How Do I Find A Great Dentist?

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I laugh in bewildered amusement whenever someone asks their social media friends: “Can you recommend a good dentist/orthodontist/pediatric dentist/etc?” You see, no matter how much you like your oral health care provider, you generally have no way of knowing how “good” they are.

Sure, you can attest to how clean and well decorated the office is, and how friendly the staff is and even as to whether they are gentle and kind when you’re being treated, but take it from someone who’s been in the field for almost a quarter of a century when I say that you simply can’t objectively evaluate your provider. You have no way of knowing if they are doing great work and I am sorry to report that when I was a general dentist, I often had the unenviable task of telling patients that the dental work their “friend” placed 3 years ago needed to be replaced because of decay or breakdown, even though it felt fine.

Aren’s the best dentists the busiest ones?

I’ve seen dentists whose patient absolutely loved them, with the most modern practices turn out work that was sub par, and I’ve seen some of the most gifted clinicians go bankrupt. So, how should patients go about finding a good provider? Well, there’s a difference in the process between general dentists and specialists because of how patients find them, and there’s a difference between different specialties because of how you can (or can’t) evaluate their results.

For instance, if you were looking for a cosmetic dentist to do veneers on your front teeth, you could get a pretty good idea by looking at the veneers he or she did on your best friend and determine whether or not they looked reasonable. Note: This can sometimes be tough because the best porcelain veneers are the ones you didn’t even know your friend had, right? But it’s a lot easier to judge a cosmetic dentist than, say, a periodontist who has helped your friend achieve a higher level of gum health.

Finding a good general dentist

Knowing what I know about general dentistry, if I were new to a town and looking for a great general practitioner (GP), I’d start by calling a few dental specialists. I’d take 15 minutes and call 10 offices of various dental specialists and tell them you were new to town and ask them “who is the best general dentist in town?” It’s an easy question, but the politics and friendships associated with business relationships will get a few offices referring you to someone with whom they are social but not necessarily the best. If a GP refers 20 patients a month to a specialist, the woman on the phone may be a little worried about referring you to someone else and undermining the relationship with their best referrer. That’s why I said to call 10 offices; you’ll see a few names emerge as a trend.  Sounds like a lot of work? It’s only 15 minutes of your time!!! The people in dental offices have an opportunity (and knowledge) to objectively evaluate each other’s work in a far better way than the general public, who are untrained.

Finding a good dental specialist

If you need to see a specialist, you’re likely to have been given a few names from your general dentist (that’s if your GP refers, which is an altogether different blog post for the future). When I first started as a GP in 1992, I found out over time who were the best specialists in town and would exclusively refer just to them. If you needed braces, I would give you the name of my most trusted and best orthodontist. Those days are now gone. So as to not be liable for the referral given, many dentists now give several names and expect the patient to decide which one to go to.  I don’t agree with that philosophy. Our patients count on us for advice and when my patients need an oral surgeon or pediatric dentist, I give them one name and only one name. If that’s the person I’d let treat me, why would I refer the patient to anyone else? Unfortunately, as I said, many dentists are going to give several names, so it’s going to be up to the patient to do their due diligence.

I would do the exact same thing as I just mentioned to find a GP, but in reverse. I would call 10 general dental offices and ask them: “Which endodontist/pediatric dentist/orthodontist/oral surgeon/periodontist/prosthodontist in the area would you go to for treatment?” The big difference is that general dentists don’t often rely on referrals from specialists so you’re likely to get a truly heartfelt answer from the person answering the phone. You’ll see a couple of names emerge and you can call them to figure out which one is right for you.

Figuring out which offices are truly the best

But your work isn’t done yet. Remember, nobody is more responsible for your dental and health choices than YOU!!! So, call the office(s) that emerged at the top of your list and tell them that you’re new to town and are looking to make an appointment. Observe the reception you get. The great offices will make you feel at home. They’ll ask you about YOU and who you are. They’ll give you details about what to expect and maybe even have welcome videos to send you. Warmth can’t be faked and it starts at the top of the practice. If you get put on hold for two minutes and they tell you what happens if you miss an appointment, it tells you a lot about the discussions this team has at their team meetings.

