What Constitutes "Ideal Dentistry" Today?
Compendium features peer-reviewed articles and continuing education opportunities on restorative techniques, clinical insights, and dental innovations, offering essential knowledge for dental professionals.
March 1, 2011
Volume 32, Issue 2, March 2011
Page(s): pp 8-9
Not that long ago, dentistry was a much simpler profession. Most practices were "drill and fill" offices where cavities occurred more frequently than now. Elective dentistry was not in high demand and comprised only a fraction of the average dental practice’s schedule. A limited range of cosmetic dentistry options was geared more for the rich and famous than for the average patient. Even orthodontics was something more for children of the well-to-do.
Things have clearly changed. In recent decades, dentistry has seen an explosion in technology and the number of services available to patients. Many of these services are in demand from the general public and are affordable for a growing number of patients.
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All of this technical innovation, combined with shifting patient perceptions toward elective dentistry, has created a pressing question for dentists: What services are appropriate for their patients? Perhaps a larger issue needs to be addressed: Has the definition of "ideal treatment" become blurred?
I have always been a strong advocate of doctors offering ideal treatment to patients based on a comprehensive evaluation of their immediate and long-term oral health requirements. Before it can be determined whether patients will be interested in or have the financial capability to accept treatment, the ideal treatment plan should be developed and presented. In the process, patients will come to understand that the dentist has their best interests in mind.
Presenting ideal treatment also serves to:
The benefit is that patients receive a complete picture of what it will take to achieve optimal oral health. There is, however, a complicating factor: They also receive information about services that are important to their overall well-being but not necessarily mandatory for good oral health. Should the doctor present these additional options as part of the big picture for oral health or rather as a distinctly separate plan? Many dentists find this a difficult question to answer.
Today, cosmetic and implant dentistry both many options. These increased choices lead to several questions dentists find themselves asking:
• What is ideal treatment for patients?
• What are the ramifications if a patient does not accept the ideal recommendation?
• Do certain elective services represent ideal treatment or are they simply a luxury?
The third question is the most difficult one to answer. In fact, dentists are unlikely to reach a true consensus on it. Consequently, many patients are not offered all available services. Dentists should keep in mind that patients depend heavily on their professional advice. Despite a wealth of dental data available on the internet, patients still prefer to receive their oral health information from their doctor first-hand.
To create a more comprehensive approach to ideal treatment for patients, dentists will be well served to institute the following:
• Provide a thorough diagnosis for all patients, including periodontal, tooth, cosmetic, implant, and occlusal. This ensures that comprehensive dentistry options are evaluated for each individual.
• Educate patients about all aspects of their oral health to ensure the optimal treatment outcomes. Also, explain whether the diagnosis represents a short-term or long-term problem.
• Create treatment plans that explain all ideal options and why these are different from and/or better than other options.
• Focus on multiple methods of payment options so that motivated patients can take advantage of ideal treatment within their financial capability.
By promoting ideal treatment, dentists are better enabling patients to achieve optimal oral health. However, it seems that the definition of oral health needs to be expanded to include elective services. This is not to say, for example, that patients without a perfect anterior shade lack excellent oral health. Nevertheless, patients should be made aware of all their options.
At this point, the situation becomes complex for the dentist. Should cosmetic dentistry be recommended? Remember that today’s concept of ideal treatment is more likely to include services that are not necessarily essential to the patient’s overall health but may be beneficial to their psychological well-being and quality of life. The ethical aspects of cosmetic versus need-based dentistry (and the benefits to patients) will need to be determined by each individual doctor, bearing in mind that these options give patients greater freedom to determine how they wish to pursue their oral health and sense of well-being.
Like many professions, dentistry has become more complex with each passing year. New services present greater opportunities for dentists and patients. Once a dentist has established his or her definition of ideal treatment, it should be presented to patients in an educational manner that makes them aware of not only their options but also the ramifications of completing—or not completing—treatment.
Is there a right answer to what constitutes ideal treatment? Yes—whatever allows dentists to continue serving patients in the most comprehensive manner and motivates patients to take pride in their appearance and their oral health.
Roger P. Levin, DDS is the founder and CEO of Levin Group in Owings Mills, Maryland.
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