doesn't mean your new dentist is a crook.

I recently had a new patient come in for a new patient exam. First thing she tells me is that she only changed dentists because her old dentist retired. She loved him and told me how great a dentist he was. She even mentioned how he told her how good her teeth were.

As I started looking at x-rays, the first tooth I looked at had a deep cavity- a likely root canal. In the end, I found several cavities and teeth that needed crowns, all in a patient who reportedly was just given a clean bill of health by her previous dentist.

As I am finding all of these teeth that need treatment, of course I am concerned about how she is going to take the news that she has several decayed and breaking down teeth that need work. There is a little fear that the patient is going to think I am overdiagnosing for my own gain, like many of the above posters have thought about past dentists, but I can't ignore what I am seeing. I owe it to the patient to honestly assess the situation and inform her of what I see.

As I do the exam and inform the assistant of each tooth that needs treatment, I know the patient is going to be surprised and questioning me.

In fact, she comments, "I don't know if my dentist missed all of this, or if any of this really needs to be done."

She says more than once through the appointment, "Did my dentist really miss all of this? Could these really develop since I last saw him?" I can understand her frustration and she truly doesn't know who to trust in that moment.

Thankfully we have an awesome intraoral camera that I can take close up detailed photos of each tooth. I blow up the digital x-rays and photographs to show her the cavities and fracturing teeth, and I spend an extra 30 minutes photographing, documenting, and educating the patient.

I have no idea if the previous dentist overlooked all of that stuff or was just so far behind what modern day dentistry today offers, but I know what I saw, and I know what she needed.

The pictures were convincing. They helped gain the patient's trust and we moved forward with ALL of the recommended treatment and I took intraoral photographs as I worked so she could continue to see what I was seeing.

One thing to understand is that dentistry has advanced a ton in the last 40 years. We have gone from just extracting teeth and doing dentures, to doing fillings to stop decay, to flossing and brushing and professional cleanings to prevent tooth decay and gum disease, to root canals instead of extractions, and crowning damaged teeth instead of letting them fracture to where they have to be pulled.

We now know that treating things while they are small problems is better than letting big problems develop. Technology has improved to help diagnose problems earlier. We can also do implants, instead of bridges when teeth do need to be removed.

Hardly anyone has dentures anymore because we have learned to treat things proactively, rather than reactively. We can prevent infection, tooth aches, and tooth loss by intervening.

I will also say that it is incumbent for even the old dentists to keep up with the current standard of care. Some do not. Some continue to treat reactively, rather than proactively or preventively.

Everyone has a choice. You can go to a dentist who treats reactively and has more of their patients experience tooth aches, emergencies, have more teeth pulled, and wear more dentures, or you can find a dentist that recognizes that earlier intervention (NOT TOO EARLY) will prevent more major dental problems and premature tooth loss. And you as a patient have a choice to refuse to have modern dentistry done as well.

The most important thing is to find a dentist you trust. If you don't trust them, go somewhere else.