Ask them: “So tell me what makes Dr. X different than everyone else?”  I guarantee you’ll catch them off guard and there won’t be a script. If they can only say “he’s a really nice guy and his patients love him” move on.  I’d like to hear them say that the doctor spends a ton of free time attending continuing education classes, belongs to study clubs and perhaps even is a lecturer. You can’t fake those things.

Of course, when you go to the office it’s important that the dentist spend a fair amount of time with you. Whether you see the hygienist first and the dentist is an afterthought versus dedicated time first with the dentist is a very telling sign about the practice philosophy. Your heart will tell you whether the dentist cares about you or your child personally or if it’s all an act. Always listen to that little voice inside if it feels wrong.

Talk is cheap

Sure, it’s nice to hear that the doctor leads a “faith based life” or os “dedicated to his patients” but those are just words. You’re hopefully going to a dentist for the skill  they display and kindness or gentleness is something you’ll be able to figure out on your own pretty quickly. But I have good news for you.  There’s an objective way to differentiate offices.

Less than 1 in 15 general dentists ever achieve Fellowship in the Academy of General Dentistry. It’s a distinction which means that the GP took a certain amount of hours of continuing education in many areas, was a member of organized dentistry for a while and cared enough to take a written examination. It really isn’t difficult and is within the reach of any GP who really wants it. I got my certification when I was in practice for 7 years and it put me in an elite group of providers with the letters “FAGD” after their title. One can even go farther and become a “Master” within the Academy of General Dentistry (MAGD), an ever more rare distinction.

If you’re calling a specialist’s office, board certification is important. All specialists have to attend an accredited specialty program (though several recent court rulings have started muddying that definition) but board certification isn’t mandatory. To be a Diplomate in the American Board of Orthodontics, for instance, one must pass a written examination, travel to St. Louis with records of 6 treated patients and defend their clinical decisions and outcomes to a board of their peers. It can be a pretty stressful process.

With regard to Fellowship in the AGD or specialty board certification, you’l hear many clinicians say: “I could have done it but it wasn’t important to me” and it’s true that I know some great clinicians who haven’t achieved those distinctions.  But the best clinicians I know in every specialty ARE board certified or and the best GPs I know ARE FAGDs. I wanted to stand out and PROVE to my patients that I was different and got my FAGD AND my board certification. As far as I know, I am the only clinician with those two distinctions and I’m proud of it. My patients can know that I have tangible proof of wanting to be the best I can be in my profession.

Find the one that’s right for you

Hopefully, you’ve gotten a better understanding of the complexities of finding an oral health provider who’s right for you. Asking a friend who they go to is a great first step, but I hope you can appreciate the laughable statement of patients who say “my dentist is the best” when what they really mean is “I really like my dentist”.

Good luck on your search and always feel free to contact me if you have any questions.

 

 

 

How Do I Become An Orthodontist?

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The most wonderful thing about being an orthodontist is working with children and adolescents and having the chance to impact them personally in addition to changing their smiles. Many orthodontists entered the field because of the positive experiences they had when they went through orthodontics, so one of the most common questions I get from patients is “How do I become an orthodontist?”

In theory, becoming an orthodontist is very straightforward: Finish high school and college, attend dental school and then finish an orthodontic residency. In all, it’s about 10-11 years of schooling after high school. With no breaks in the educational process, one can expect to finish school and be an orthodontist at around age 28-30.

In reality, the process of becoming an orthodontist is actually more difficult than you might expect. There are both academic and financial hurdles that while manageable, need to be considered.

