Secret Signs of a Great Dentist

  by Carole Jackson, Bottom Line Health

                As she asked around for the name of a really good dentist, a colleague recently commented that it’s easier to find a great auto mechanic these days! Lots of dentists advertise via direct mail and on the radio, but they’re not necessarily the best ones — and the old-school ones with 10-year-old tools and techniques may not be such a great choice either. While I like my dentist just fine, the remark led me to wonder what I would do if I had to find someone to replace her. Asking for recommendations is a good start, but what would I be looking to learn?

                I called Michael Apa, DDS, who practices with the Rosenthal Apa Group in New York City and teaches at the New York University College of Dentistry for Aesthetic Advantage, to ask how he would choose a dentist. Beyond the obvious — someone who comes highly recommended, has good academic credentials, is convenient, personable and, of course, covered by your insurance plan (if you are lucky enough to have dental coverage) — he gave me some great insider secrets to evaluate whether a dentist really is as good as people say …

                Clue Number One: What modern tools and toys are on display? Dental techniques and the equipment they require change so rapidly that few offices have everything out there. So you shouldn’t expect the moon and the stars — this is expensive equipment and few dentists can afford all of it. However, the dentists who are most likely to provide high-quality care will have at least some standard equipment available, says Dr. Apa…

  • Many dental offices now use digital X-rays, which are easier to read and therefore more accurate and — importantly — require less radiation than those of old.
  • For 21st-century teeth cleaning, ultrasonic cleaning instruments use sound waves to break up and remove plaque and tartar, including that which has accumulated under the gums. This makes cleaning teeth faster, more efficient and, for most people, more comfortable.
  •  Lasers are now used to trim soft tissue such as gums and other areas around the mouth, with benefits that include less bleeding than traditional procedures, often no stitches or discomfort, and faster healing. Some offices even have laser equipment to cut hard tissue — i.e., your teeth. With laser “drilling” you no longer have to hear that high-pitched whine, and since it doesn’t hurt, you don’t need anesthesia either.
  • Many offices now have a Cerec machine, which Dr. Apa calls a “miracle tool.” It uses a technique called CAD-CAM (computer-assisted design-computer-assisted manufacture) to create fillings, crowns, veneers and so on in just one patient visit. The Cerec scans a tooth, takes measurements and then precisely carves the needed item from a ceramic block. Since it creates digital “impressions” of the tooth, there’s no need to create putty impressions either.

                               Clue Number Two: He/she examines your mouth for clues about your overall health. Dr. Apa says that today’s best dentists consider it their job to monitor your mouth for other problems beyond cavities and receding gums. More and more studies reveal dentists to be the new health-care generalists, on alert for many health problems that may reveal themselves in the mouth — among them TMJ, circulatory problems, inflammatory disease, sleep apnea, precancerous lesions and oral cancers. All dentists should routinely perform visual examinations of the mouth, and many now do this with a special light that changes color if it lands on suspicious tissue.

                 Clue Number Three: Who’s in the “in crowd”? When an unusual oral problem presents itself, you need an expert in treating that particular issue — this comes down to who your dentist knows. As Dr. Apa says, not everyone can be good at everything, and to become really excellent requires lots of experience and specialized training. Ask dentists for their lists of patient-referral specialists, and expect to find names of endodontists (for root canals and tooth implants)… periodontists (for gum disease)… TMJ specialists (for headache and jaw pain)… and dental surgeons (for tooth implants). Yet another area where it is best to work with an expert is cosmetic dentistry — today it has turned into a sophisticated practice that few general dentists are trained to do.

                 Clue Number Four: Lab work is done locally, not off-shore. Many dentists now outsource lab work for such things as veneers, crowns and bridges to China, Mexico or other foreign countries. While this may not be a terrible practice, it’s not optimal, says Dr. Apa. He explained that offshore labs typically do “good enough” work, but when dentists have a personal relationship with lab owners, they are more likely to get a level of excellence that helps assure the best product, and this is more likely with US labs.

                 Clue Number Five: According to Dr. Apa, graduating from even the finest dental school is just the start of a dentist’s education. He suggests asking “so, how’s school these days” to see what your dentist has to say — paying attention not only to what he/she says, but also to the comfort level in discussing it. The only way for dentists to stay on top of their profession is to regularly attend conferences and workshops offering continuing education (CE) credits. Nearly all states require CE credit hours, but the range is wide — from 15 to 100 hours, depending on the state. And Dr. Apa told me that good dentists take many more credits than that each year. The best dentists commit themselves to a lifetime of learning to stay current and keep their skills sharp, he said — and that sounds like the kind of dentist we all want to find.


               Michael Apa, DDS, practices aesthetic and restorative dentistry in the Rosenthal Apa Group in New York City and is an instructor at the New York University College of Dentistry for Aesthetic Advantage.