In my last entry, I was talking about how we hated the long new patient exams in dental school, but after all these years we're taking just as much care in the initial visit to help patients understand their condition and their options.

Back in dental school, we also used to complain about only treating a couple patients a day. Is that still worthwhile? When I first got out of school, I bought a very busy practice where we would see dozens of patients a day, typically treating only the very worst tooth for each patient. This is not the way we were taught in school. The dental schools, to their credit, teach comprehensive dentistry--looking at the entire mouth and treating it as a whole.

Unfortunately, what happens when a young dentist joins a private practice is that he/she finds that the practice and the patients allow patient care to be dictated by insurance benefits. The insurance model provides an incentive to dentists who place oversized fillings and do other treatment that is "usual and customary." Sadly, "usual and customary" is not the highest standard of care. To my way of thinking--and to many others who strive for excellence--it is in the patient's best interest to look at the mouth as a whole and make a diagnosis and treatment plan for the very best quality treatment available, without regard to insurance coverage.
Insurance usually pays for very little anyway so why allow the insurance plan to influence treatment planning?

So once again, I have to admit that the dental schools were right in the approach to "Comprehensive Patient Care." And the patients are the ones who benefit most. If a patient has multiple problems, we treat all the problems, not just the worst tooth in the mouth.