I tell everyone who is interested in becoming an orthodontist that first and foremost you must be a great student. Not a good or very good one, but rather an excellent student. I’m not just talking about grades, which is mandatory. I’m referring to being the type of individual who interacts and studies everything. Orthodontics is a profession that uses the mind much more than the hands. Think of it as a job that requires solving puzzles everyday. It’s very different than general dentistry, where most of the work happens by the dentist themselves performing an actual procedure on a patient.

So, you need to have college grades good enough to get you into Dental school and it’s at this point where the real importance of grades plays a role. You can’t just sit back and revel in the fact that you got into dental school (with a bunch of other high achievers, I may add). Nope, you need to excel there as well. The primary differentiating factor that orthodontic residencies look at is grades. You may have done mission work in Samoa, climbed Everest or invented a new computer coding language, but none of that matters until you pass the primary gatekeeper, grades.

The generally accepted rule is that you should be in the top 10% of your dental school class which is tougher than you might think. Remember, everyone in your class had to work pretty hard to get good grades for dental school admittance and they’re no dummies. In a class of 80, it means that you want to be in the top 8 or so. There have been many orthodontists who weren’t in the top 10% but the overwhelming majority were.

There are only about 300 total spots per year for all orthodontic residencies combined, and you’re going to be competing with many students who were top 5 in their dental classes (A LOT of #1’s), so while getting accepted with grades outside of the top 10% is a possibility, I wouldn’t gamble all of your hopes and dreams on that happening. Remember, statistics show that every single year, about half of those who apply to orthodontic residencies don’t get in. It’s not that they get into “lower level schools” (those don’t exist). They simply don’t get in and need to readjust their life plan. So, I tell everyone that if you want to be an orthodontist and can’t get awesome grades, you should be prepared to be a general dentist or another type of specialist for the rest of your career. If you can’t consider that, you know what you have to do in school. Enough said.

The other thing one has to consider is the cost of going to school. College and dental school are generally not free and the vast majority of orthodontic residencies require that you pay tuition (and living expenses) while in school, so be prepared to take out school loans…a lot of them!  It’s not unusual to see orthodontists graduate school with $400,000 or more in school loans.  The good news is that most orthodontists do OK for themselves in terms of salary, and you will likely pay back your loans (albeit over a long time)  but taking out massive loans is a very scary experience and you should be prepared. Being 28 years old and starting your career with a half a million dollars in loans is a scary thing to go through.

A great place to start finding out of orthodontics is for you is by interning or assisting in an orthodontic practice. Many practices require someone to help with smaller tasks like cleaning or sterilizing instruments and it’s a great opportunity for a teen to learn about what really happens in an orthodontic practice behind the scenes. Every state is different, so check online and see what restrictions are placed, but I would tell my own children that they shouldn’t consider being an orthodontist until they work in an orthodontic practice for at least a little while.

I love coming to work every day and the joy I see in my patients’ eyes when they smile their new smile for the first time makes my journey worth it. For those interested in becoming orthodontists, I support you 100%. It’s an amazing profession and I hope that it happens for you. If there’s anything I can do to assist you in any way, please don’t hesitate to ask.

All the best,

Glenn

Teeth, Braces, Invisalign and the secrets of the universe…

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OK, so maybe not ALL of the secrets of the universe, as the title might suggest.

I was a practicing general and cosmetic dentist for 20 years before going back to school to become an orthodontist. I am currently (to the best of my knowledge) the only practitioner on Planet Earth who is both a Fellow of the Academy of General Dentistry and a Diplomate of the American Board of Orthodontics, so this gives me a unique perspective on the worlds of orthodontics and dentistry. I tend to see these two professions through a different lens than most clinicians.

I know how busy everyone is nowadays, so my hope is that I can help you get the most relevant information to assist you and your family in making informed choices about your oral health.

I’ll try to keep this light, informative and lots of fun, and of course, I’d love to hear from all of you to find out what are some of the “hot button” topics in dentistry and orthodontics that intrigue you and need more clarification.

Wishing you all the best,

Glenn