The Real Truth About Dentistry – TeethRemoval.com

An intriguing long form piece appears in the May 2019 issue in Atlantic titled “The Truth About Dentistry: It’s much less scientific—and more prone to gratuitous procedures—than you may think,” written by Ferris Jabr, see https://www.theatlantic.com/magazine/archive/2019/05/the-trouble-with-dentistry/586039/. This article has a lot of people talking including dentists, physicians, and patients who have experience with dentists throughout the Internet on forums and Twitter (see https://www.whitecoatinvestor.com/forums/topic/the-truth-about-dentistry-critical-longform-piece-in-the-atlantic/). The main shortcoming with this article in the Atlantic is it relies on an anecdotal story which forms the basis of the entire article. There are several themes to the article that will be discussed below along with additional themes not mentioned that are involved to form the real truth about dentistry.

1. Dentistry is a Business and some Dentists, just like in other Professions, are Bad Apples.

The article describes a dentist Lund who overtreats patients by performing more expensive procedures that are not necessary in order for him to make more money and does this for many many years. Dentist Lund’s way of making extra money is by having patients with cavities receive root canals with incision and drainage when cavities are the proper treatment.

I had a brother inlaw that was a dentist. I mention how the dentist is always trying to sell me on something. He said to me “We are a business too”. That was all I needed to know…..

— Patrick Husting (@patrickhusting)

“Years ago, at a routine dental cleaning, the wife was diagnosed with 18 asymptomatic ‘small cavities’  that needed to be fixed. So we got a 2nd opinion, lo and behold, no cavities. Somebody apparently needed a new boat.” – portlandia via whitecoatinvestor.com

2. There is a Unique Power Dynamic in Dentistry that is Unlike Other Relationships

Many aspects of the dental experience have resemblances to torture experiences. When a dentist is standing over a patient inserting sharp instruments into their mouth they often feel powerless. Perhaps because of this the vast majority of patients who see a dentist do not get a second opinion from another dentist. This is unlike medical doctor visits where seeing a second doctor for another opinion is more commonplace. Furthermore the vast majority of patients are not reading medical and dental literature on their own and discussing it with their dentists if there were any disagreements.

dentist mouth - The Real Truth About Dentistry
This image is from Pixabay and has a PIxabay license

3. Dentists Have very Little Checks and Balances on Their Practice

The article presents a story of a young dentist Zeidler who buys the practice of of retiring dentist Lund who had overtreated patients for years. After several months Zeidler suspects there is a problem because he was only making 10 to 25% of the prior dentist Lund’s reported income. Zeidler also encounters many of the patients of the practice and notices a large number of them have had more extensive treatment performed than needed. Zeidler spends nine month’s pooring over Lund’s patient records. The records demonstrate vast amounts of overtreatment. Thus the overtreatment by the dentist went unchecked for many many years and it was not until the dentist retired and the patients and records were seen by someone else that the overtreatment was detected. Most dentists have individual private practices which is unlike medical doctors who usually work for a hospital or organization with more oversight.

4. There is Little Scientific Evidence to Back Dental Treatments

The article discusses oral health studies performed by Cochrane which is a well respected evidence based medicine organization that conducts systematic reviews. Nearly all of the studies performed in the field of dentistry by Cochrane have shown either: 1) there is no evidence that the treatment works or 2) there is not enough evidence to say one way or the other that the treatment works. What to do in regards to dealing with healthy asymptotic wisdom teeth is one of these treatments in dentistry where there is a lack of scientific evidence to support either preventative removal or watchful waiting.

5. Dentists are Paid Based on Treatment and Not Prevention which is being made Worse Due to Large Student Loans

The reality is if everyone had healthy teeth and no need for dental treatment besides occasional cleanings, exams, and x-rays dentists would not make much money. The pay structure for dentists rewards procedures and treatments. Dentists today graduate from school with a large amount of debt and they also want to buy an individual practice to run. This can lead them in debt of well over $500,000 which can push them to recommend treatments and procedures that are not really needed to try to pay this debt off.

