This dentist survey asked if dental amalgam should be banned in the U.S.

Most dentists said amalgam is safe enough for continued use and should not be banned.

Close to half of our survey respondents (48%) think it’s a valuable restorative material.

“We are already adequately governed regarding amalgam use and disposal. We need to advise patients regarding BPA in composites and the drawbacks to composites so that patients are better able to decide on their poison. Or they can use gold.” New York dentist

“The latest from American Association of Dental Research and the International Association of Dental Research is that Amalgam is the most cost effective restorative material, and it has no adverse health effects.” Florida dentist

“Amalgam is still the best restorative material in many situations where it is impossible to keep the field of operation dry.” Illinois dentist

A quarter (25%) of the dentists in our survey think amalgam should not be banned, even though they don’t necessarily think it’s the best material.

“Since it hasn’t ever been proven to be unsafe, it should be left alone – very few people want amalgam in their teeth, and it will die a slow death of it’s own.” New Hampshire dentist

“It may have a place in certain situations, but I personally have not used it since 1999.  I also do not think it has definite, dreaded effects on our patients’ health. After all, if it were the deadly material that some have described…why is it safe to bury deceased amalgam patients conventionally and not in toxic waste landfills?” General dentist

“What is leaching out of our composite restorations? I haven’t seen a conclusive study that absolutely proves amalgam is dangerous.” West Virginia dentist

However, 28% of our respondents are on the other side of the amalgam issue: 10% said they tend to think it should be banned. Another 18% think it should be banned, and no one should be using amalgam at all.

“The most toxic heavy metal on the planet! We can’t throw it away, but ok to put it in our teeth? Really??” Tennessee pediatric dentist

“The EPA deems it a bio hazard for the environment. Enough said. The retentive undercuts [required for amalgam] further weaken tooth structure which leads to fractures. With resins a dentist may do minimally invasive dentistry which results in better tooth strength and potentially fewer fractures. I have clinical pictures of an old, class II resin which was placed in 1985 that is still functionally intact with no signs of any marginal breakdown. That shoots down the knock that resins don’t last.” North Dakota dentist

“Anyone interested in the subject should check out the Compendium February 2013, volume 34, number 2. The article “Mercury from Dental Amalgam: Exposure and Risk Assessment”. It’s an eye-opener and reinforces what I have thought about for a long time. Clearly the ADA is avoiding the subject because it knows that all h**l will break loose liability-wise when it finally issue recommendations against it.” Florida dentist

What’s your opinion about using dental amalgam?

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Unfortunately, the costs keep Invisalign from many patients who might otherwise consider adult ortho.

In a dentist survey we conducted, we found the average cost of Invisalign treatment from a general dentist was about $4,800.

Specialists were a little more expensive at around $5,400.

Treatment from an orthodontist averaged about $6,900.

Jim Du Molin and Julie Frey discuss what dentists think about Invisalign braces:

“Costs are too high for this to be a mainstream treatment for people willing to have adult orthodontics,” said a Michigan Dentist.

“The lab fees are excessive, and Invisalign could use some competition,” said a New York Dentist.

While there’s a lot more interest in adult braces than there used to be, it’s still not quite mainstream.

And with lab costs like that, it’s hard to imagine it truly going mainstream.

What are your thoughts about Invisalign braces?

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Most dentists approve of adding fluoride to public water supplies.

While most of our survey respondents think it’s a good idea, the 35% of dentists against fluoridated public water hold some strong opinions.

“Forced medication,” said one General Dentist.

“Mass medication is morally WRONG! This is especially true when there are better alternatives such as, in this case, FLUORIDATED SALT. Give people CHOICES and let them decide for themselves.” California Dental Implantologist

Here are a few comments from the 65% of dentists in favor of public water fluoridation:

“Absolutely. I practice in a rural setting and the difference between the children who live in a fluoridated community and those that don’t is astounding. It really does make a difference.” Wisconsin Dentist

“It is not as important as it was in the past as most processed foods and drinks are also made of fluoridated water. So, even communities that are not fluoridated are getting fluoride in their diets.” Texas Dentist

“If you ever practiced in an area with fluoride and moved to an area without it, you would be overwhelmed by the amount of decay, as I was.” Massachusetts Dentist

“If communities reject fluoridation, there will no longer be a ‘busyness problem’ for dentists!” North Carolina Oral Surgeon

Is your community’s water system fluoridated? Do you think it’s a good idea?

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In this survey, 46% said they had concerns about safety, while 54% are not particularly worried.

Jim Du Molin and Julie Frey discuss dentists’ thoughts on BPA safety:

“I’ve never had a patient even mention it, unlike the wackos who won’t let fluoride touch their kids’ lips,” offered a Michigan Dentist.

“I have some worries about safety,” said one General Dentist. “To temper this, you’ve got to remember that ANYTHING in the body outside of what is indigenous is considered foreign and has potential to elicit yet another of those unexpected side effects, sort of like most of Congress’ laws. Since I stopped doing sealants years and years ago, I am less concerned about the effect on most adults.”

“Are any of my patients worried about BPA? They should be!” exclaimed an Orthodontist. “My kids will never have sealants. Sealants are BS. Another way the insurance companies dictate how a dentist can make money: by compromising morals, yet again.”

It’s worthwhile to bring up safety concerns about Bisphenol-A in dental sealants and fillings. Unfortunately, the science isn’t particularly clear.

We still don’t have definitive scientific evidence that everyone agrees on when it comes to mercury, or even fluoride. So don’t expect the BPA controversy to be resolved anytime soon.

