A Trip to the Dentist

H aving waited for 30 minutes in the dentist’s waiting room only to find out that the hygienist wasn’t coming in, I knew it was time to find a new dentist. Fortunately, there’s one just down the hill from my office, a 5 minute walk away. The practice’s Web site made it seem very inviting — a full-service, family dentist office — and my insurance was accepted by the practice, too. I scheduled a visit for my semi-annual cleaning. Teeth are very important. I’d hate to lose them. While not a compulsive tooth-cleaner, I do follow the adage, “you only need to floss the teeth you want to keep.” With regular flossing and a Sonicare toothbrush, the teeth (and gums) have been doing great. The semi-annual hygienist appointment seems almost unnecessary, but reassuring. The one with the new dentist’s office seemed no different . . . until the pitch. The Sales Pitch “Mr. Feldman, have you considered having your teeth whitened? We offer a new system that works well and is more convenient than the old way of doing it.” A nice, tasteful pitch for cosmetic dentistry services. However, attuned to the debate in dermatology about the places of medical and cosmetic dermatology, this jarred me. While I politely responded that I had heard about such a thing but hadn’t considered it for myself, I thought about how the hygienist — perhaps the whole staff — probably received an incentive for how much cosmetic business was drummed up. If dentistry is much like dermatology, I wondered if patients like me, only interested in medical treatment that didn’t cover the office overhead, were a drain on their practice. The dentist came in and did an exam. “A cavity,” she pronounced. “We should have you come back for a filling.” I told her my previous dentist had said there was a pit in that tooth and perhaps it might not be a cavity. She said we could watch it. Having heard the pitch for their cosmetic services, I wondered whether she was oriented to doing procedures where they might not be entirely necessary. Perception Matters Whether unobtrusive marketing of cosmetic services is good or bad is not for me to say, though if a “do-not-call list” existed for cosmetic services, I’d have my name on it. Time will tell if this pit is a cavity or not. In the meantime, I’ll think carefully about how the marketing we do affects our patients’ perceptions. Steven R. Feldman, M.D., Ph.D.

H aving waited for 30 minutes in the dentist’s waiting room only to find out that the hygienist wasn’t coming in, I knew it was time to find a new dentist. Fortunately, there’s one just down the hill from my office, a 5 minute walk away. The practice’s Web site made it seem very inviting — a full-service, family dentist office — and my insurance was accepted by the practice, too. I scheduled a visit for my semi-annual cleaning. Teeth are very important. I’d hate to lose them. While not a compulsive tooth-cleaner, I do follow the adage, “you only need to floss the teeth you want to keep.” With regular flossing and a Sonicare toothbrush, the teeth (and gums) have been doing great. The semi-annual hygienist appointment seems almost unnecessary, but reassuring. The one with the new dentist’s office seemed no different . . . until the pitch. The Sales Pitch “Mr. Feldman, have you considered having your teeth whitened? We offer a new system that works well and is more convenient than the old way of doing it.” A nice, tasteful pitch for cosmetic dentistry services. However, attuned to the debate in dermatology about the places of medical and cosmetic dermatology, this jarred me. While I politely responded that I had heard about such a thing but hadn’t considered it for myself, I thought about how the hygienist — perhaps the whole staff — probably received an incentive for how much cosmetic business was drummed up. If dentistry is much like dermatology, I wondered if patients like me, only interested in medical treatment that didn’t cover the office overhead, were a drain on their practice. The dentist came in and did an exam. “A cavity,” she pronounced. “We should have you come back for a filling.” I told her my previous dentist had said there was a pit in that tooth and perhaps it might not be a cavity. She said we could watch it. Having heard the pitch for their cosmetic services, I wondered whether she was oriented to doing procedures where they might not be entirely necessary. Perception Matters Whether unobtrusive marketing of cosmetic services is good or bad is not for me to say, though if a “do-not-call list” existed for cosmetic services, I’d have my name on it. Time will tell if this pit is a cavity or not. In the meantime, I’ll think carefully about how the marketing we do affects our patients’ perceptions. Steven R. Feldman, M.D., Ph.D.