You know someone who has said to you, “I used to see the dentist, but nothing ever worked.” Maybe it’s you. If it is, rest assured that there is hope for you. I’m going to tell you a personal story, something that happened to me right here in Florida, which totally changed my perspective on dental care. You know how you do one thing, and it leads to something else that you never expected? It’s one of those stories.
I’ve had a very large periodontal practice here for many years. Patients with gum problems were referred to my office by their general dentist. We’d take care of the gum problems and for the most part, sent the patient back to the general dentist for continuing care. Some patients who had particularly difficult to control periodontal disease would stay in our office for cleanings or we would alternate cleanings between the general dentist’s office and ours. It worked very well, and using this model, most of our patients were able to save and keep most of their teeth.
My world changed with the advent of dental implants. Now teeth that couldn’t be saved could be replaced without damaging adjacent teeth. And there was a new patient population that I could help, the denture patient. After all, people often don’t like wearing dentures. They usually don’t see a dentist after the dentures are made even though they should. And I could help those patients by giving them implants which would make their dentures more stable and comfortable than ever. So I advertised that fact right here in Florida Today as well as on television.
Now you would expect that the response would be great, and it was. But I was in for a tremendous surprise. The majority of the patients coming in were not denture patients. They were patients who had given up on dentistry. There was an entire group of patients who had multiple dental visits, and continual dental failure. WOW!! That was a revelation to me. It was at that moment that the character of our practice began to change. Because I could help this patient. It all began with diagnosis. That means really looking at the entire mouth and helping the patient to see the entire mouth. It was then prognosis. What teeth will really last for a long time and what teeth won’t? There is no sense in investing money on teeth that won’t make it. Periodontists are specifically biologically trained. And therefore, we prognosticate biologically before we treat mechanically. The result is predictability.
When we have a disease, we depend upon our physicians to diagnose the problem first and then do treatment. When we have a dental problem, we need the same thing. It is sometimes not enough to get a filling or a crown or a root canal or even gum surgery. Because every tooth in the mouth is dependent upon other tooth in the mouth, it is necessary to have a full mouth diagnosis and prognosis before doing treatment.
Periodontists are trained in full mouth diagnosis, full mouth treatment planning, and coordinating treatment with the treating dentist. In fact, periodontal residents have weekly treatment planning conferences with their professors and other residents for three years to do exactly that. When I was teaching at the University of Florida, treatment planning was strongly emphasized in the Department of Periodontology.
Most people don’t know that they can see periodontists without being referred. But you can. Particularly if you have complex needs, the time spent in such a diagnostic and treatment planning visit can work wonders, save you considerable money, and give you the predictability that you are looking for.
Dr. Lee Sheldon is a periodontist and has a full-service dental practice with his son, Dr. Matthew Sheldon. Dr. Sheldon is a featured guest on the Focus on Seniors radio and television programs on WMEL radio and BrightHouse television. Drs. Lee and Matthew Sheldon have just published their new book, The Ultimate Mouth Manual, Second Edition, which is available at all bookstores (also downloadable for free here).
Lee N. Sheldon, DMD