Karen Vasso, a 43-year old farmer from Chelmsford, Massachusetts, takes good care of her health. In addition to the copious amounts of physical exercise she gets while working, she’s an avid swimmer and triathlete, who’s completed a few solo 12.5-mile swims around Key West in Florida. She also has a background in nutrition and knows that good dental health is an important aspect of overall wellness. She’s long sought to make visiting a dentist regularly a priority. However, a couple of bad experiences over the years have caused her to think carefully about what makes a good dentist and how to find the right one for her.
The first incident occurred several years ago. At the time, Vasso was a single mother and her health insurance wasn’t terribly robust, so her options of which dentist she could see were limited. “I went to this quiet, dark office in the basement of a building” in a nearby town. The office was mostly empty, save for the dentist himself, and Vasso recalls thinking, “this is scary.” Undeterred by her gut intuition, she went through with the appointment. “He cleaned my teeth and at the end he said, ‘you have a cavity. I’m going to need you to come back for a filling.’ I know my teeth. I have extensive knowledge about nutrition and how that affects dental health,” and she says she suspected she didn’t actually have a cavity.
She asked the dentist to show her on the X-ray where the cavity was. “He kind of backed out of it. He had nothing, so I left and never went back. Because he was the only dentist my insurance covered, I didn’t go to the dentist for several years,” she says.
Fast forward a few years to a new town and new health insurance, and Vasso decided it was time to do something about the lack of routine dental care she’d had for the past couple of years and scheduled an appointment with a local dentist. She opted for “a very big chain dental practice” that was in her insurance plan and made an appointment for a cleaning. “They did a cleaning and a cursory exam and told me I had six cavities. It blew my mind – there’s no way I have six cavities,” she says, feeling outraged.
Before she was even able to get clarification on where and how severe these cavities were, she’d been herded to the front desk to settle her bill and make several more appointments for additional dental work. Vasso decided she didn’t trust that dentist and made an appointment elsewhere for a second opinion. As suspected, that subsequent dentist confirmed she had no cavities at all, let alone six of them. “Can you imagine them drilling into my teeth for no reason? It blows my mind,” she says.
While Vasso’s experience may be extreme, it illustrates how important it is to find a dentist you can trust. “The dentist has an obligation to be truthful,” says Dr. Ada Cooper, a dentist in private practice in New York City and a spokesperson for the American Dental Association. “The best doctor-patient relationships are based on truth and trust, and trust in treatment planning is absolutely critical. Once you and your dentist have that trust, you can go forth and be partners in a way that will help you gain so much in terms of your dental health,” she says. She refers to this as “finding your dental home,” a place where you can be assured that the provider has your best interests at heart and offers the right care that you actually need.
But it can be hard to know whether what your dentist is telling you is accurate. Cooper says that, as Vasso did, you should consider whether what you’re hearing makes sense. “If it doesn’t seem or sound right – if the recommended treatment doesn’t make sense or the dentist doesn’t seem willing to answer questions or is unable to provide clear enough answers or you don’t feel comfortable asking, then it’s time to look for another dentist.”
When looking for a dentist, Cooper says you should seek one that practices close to your home or work and that has convenient hours. It’s also important to consider any unique communication issues you might have. For example, “if English isn’t your first language, do you need a translator? In my practice, I have a lot pf patients who are Japanese,” she says, and although these patients “speak English perfectly well out in the world,” when it comes to the specific or technical vocabulary of health care, having a translator to convey this information in a patient’s native language can facilitate better understanding. “Sometimes having a translator there who can offer assurance about what’s going on in your own language can be extremely important,” she says. Arranging with the dentist ahead of time to have a translator available or bringing a friend or family member who’s able to act as translator are both strategies you can employ to make sure you don’t miss anything.
As a spokesperson for the ADA, Cooper also encourages people to look for dentists who are members of the American Dental Association. The ADA represents more than 161,000 member dentists across the United States and Puerto Rico.
“The ADA requires that their members make certain promises,” Cooper says. “Those are promises that are critical for patients but they’re also critical in helping to determine whether a dentist is a good dentist.” These promises include preserving patients’ rights to be involved in making decisions about their treatment; doing no harm; staying current with science, technology and medical innovations; providing patients the highest quality care; being fair and not discriminating against individuals from any walk of life; and being as truthful and honest as possible with every patient, Cooper says.
The ADA offers a member-dentist search feature on its website. You can also ask friends and family for recommendations about which dentist they use and whether they’re comfortable with the care they’re getting.
Being sure you’re getting adequate dental care regularly is important for longevity and overall wellness. Although dental health can sometimes be overlooked (many health insurance plans don’t even include dental coverage), the Mayo Clinic reports that “your oral health offers clues about your overall health,” and problems that originate in your mouth can have lasting repercussions for the rest of your body. Poor oral health has been connected with several conditions and diseases, including endocarditis (an infection of the inner lining of the heart), cardiovascular disease and premature birth and low birth weight. It’s a two-way street between oral and overall health, and certain diseases, such as diabetes, HIV/AIDS, Alzheimer’s, eating disorders, certain autoimmune diseases, rheumatoid arthritis, cancer and osteoporosis, can all negatively impact your oral health.
A good dentist can spot signs of cancer and other diseases before other doctors might and can help keep small problems from becoming big ones. That’s why regular checkups are so important. “The most frustrating part [of being a dentist] is seeing patients who had very manageable dental problems but who let them grow into bigger problems. By the time they have treatment, the problem involves much more expense and time to treat, or it’s gotten to the point where the tooth is not restorable,” Cooper says. The common misconception that “if it doesn’t hurt, then you can wait to address it,” isn’t the best way to approach dental health. “If you wait until it hurts, invariably the treatment is going to be more extensive and expensive,” she says.
In all cases, maintaining good oral hygiene is an important way for you to reduce the chances of developing oral health problems. This means brushing your teeth at least twice a day with fluoride toothpaste, flossing daily, eating a healthy diet, replacing your toothbrush every three to four months, avoiding smoking and tobacco use and scheduling regular checkups and cleanings with your dentist. Because “dental health is such an important part of your overall health. It’s important to find a dental home,” whether you’re dealing with a serious condition or dental health problem or just need routine cleanings and X-rays, Cooper says. Finding the right dentist for you might not be the easiest thing to do, especially within the constraints of insurance, but advocating for yourself and looking for a dentist you can trust is a process that will pay health dividends down the road.