Corporate dentistry is when a dental office is owned by investors, venture capitalist, or any providers that have multiple dental offices. These are also called DSO’s in the dental world, meaning Dental Service Operators.
This has become a big and lucrative business. Dental schools tuition has gone from around $40,000 debt upon graduation in the 1980s to an average of nearly $400,000 today. With interest rates for school 6.8% and higher, most have no choice but to just get a job. Opening a practice is no longer possible with debt like this… and investors know it.
So, they very often employ recent graduates that just need an income to pay these incredibly high loans.
Employment from corporate investors comes with a certain expectation. You must produce (do treatment) and do enough treatment or likely be let go.
Corporate practices have advanced metrics, algorithms, and numbers. They expect an average amount of diagnosis and treatment per patient. Let me remind you, these are NOT dentists telling the dentist what they should be doing.
How does that make any sense?
This puts even our best and most ethical dentists in a bad situation. What are they to do? Obviously, always the ethical thing and what is best for the patient, but that clearly isn’t always the case.
Feeling like a used car salesman is pushing you as a patient in these places has become common. The trust between dentists and the community is fractured compared to what it once was.
Understanding why you might feel pushed and why its so expensive is a good start.
These practices are not named obvious things like “DSO Dental” and “Corporate Dental Center”. They blend and use city names, local names, and try not to let the public know they are a corporation most of the time.
At Helping Hand Dental Clinic, we are NOT a corporate dental office. We educate. We diagnose and explain the pros and cons of each way we can attack an issue. Then, we let you know the options and let you decide according to the education, information, finances you feel comfortable with.
This is a complicated question.
It’s not fair to just say “the dentist diagnosing more cavities is greedy and wants more money.”
I’m not saying that’s never the case.
Nor am I saying it’s always the case.
Let’s look at it closer, shall we?
Our teeth I have 3 major parts to them. The outer shell called the enamel, an inner layer called dentin, and a nerve in the center of the tooth.
1. If cavity penetrates the outer layer (enamel) it is considered a cavity and the universally accepted treatment is removing it and placing a filling.
2. If bacterial cavities get beyond the first two layers (enamel and dentin) into the nerve; the universally acceptable treatment would be either a root canal or an extraction depending on patients desires.
Now what happens when those cavities are so close to the 2nd layer (dentin) like the x-rays above? Is it through the outer layer in all 4 scenarios? Hard to determine 100%, but it’s close.
That’s when the dentist has to take into account a number of things from patient’s age, dental history, other active caries/cavities, home care and oral health, accessibility to treatment, diet… and the list goes on. Diagnosing cavities really can be both simple and complex as you can see.
As a dentist, I would consider myself very conservative.
Borderline cases, I don’t want to treat unless it is necessary. I’d rather educated and let patients know their options. Whether the next in 6 months we have to do treatment or the patients health improves, it’s on the patient individually.
To me, it’s important to give every patient a chance to use my knowledge and experience with current science, research studies, and home care to have a healthy mouth.
Lastly, if you ever feel uncomfortable with a diagnosis, I always recommend getting a second opinion. Whether it’s my patient or another dentists’ patient, it’s your oral health. Asking questions is always a good thing.
