R.V. TUCKER (WINTER 1978), THE DENTAL PATIENT HAS A PROBLEM, OPERATIVE DENTISTRY, VOL 3(1), PP 25-26
POINT OF VIEW
The Dental Patient Has A Problem: In his search for good dental treatment the patient is handicapped by his lack of knowledge of good dentistry.
How many times have you wondered what the patient would think if he or she had your knowledge of dentistry, yet received the type of restorative dental care that we see so often in the mouths of our patients?
It is unfortunate that, although good dental health is considered essential to nearly everyone, few people know what it is, or how to get it. They innocently place the care of their mouths in the hands of someone whose credentials they probably investigated very little.
At a recent annual meeting of the Associated Ferrier Study Clubs it was reported that a
computer readout involving an enormous number of patients in California disclosed the following facts. The average length of time a full veneer crown lasted was between two and three years. The average bridge lasted three to four years before replacement. This is hardly a testimonial to fine restorative dentistry.
The problem is complicated by the fact that it is difficult for a patient to evaluate the quality of dental operations involving marginal integrity, proper contours, occlusal harmony, and many other factors. As a result, the dentist is evaluated by other criteria which the patient better understands, such as friendliness, a handsome office, or lack of pain in treatment, all of which are important but contribute little to high quality dental care. The quality of restorative dentistry is not empirical and does not adapt to the usual measures of control; thus the patient has difficulty in knowing whether or not he has received good treatment.
It would seem reasonable that a patient, who cannot properly evaluate restorative dentistry for himself, could at least depend upon the dental profession or a peer review committee to eliminate from practice those dentists who perform their operations poorly. To some extent this is true in that a few grossly inept or disabled dentists might be eliminated from practice. However this would not help the patient who is seeking dental care of high quality. There is recent concern that the nation’s judicial system will strike down state laws that prevent commercial advertising by dentists. Such an action would also require removal of the advertising clause in the codes of ethics of dental associations. Of course the public could hardly be expected to understand the implications of such a “consumer interest” cause. To those who really know the dental profession it is obvious that advertising would promote the interests of those dentists who would compromise quality of care. If this were not true, advertising would be unnecessary.
Too many unknowledgeable and unsuspecting dental patients allow themselves to be herded through a production-line office in the name of efficiency, probably without even the satisfaction of less cost. Unfortunately for the patient cheap dentistry does not necessarily come at a cheap price.
In spite of our shortcomings, the patient still must turn to us in the profession to solve his problem. Most would prefer dental treatment of fine quality if they knew what it was and how to get it.
For a start this is what we should do:
1. Educate people through the media and in our offices about the particulars of good dentistry so they can appreciate and demand it.
2. Cooperate with peer review in spite of its inherent weaknesses.
3. Help educate patients to seek dentists by referral.
4. Ask our nation’s dental schools to place a renewed emphasis on teaching restorative dentistry of the highest quality and attempt to instill in each student that illusive quality and discipline that causes him to accept only the very best from himself while he practices his profession—a very difficult task for our schools.
Yes, the dental patient has a problem in obtaining restorative care of fine quality though he may not know it. Let’s help him solve it.
P 0 Box 446, Ferndale, WA 98248, USA
RICHARD V TUCKER, DDS, conducts a practice full-time. He is director of the Frank Allen Dental Seminar, the Richard Tucker Study Club, and the Redmond Dental Seminar. He is vice-president of the Academy of Operative Dentistry and a past president of the Washington State Dental Association. He is a member of the American Academy of Restorative Dentistry, the American Academy of Gold Foil Operators, the Vancouver Ferrier Study Club, and is a Fellow of the American College of Dentists.