6. There is a Lack of Focus on Quality Improvement due to a Culture of Cover-Up

Everyone can agree that patients want high quality care at an affordable price. However dentists are hesitant to make real strides towards quality improvement due to fear of being sued and increased liability insurance premiums. Human error can never be completely eradicated and human nature is not perfect. Humans have varying anatomy that can’t always be anticipated. Thus protocols should be in place for dealing with things such as sexual assault in the dental office and to address what one should do when the wrong tooth is extracted. Similarly protocols should be in place to best identify what to look for on panoramic radiography to determine if a wisdom tooth is at high risk of damaging a nerve and if cone beam computed tomography or coronectomy should be performed. Similarly protocols should be in place when a sharp or needlestick injury occurs in the dental office. In addition protocols should be in place for when a dental instrument breaks and is left in a patient during a procedure. It seems that dentists could be sharing data with each other about what goes on in their practice and they could be addressing sensitive issues instead of pretending that they don’t and won’t again occur.

This content was originally published here.

SBA Finalist Spotlight: Northern Virginia Orthodontics

Thank you to Northern Virginia Orthodontics for answering a few of our questions.
Congratulations on being named a finalist for Health & Wellness Business of the Year!

1.Tell us your story of how your company got to where it is today? 

After finishing my orthodontic residency at the Medical College of Virginia in Richmond in 2006, my wife and I knew we wanted to move to Loudoun County. We both grew up nearby, and were aware of the planned residential growth, excellent schools, and the fact that Loudoun would be a great place to raise our kids and open an orthodontic practice. We settled on Brambleton Town Center, centrally located in Loudoun, to both live and work. With my vision to make an impact on patients, my team, and my community, I opened Northern Virginia Orthodontics in February of 2008. We saw just two patients that day, and despite the economy crashing in 2008 and 2009, NVO continued to grow thanks to our dedication to treating patients like our own family, over-delivering on top-notch service, and changing lives both inside and outside our office.

Since opening our doors in 2008, we’ve expanded twice in our Brambleton office, added the East Coast’s first, adult-only Invisalign Center, earned the title of Washingtonian Magazine’s Top 50 Places to Work, treated the most Invisalign patients in the state of Virginia, and in 2017 became the #2 Invisalign provider in the entire country.

Despite all these incredible accomplishments, what I’m most proud of is NVO’s impact on the local community. To date, NVO has donated over $1 million to local schools and organizations, as well as to pediatric cancer research and awareness. With our brand new 501(c)(3), The NVO Foundation, we can continue to do even more to help those in need right here in Loudoun County. It’s been an incredible ride going from just two patients that very first day to now seeing over 100 patients on a daily basis, but NVO is just as committed as ever to changing smiles and impacting lives.

2. What would it mean to you and your company to win a Small Business Award?  

Winning an award of this magnitude would serve as affirmation that Northern Virginia Orthodontics is impacting and improving the Loudoun County community, and would serve as fantastic recognition for our entire team.

3. If you weren’t running your own business/working at this business, what would you be doing?

I’ve always had a passion for medicine and helping others, hence becoming an orthodontist. I couldn’t imagine not working at NVO, but if I had to do anything else, I’d probably be a pilot.  I love flying and aeronautics.

4. What book are you reading right now? / What is your favorite book?

“Tools of Titans” by Tim Ferriss. It’s a study of successful people’s habits, and focuses on three critical elements – health, wealth and wise. Great read for anyone, especially business owners.

5. If you have 24-hours off, and your family was out of town, what would you do?

I’d work out, eat a healthy breakfast, then look for a D.C. sporting event to attend, like a Nationals or Capitals
game. Then a good glass of wine with dinner and call it a day – but I’d rather be with my family!

6. What is the smallest thing that has made the largest impact on your business?

Having no fear of change. It’s absolutely essential to assume risk, and to be open to change as your business grows.

7. What did you want to be when you grew up as a child? / What was a childhood dream that you had?

A professional baseball player. Baseball was my passion growing up, and remains a giant part of my family. My oldest son is currently plays baseball at the University of Arizona, and my wife and daughters love the sport as well.

8. Who is the one person that has influenced you the most in your career?

There are so many people that have influenced me along the way, but my older brother has definitely influenced me the most. He has a solution for every problem. He is an attorney by trade, but is always there when I need an opinion on anything business-wise and has been a huge part of NVO’s success.

9. What is your favorite thing about running a business in Loudoun County?

The growth and success of the county, and the pro-business mindset of its leaders.

10. If you’re not in the office where can we find you?

At my son’s baseball game, my daughters’ soccer games, a local winery, a D.C. sporting event, teaching the orthodontic residents at MCV (Medical College of Virginia), or out helping others.

11. What is your favorite weekend activity in Loudoun County?

Visiting one of Loudoun County’s many incredible wineries with family and friends.

The post SBA Finalist Spotlight: Northern Virginia Orthodontics appeared first on Loudoun Chamber.

This content was originally published here.