When I was contacted by CBC Marketplace to be a consultant to the episode ’Money Where You Mouth Is’ I knew it had the potential to reveal some of the problems we have in our profession. Many of us are concerned about the way some dentists push cosmetic dentistry on patients and in my opinion this is the number one reason we have sunk down in the level of public trust over the years.
Too many have focused on other issues like marketing as the true evil. The black stain on our profession is the way we have allowed commercial interests to dominate the postgraduate education in dentistry. This has been particularly overpowering in the aesthetic dental programs where many have been sponsored by dental labs that are in business to do more ceramic work.
Just as the medical doctors have been led around by big pharma, thousands of dentists have crossed the border to the U.S. and practiced illegally outside their licensure while training in cosmetic dentistry. Patients have flown down with the dentist for smile makeovers and come back with potential complications. The dentists came back overconfident in their skills and in the mistaken belief that they were anointed ‘smile experts.’
The reality is most of the synthesized rules of smile design have led to a large group of dentists who actually make people’s teeth look worse. Why would the undercover patient need veneer treatment for a midline problem? While it is a matter of opinion, the even greater secret is aggressive cosmetic dentistry will lead to premature tooth loss and substantial long term costs and complications to the patient who entrusts the dentist for a Hollywood smile.
This Ugly Truth about Cosmetic Dentists is our dirty secret. We know there are top level cosmetic/oral rehabilitation dentists, and there are also dentists teaching cosmetic dentistry that have used celebrity patients to hide the fact that they are simply veneer salesman. The new phase of cosmetic dentistry will not be based on trying to find excuses to bond porcelain on as many teeth as humanly possible.
This Marketplace episode goes beyond simple honest variations in treatment planning. The 15-year-old patient who was told she lacked enamel on her teeth and needed 25 crowns was an example of malpractice. Recommending the most invasive treatment for a young patient proved that paying more does not mean better care. This would have been a rip off and could have been considered physical battery.
We tolerate aggressive cosmetic dentistry because we have a code of silence. I was told it is bad karma to speak ill of colleagues, but I think it is bad karma to let this abuse continue. The profession is out of control and as an example sponsored cosmetic programs are trying to reach into the dental schools to start the brainwashing even prior to graduation. Why wait? Dentists are just as vulnerable when they graduate. Dentists have been selected for entry by an amazing power of absorption and regurgitation of information, without critical thinking (which is usually punished).
The dental profession is worried about so many little things. What should be a concern is it is neglecting the safety of the public. More undercover investigations are necessary to help understand the level of inconsistency among our members. Dentistry has a long way to go before it can dilute the toxic thinking that has poisoned those who are a little too quick to recommend ‘advanced’ cosmetic treatment. That’s sad.