What makes your dentist good?

I’m dental-phobic. I have horrible nightmares about my teeth (all falling out, or chasing me and devouring my face :(). I’m terrified about the prospect of going to the dentist, and I’ve only been 4 times in my entire life (3 of those before age 18). It’s been about 5 years since I had a dental appointment, which was in a totally different geographic area. They had recommended oral surgery for a couple extractions, which I never had done because I was uninsured and those teeth weren’t in pain. But now, I’m at a point where I can’t avoid going any longer. I do have insurance this time, at least. I’ve got an unpleasant bicuspid situation going on (among other things). So, I need to find a freakin’ dentist; I’m trying to evaluate providers before I pick one.

What does your dentist do that makes him/her better than average? Are there any signs that should make me run screaming out the door before I let them laughing-gas me? Is there a way to express how terrified of dentistry I am without them laughing and calling me a chickenshit behind my back?

In my experience (which is considerable), a small dental practice is the best approach. The dentist will have fewer customers, and closer relationship with each one. That’s not all it takes though. A lot of it is personality. A good dentist should be reassuring and willing to accomodate your needs. You have to tell them about your fears, and if they seem dismissive in any way, go to another dentist. You need to avoid the power mad type who insist you do it their way. If you want to move to New York or Rhode Island, I can point you to a couple of great dentists (although the one in NY may have retired by now). Otherwise, do what I did and consult with a lot of dentists until you find the right one.

Without actually meeting them I don’t know how you’d know ahead of time. I’ve done well getting recommendations from neighbors and friends, but try and ask the people who really have had dentistry done, not the people who like my sister has had one or two cavities filled in her whole life.

Here’s what I like about my current dentist, that has caused me to recommend him to friends:

He asks questions about my dental situation that leads me to believe that he really knows what’s going on (Is it constant, dull, throbbing? Does it react to cold or sweet?)

He offers options. And his answers when I ask “what if we just pulled it” seem reasonable (and sometimes he even says “nothing, really” I’m missing a few molars because I needed the $200 option not the $1400 option.

As far as procedure, he is hands down the best number I’ve ever been to, and I’ve been to dentists in six different states. Had four fillings at my first visit, I’ve had root canals and extractions, and fillings replaced and root canals rerooted. I know from dentists. I’ve had procedures where after 3 shots I was still feeling everything. Dr. S gets it right every time.

He also explains what he’s doing as he goes, but not in a cloying way. “Just changing burrs to neaten it up. This one will be louder”

He’s never seemed impatient with me when I’m trying to tell if my bite is correct (it’s hard when you’re numb, but really important) which is not true of all of his colleagues.

Another thing I like, that has nothing really to do with his abilities as a dentist, is that in the four years I’ve been going to him his entire staff has stayed the same. It just leads me to conclude that he’s a decent boss, which isn’t crucial to the care of my teeth, but gives me a good feeling.

He will make sure I have enough Novocaine in me (and that it has kicked in) before he starts drilling. I have had impatient dentists who go, “Oh, that’s good enough, just let me know if I hit a nerve!”

He is also not an alarmist hard-sell, like his partner (whom I try to avoid). Every time I see the partner she tries to schedule fillings or filling replacements that I don’t actually need (“Well, that looks like it may *become *a cavity!”) and tries to sell me all these expensive products.

For me, it’s not lecturing me about not having been to the dentist in a while. What happens is, I move to a new place, then don’t get around to finding a dentist for a while. Then I’m afraid to ask anyone for recommendations or go to a dentist, because I’m afraid of what they will say about my not going for a while.

I always mention this fear over the phone (so they can’t see that I’m so scared I’m actually crying and shaking) when I make my first appointment, before I ask about scheduling. I’ve never had anyone laugh at me for it. If they did, I’d hang up on them and not go to that dentist. There are other dentists.

If someone at the dentist’s office does laugh at a prospective patient, know that they are acting in an unprofessional manner. Most people who work in jobs that involve interacting with customers and prospective customers know that laughing at a prospective customer is always a no-no, no matter how stupid or cowardly that person is acting. That’s just not how a professional should act.

A dentist that doesn’t work with patients with dental fears is closing themselves out of a very large segment of the market. It’s estimated that at least 75% of US adults have some level of fear about going to the dentist. Treating 75% of your prospective customers with derision is no way to run a business, any business. A large percentage of their customers being scared also means that any one person who’s scared is less likely to be noteworthy. Dentists and their receptionists literally see this every day. If someone is doing something that you see people doing every day, it’s not very likely that you will talk about it behind their backs.

You may have limitations about who you can choose due to your insurance (which I know you know full well because of your response in the “choosing a family therapist” thread), but a lot of dentists will use wording in their advertisements that signal, “We’re used to working with people with dental phobia!”

Looking for a sedation dentist might be another strategy.

I used to have regular tooth nightmares, too, and once I got hooked up with a dentist I really like, they stopped!

My dentist recommends not going to a dentist.

Really. He maintains that six monthly check-ups are a rort, and merely an opportunity for unnecessary interventions. The more interventions, the more dental issues.

He is the most gentle dentist I’ve ever had (admittedly I’ve only had 3 others) and reckons you should only go to the dentist if you think there’s something wrong.

Anyway, the only procedure I’ve ever had (aside from 4 extractions for braces as a kid) is having them cleaned - and I only do that about twice a decade. :eek: I mean :smiley: as a lucky one with perfect (and white) teeth.

