Reviewing a 1-star review! Dentist talks about bad reviews. "I don't have gum disease!"

I want to talk a little bit about another negative dental office review. This one is kind of interesting. It really gives us a clue to how the dental exam could go, could go better, and how it went very, very poorly. So let's read through it. I waited over an hour in the room to be seen by the dentist. When she finally showed up, she checked my gums but not my teeth, while the benefits coordinator was adding the cost of the things to see what the profit would be right in front of me and my brother. Dennis said that I have gum disease and left, still didn't check my teeth. The benefits coordinator then pressured me to spend $300 out of pocket for gum treatment. This was one day after seeing one of the best orthodontists in the state, who said my gums were fine. I had to make sure over three times that she wasn't going to charge me for something that I did not want, since she kept just trying to get me to sign that I would pay. I then got a topical cleaning. What kind of dentist checks teeth before the cleaning? My room did not feel clean. They did not seem knowledgeable. We'll never go back. A second opinion said that my gums were fine. Maybe in the future, this office should care about their patients instead of profit. Additionally, they were conveniently having technical difficulties when I tried to submit this on their customer satisfaction survey. I tried three times with seven likes. So let's talk a little bit about gum disease. Gum disease is really, really common, and there are some studies that not suggest but show that gum disease is the number one most common chronic disease that's out there. Periodontitis, a periodontal disease, is exceedingly common. So periodontal disease is an infection in between the tooth and gums. If left untreated, it increases all sorts of risks and is the leading cause of tooth loss if left untreated. But it's very, very common. And there's a good chance that the dental exam took 20 or 30 seconds, and the patient may not have been aware that the dentist was actually evaluating the teeth, because sometimes in the presence of gum disease, there may not be any tooth decay. And so the dental exam, the tooth exam, may go very, very quickly, whereas the gum exam requires us to literally measure the pocket depth of 168 sites, assuming there are no wisdom teeth present, which takes some time. And so that may have drawn the patient's focus from the tooth exam to just the gum exam. So with that in mind, having an active gum infection requires more than a basic cleaning. A basic cleaning is practicing below the standard of care and actually puts the patient at higher risk. So having the correct diagnosis is absolutely critical. Now this comment about having the benefits coordinator adding the cost of things right in front of the patient, you know, this is something that I can't necessarily speak to. I think there are some things that are done in poor taste sometimes, and talking about costs and fees with the provider in the room I think is inappropriate. So I think, you know, potentially this could demonstrate that the front office team and the provider or the dental assistant or the hygienist, whoever it was that was doing the presentation, needs to revisit their presentation protocols. Because it's something that, generally speaking, when you're presenting financial costs you have to do it with a certain amount of rapport and a certain amount of decorum. Otherwise it comes across as really salesman-y, really pushy. So we have to be cautious as we're doing that. Okay, so comment about seeing one of the best orthodontists in the state. I don't have any doubts that there is a best orthodontist in the state. It's hard to say how they determine that. But an orthodontist doesn't generally, not that they don't, not that they all don't, but an orthodontist doesn't necessarily measure the gums. Many do, but many don't. So they'll just evaluate the teeth, they'll look at the gums, but they won't actually take the time to measure each spot. So it's possible, it's actually fairly likely that the orthodontist really had no clue as to the gum disposition, unless they were to have spent the two to three minutes actually measuring. Unfortunately, just looking at the gums oftentimes is insufficient to tell a patient whether or not they have gum disease. You need a combination of x-rays and periodontal probing and an enteral exam to determine whether or not a patient has gum disease. And just looking at x-rays or in the mouth is not sufficient clinically to diagnose gum disease. Although sometimes it is a very strong indicator, we have to do a good job of diagnosis. Okay, so what kind of dentist checks teeth before cleaning? Well, this is something that I routinely do. I'm not saying I know everything or that I'm very smart or know most things, but I am saying that a clean mouth is much easier to look at. If you have a patient that hasn't been in in years and they have plaque or tartar or stain everywhere, sometimes going through and having the dental assistant polish and floss beforehand yields a much easier process for me to do a basic cleaning or a basic examination and evaluation. So oftentimes in a situation like this, I will have my assistant polish and floss first. That's not a cleaning. That is a polish and a floss. However, sometimes in the other order, we'll do things in the other order. So I'll go in and do the evaluation because many patients, as we've discussed, have periodontitis and don't need a basic cleaning. And were we to complete a basic cleaning ahead of time, before a diagnosis of what they needed, that's practicing below the standard of care and that's also completing something that is not, that shouldn't have been completed, meaning the basic cleaning. A basic cleaning is actually a diagnostic code and indicates that the gums are healthy, whereas for patients who have periodontitis, that's an active infection. So there should be no basic cleaning completed in that case. Otherwise, it puts our license on the line in some situations. Topical cleaning. Yeah, I think we're talking about a basic cleaning, a polish and a floss, maybe a little bit of scraping. The room did not feel clean. That's a common issue, especially in a busy office. Sometimes dental assistants or cleaning staff or front office staff or the dentists or whoever it is just don't clean as well as we should. It's really important that the rooms are clean. Got a second opinion. I would hope that that second opinion involved measuring of the gums because there's no way, as we've talked about, to actually determine if you have gum disease unless you have a good thorough set of x-rays, an enteral exam, and measurements of the periodontal probings. Maybe in the future this office should care about their patients instead of profit. I would agree. Sometimes it feels like dental offices focus too much on profit. However, if the dental office can't turn some sort of a profit, or at least break even, the dental office will cease to exist. It's unfortunate, but we are blending now profit with protecting people's health. We're blending profit with health care, and that's just the way our society is set up for better or for worse. I think it's worse many times. And so we have to find some sort of a happy medium. So the decorum and the diplomacy with which the financial question marks are presented is really, really critical. I don't think there was anything untoward to address the last comment in the technical difficulties. It was probably honestly just a system being down. So I'm hopeful that this patient considered an additional opportunity to communicate with the dental office, to let them know of the negative experience that was had. The challenge that we have in a dental office is, in order for a dental office to be productive and actually provide enough income for the dentist and the team on site, there has to be a certain level of busyness, a certain level of, you know, number of procedures and patients. Otherwise, we're just totally ineffective. And so this has to happen routinely. Otherwise, the dental office will go out of business. So that's the way it is, unfortunately, blending income and busyness with patient health care. Just like hospitals, I mean, we've all experienced the same thing. So you've got to do your research, find a place that works well for you and that is focused on patient care and long-term connection and long-term oral health care. So hopefully this review has been helpful. Thanks for watching.