Should I trust my dentist? Evidence based dentistry.

I don’t get this question asked to me in a direct fashion but I sense it is lurking in the background of patients’ minds. And honestly, it is no different than what people think when they get their car checked or HVAC system checked. I know that I even think to myself, “Do I really need a new HVAC or circuit board in my car” when I am told that I need to replace an expensive item.

I can’t speak for the mechanics but in dentistry, we have what they call “evidence-based treatment”.  That is just a fancy way to say that there is a cavity in a tooth and that it needs to be treated in the correct fashion. We have intraoral cameras nowadays so the dental hygienist, dental assistant, or dentist simply takes a picture of the tooth. Generally speaking, if the image has a big black spot then you have a cavity. If that black spot is under or near a large filling then a crown or root canal may be needed.

The big thing is that there should be a dialogue between the dentist and the patient. And most of dentistry is very obvious. If the tooth hurts it needs a root canal, extraction, or some sort of gum or crown work. A picture goes a long way in that explanation process.

The big question is the treatment. Reasonable dentists will differ on treatment options.  The only thing worse than telling a patient they need an expensive root canal or crown is trying to save them money and having the filling break or fall out prematurely. The patient almost always says “YOUR filling hurts or fell out”. I prefer to solve the problem and not have to address it again for at least a decade.

Lastly, two dentists may differ on treatment options. So if you go to two dentists they may differ in the treatment or even the diagnosis. They both may be reasonable. It is just that dentistry is an art and a science. I mean that it takes experience to anticipate and plan treatment based on hundreds of previous treatments that worked or that did not work and knowing the reason why each had that particular outcome.

If in doubt, ask for intraoral photos and an explanation. It should sound reasonable. And if another dentist disagrees, show them the black spot on a tooth from the picture and ask them to explain. When all else fails, ask the local dental board or dental society to give their judgment, otherwise you may falsely believe the dentist not doing any treatment only to find out years later you errored in judgment.


Please feel free to call my office for a free consultation or second opinion.

Call Dr. Emmi at Smile Solutions 302-999-8113.

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