Looking up online reviews on google or even Yelp can help too. That’s how I chose the last couple of dentists.
As for the idea of not going to the dentist regularly, some people might be able to get away with that, but if there is a problem brewing then it could just end up making things worse. I think the more you try to avoid the dentist, the worse it makes the visits when you do go because by then a problem that might have been fixed pretty easily if caught early could involve some extensive and painful work.

He takes any concerns or fears seriously and is willing to work with a patient to calm fears or provide distractions and/or medication to handle anxiety.

He takes any complaint of pain seriously.

He asks about other medical issues that might affect dentistry (in my case, it’s allergies. For my spouse, it’s the hardware in his right leg and diabetes.)

He doesn’t dictate. He lays out your options and tells you the potential consequences of each choice and lets you, the patient, decide.

He has no problem if you want to seek a second opinion.

He is willing to talk about payment plans not just for expensive items, but also for routine care if you’re poor.

Anyone who dismisses your fears, your concerns, or your pain.

Anyone who heavily pushes cosmetic stuff. My dentist offers tooth whitening and veneers, but he doesn’t push them. The strongest “sell” is “have you thought about X?” but if you say you’re not interested it’s no problem. About the only thing he gets pissed over is tongue/mouth piercings.

As calmly as possible, tell the person you’re making an appointment with that you have had bad experiences in the past and you wish to talk to the dentist in person about your concerns and fears. As calmly and concisely as possible state your fears and concerns to the dentist.

For example, I tell every dentist I go to that I do not handle dental pain well, and in the past both pain and fear of pain led me to avoid the dentist for years at a time (true). My fear centers around pain - if there is no pain there is no fear. Being pain free is extremely important to me but I, personally, don’t require being knocked out, gassed, etc. for everything, I just want assurance that if I state something hurts it will be taken seriously and if necessary adequately medicated until there is no more pain.

For other people it’s anxiety. Even if it doesn’t hurt they have fear. You handle that in a different manner. For others, it’s the sounds (in which case a set of headphones and some music might be the answer - just about all dentists these days have some sort of set up to allow for that, or will let you bring your iPod or whatever). The better you can articulate your concerns the more a good dentist can do for you.

One mark of a really good dentist is that if you say “I’m afraid of going to the dentist” he can ask you questions to determine why you are afraid and propose solutions to help with that.

Someone who does this is an asshole. A dentist who shames you or laughs at you about your fears, concerns, or pain is not only an asshole, they’re an unprofessional asshole.

He’s been dead for 30 years!

You are not alone in being afraid of going to the dentist. There are dentists who have specialized in “fear-free” treatment. This means that they use local anesthic so you don’t feel what they’re doing (this, plus the drill speed, have improved much since the 80s); they play soft music to help you relax; the room is painted in pastel colours instead of sterile white - some have TV flat screens on the ceiling so you can watch a movie or nature while the doctor does the work; they use aromatic oils to relax.

Asking your insurance company, looking into the white pages or asking the local Association of doctors for dentists who specialize in that approach would be a good start.

Because you’re not alone, good dentists will be used to this fear. They won’t laugh at you behind your back, but take you and your fear seriously and tell you how they plan to deal with it. (That’s not to say that some old-style curmudgeons aren’t still around - but when during the first talk they react huffy, then leave).

Tell the office when making the appointment that you want a talk and estimation first, not treatment, on this visit. This means talking to the doctor about your fear, the doctor assuring you, and then the doctor looking into your mouth and describing what he wants to do, how long it will take, in detail. (Along with a written estimate of how much it will cost).

Be prepared to do this first visit more than once until you find a doctor you feel comfortable with - because then you have one for the rest of your life.

The only tip is that younger doctors may last you until they retire, and in bigger practises (with more than one doctor) the chance is good that when they retire, a new doctor will take over.

But this is just a general tip, not a fixed rule - many middle-age people might feel uncomfortabel with a doctor “who’s old enough to be in high school” and prefer a doctor of similar age even if that doctor will retire in 15 years. So go with the doctor you feel a good rapport and sympathy with, so you really will keep going after the immediate emergency.

Thanks so much for the tips, I feel a *lot *better already. It was really easy to log onto my dental insurance’s website and print a list of providers and my insurance card–that’s a first, usually it’s really complicated and obfuscated and other kinds of ated. I have tentatively picked a dentist from that list who has a website, specializes in sedative dentistry, and provides reduced-cost care to the indigent (like a sliding scale thingy). I figure a dentist who’s willing to work with poor people for less money is 1) kinder than average, and 2) used to seeing some pretty bad teeth. So maybe mine won’t look so bad in comparison.

Thanks for the tip about Yelp, too. I never thought to look there, even though it makes sense that people would review their doctors and stuff.

I went today! They managed to get me a Saturday appointment within 2 days, I was very happy about that. I just got some xrays and a cleaning and got my cavities diagnosed. I’m going to take care of them as I can afford it. I really liked the dentist. She was young, competent, and very nice. And it’s a private practice under just her name, so I’ll always be seen by the same person. yippee :slight_smile:

I learned the hard way that its less painful to get cleanings every 6 months. A 6 month cleaning is simple and there’s not much plaque to remove. I waited 3 years one time. It was my worst experience ever with a cleaning. My gums were sore for three days. I swore than that I’d never wait that long again.

The biggest thing I look for in a dentist is someone that sticks with the basics, I don’t want anesthesia gas for a filling or crown. I don’t want my teeth whitened. I don’t want any expensive cosmetic procedure.

Clean my teeth, do the x-rays for cavities and do any fillings or crowns painlessly.