Lessons Learned

Wednesday July 20, 2022

I have focused the majority of my career on family preventive and general dentistry. While I enjoy most aspects of what I do, I firmly believe that a good percentage of dental problems are avoidable, which means that dentists shouldn’t be as busy as we are with routine fillings, removal of teeth, and many other procedures. While there are other factors at play, such as genetics, personal responsibility is often at the head of the pack. 

Prevention often takes a back seat to fixing problems. Decayed, broken and worn teeth all had nothing wrong with them at some point. Granted, you have to fix what is already broken, but “How could it have been prevented?” has always been the question I ask myself, and try to make my patients understand. 

What are the factors at play for the 6 new cavities? What could have been done to avoid the wearing-down of all the teeth? Could anything have been done during growth to alter how the airway develops? What factors are causing the chemical erosion of the teeth? These are important questions to be considered.

Much of what is being marketed to dentists today is technology; 20 years ago, it was cosmetics. The technology available today in dentistry is really cool, just like the technology available in most other areas of our lives. There are some things I would not want to live without since adding them to our office; digital x-rays, digital scanning instead of messy impressions, computer-generated restorations, telemedicine, etc. However, how much technology do we really need if we avoid the problems in the first place? 

Let me give an example. If I had to pick the single most important “technology” that has impacted dentistry in the last 30 years, it would be dental implants. Grafting of bone and dental implants have changed the lives of many people, who would otherwise have been forced to wear something removable in their mouth to replace teeth. And, while this is a great service to patients, I’m still always thinking, “What are the lessons I have learned to help my next patient avoid needing all this dentistry?”

More dentists are being trained to place dental implants, not only to replace one missing tooth, but to replace ALL the teeth. You may have seen the commercials from a large dental franchise with stories from “real” patients who have had dental implants change their lives. What they don’t tell you is that they remove all the teeth, even ones that can be saved, remove a ton of bone to be able to place 4-6 dental implants, to then have a piece of plastic with plastic teeth screwed to it. They claim – “You can put an end to dealing with missing teeth or repetitive dental work with dental implants.” 

You have to go in for the consultation to find out that upper and lower “All-on-4” dentures attached to implants will run you $60K+. They also fail to mention in any of the advertising that there is maintenance that can be costly. And, they don’t really feel like teeth. While this treatment may be acceptable for some patients, the clear choice is to avoid it. 

Keeping your natural teeth makes much more sense. Improving and maintaining any part of our health requires time, commitment and resources. There are many great dentists out there to help you maintain your teeth for a lifetime. 

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating snoring, sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have, please email them to him at jpstclair@stclairdmd.com

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