsmile.com I reference this issue as it played out in Iowa. (See my page on Iowa Sedation Regulations.) In Iowa, the oral surgeons were able to use their influence with the Iowa Board of Dental Examiners to put in place highly restrictive rules on the use of oral sedation, effectively outlawing it in the state. Many patients were hurt by this policy. Until they did this, I was able to treat hundreds of patients using oral sedation without a single adverse incident. But being able to use oral sedation meant that I could compete with oral surgeons in offering wisdom tooth extractions and other services that they wanted to perform. I had a lower rate of complications, including zero dry sockets, over a period of many years, than our local oral surgeons.

The links below, provided by Jim Du Molin, courtesy of TEAM1500.org, include contact details for any member dentists who wish to contact their ADA House of Delegates representatives, plus additional details on Resolution #77.

Three Simple Steps to Help
http://www.team1500.org/cta2.html

Calls to (ADA) Action: Briefing
http://www.team1500.org/briefing.html

State-by-State Directory of ADA House of Delegates http://www.team1500.org/delegate_directory.html

Do you have a comment? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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