Resonable and necessary dental treatment or not?

by Robin
(Florida)

I just moved to a new state and went to a new dentist recommended by a relative ( "he's nice, he's funny. ") For what I thought would be a 6 mo check up.

I have had periodontal disease for many years and have had gum surgery twice. I am in my 60's.

I usually see a dentist regularly for cleaning every 3 months. This time 6 months because of the move..

I left this appointment with a mouth full of Antridox and appointments to get a few caps and numerous fillings.

I was shown the cavities on the X-rays (dark spots.) And also the untreated cavities (?) on the X-rays from 2014 my previous dentist sent.

I Don't usually get cavities, now have about 6. I think, some on or below the gum line, others which will result in the need for caps. I already have several caps and old fillings in my mouth.

The gum pockets measured a lot of 5-6 and a couple 7 so I had the deep cleaning and Atridox done today. I know last time they were measured they were less.

This all sounds necessary I guess, but I also have been "given" a rodedent brush, Acclean and Periomed rinses and a tube of Clinpro. And a healthy loan to pay for all of it.

My question i guess is does this sound like this is all reasonable and necessary treatment or a case of "here she comes, she has a good job and decent dental insurance ".

I am concerned because of the fact they rushed me right to the hygenist today and the Rotedent..
Thanks,
Robin

Reply:

Hi Robin, Those are good questions and unfortunately I can't answer your biggest question of whether the treatment that was recommended is really necessary.

But I can give you my thoughts...

I am familiar with the periodontal products you mentioned and have been to a seminar where dentists and hygienists were trained to implement a program called Soft Tissue Management - STM. These products Atridox, Rotodent, and Periomed were all part of the "program."

The dentists and hygienists in our office agreed the program wasn't for us... for ethical reasons.

I don't like these programs because they push their products and procedures when they may not be necessary. They fit every patient into one of 3 treatment plans instead of treating their patients as individuals with different goals, priorities and budgets.

They are decent products and helpful for some but dentists who participate in some soft tissue management programs tend to over-sell and push them on most if not all of their patients and especially new patients.

Aside from the ethical problem, there are other products that I like better...Arestin over Atridox and Sonicare over Rotodent.

More importantly, I prefer to give my patients advice on products and let them choose according to their needs and their budget rather than force an expensive package on every patient. There is definitely more than one way to successfully manage periodontal disease.

Being seen every three months for a regular (and reasonably priced) cleaning has been shown to be very effective. So has good old fashioned brushing and flossing. Listerine or Colgate Total mouthwash. Using a toothpick or a WaterPik...I could go on and on. It depends on the situation.

Your sudden need for crowns and fillings may or may not be legit. It happens sometimes. But it sounds like you have enough doubt to warrant a second opinion. I know it's a pain but your X-rays are yours and can easily be transferred most offices can email them.

I'm sorry you have these questions. It's enough trouble and expense to get dental work done when you don't have any doubt. You should be able to trust your dentist.

Thanks for writing and good luck,
~Shelly


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Feb 15, 2016
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So True
by: Robin

Thanks for your quick response Shelly. You are right on the money, soft tissue management - STM - is exactly what the "treatment plan" I have been given is.
It is done, hopefully no harm done to my somewhat fragile teeth and gums.
I do feel it was unethical in that when I expressed some doubt ( about the cost mostly ) I was pushed right into the hygienist office to have the treatment done immediately. I fell for it.
I will certainly get a second opinion on the caps and fillings.
I am so glad I found your site.. It shouldn't be such a rarity to find good, honest information, so thanks for what you do.

Reply:

Thanks for your note. You are very welcome:)

Just to clarify, the term soft tissue management (STM) may be used to describe good and ethical treatment of periodontal disease. It is just this type of soft tissue management that I have a problem with...the type that fits patients into a category and forces a set of products and procedures on them. Then uses every dental code possible to run up charges.

~Shelly

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