Read more about the dental survey here.

Want your opinions heard in future surveys?

To be included, just sign up for our weekly dental marketing and management newsletter at TheWealthyDentist.com.

The post BPA & Dental Composite Safety (Survey Video) appeared first on The Wealthy Dentist.

There’s a mixture of good and bad news, depending on local economic health.

Most dentists have raised their fees in the past 2 years.

Close to a third (30%) of the dentists we surveyed said they raise fees every year.

Almost a quarter (24%) answered that they’ve increased fees during the past 2 years, but not in the past year.

At the other extreme, 5%  have lowered their fees during the past year. Said a Washington Dentist in this group, “One of our insurance providers froze our fees and lowered our reimbursement by 15%.”

The rest of the responses were split — 14% said they haven’t raised fees in over 2 years; 19% said it’s been more than 3 years, and 8% said it’s been more than 5 years since they’ve had an increase.

Although dental consultants strongly advise yearly increases, many dentists practice in locations where the local economy just won’t support increases due to high unemployment or other regional factors.

“I have a shrinking profit margin. Many of my patients have reduced or no income due to the recession and hurricane Sandy. If I raise my fees I believe fewer patients will accept treatment.” Dentist in the northeast

“I used to raise my fees every 1 to 2 years without fail. But with the economy as it has been the last few years, it has been tough to do.” Illinois Dentist

“With the economy as it is and the number of people out of work, I find it hard to raise my fees. People just cannot afford good dental care. They put off any dental work until an emergency arises.” New York Dentist

“I fell off the wagon during the recession of 07/08, but I’m back on track with yearly adjustments.” South Carolina Dentist

When was the last time you raised your dental fees?

The post Dental Practice Management Survey: Dental Fee Increases Depend on Local Economies appeared first on The Wealthy Dentist.

Basic business economics says that as your costs rise, so should your fees. But that’s not necessarily been the case for many dentists.

Jim and Julie discuss some of the realities surrounding whether or not dentists have raised their fees:

“Raising my fees just puts an onerous burden on my uninsured patients, and does not raise revenues on the majority of procedures. Rather, it just increases the amount I have to write off,” complained a Michigan Dentist. “I’m getting closer to dropping participation with all ‘managed cost’ programs.”

“I know I need to raise my fees, but people are constantly complaining of cost,” says a Georgia Dentist who hasn’t raised fees in over two years.

“I feel dental offices should always raise fees to reflect the current annual rate of inflation. We keep our fees in line with local and regional averages and adjust ours annually to keep up with inflation,” said an Ohio Prosthodontist.

If you’d like to share your opinions in future surveys, just sign up for our weekly dental marketing and management newsletter at TheWealthyDentist.com.

How long has it been since you’ve raised your fees?

The post Raising Dental Fees (Survey Video) appeared first on The Wealthy Dentist.

In this dental management survey, we wanted to find out if dentists have had good or bad experiences with consultants. Here’s what we found out:

Most dentist have had both good and bad experiences with dental consultants.

Of the dentists participating in our survey, 42% gave the consultants mixed reviews, saying they’ve had a mixure of good and bad experiences.

Another 37% of dentists gave dental consultants a strong thumbs up!

The rest of the responses were evenly split between dentists who responded in the negative, and those who had no opinion or no experience.

Here’s one of the mixed reviews from a Texas dentist: “My production increased while we were working with our consultant. It was a painful experience and time consuming. We also found that we could not maintain the tasks he gave us and that his concept of “selling” did not agree with my concept of treating. So, the increase dropped off after a year or so.”

What’s your experience with dental consultants?

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Dental practices have various missed appointment policies to encourage patients to actually show up.

Jim and Julie talk about how dentists handle patients who miss dental appointments:

Dental hygiene appointments are missed 13% of the time, according to the dentists in this survey.

What about dentist appointments?  They’re only missed 9% of the time.

“We call them immediately to find out why they have missed the appointment. We educate them as to why it is crucial to keep their appointments, mentioning that we have other patients waiting to be seen in that time slot if they had called and given enough notice. We’ll fire the patient after three strikes if there is a pattern.” Alabama Dentist

“It’s a big challenge; I wish I had a great answer. We have a written policy, include it in newsletter, call at 10 minutes into the appointment, and send a letter. The first one is a warning and free, then we charge. We hear all the excuses imaginable! People are less respectful than 30 years ago.” Illinois Dentist

“When they miss one appointment, we immediately give them a friendly reminder about our broken appointment policy. We use Smile Reminders (text, e-mail, and phone) to remind our patients about their appointments at two weeks, a few days, and the day before their appointment. This has greatly reduced our no-shows to about 5%, and also gives us time to fill their appointment if they have to move it. We are extremely happy with our low percentage of no-shows!” Ohio Prosthodontist

How does your dental practice handle no-shows?

The post Dental Management and Missed Appointments (Survey Video) appeared first on The Wealthy Dentist.

Most dentists are in favor of using dental sealants as standard treatment for children.

The majority of dentist respondents said sealants are great as standard dental treatment on most young patients.

However, a few survey particpants who practice dentistry for children have reservations. They think dental sealants should be used conservatively, and only on selected young patients.

“We only recommended sealants for patients with very poor home dental care, high caries risk, and deep developmental grooves in molars. Although, I would prefer to refrain from placing them. They tend to turn into restorations and develop decay underneath.”
Suburban dental practice

“Dental sealants are great for doing bulk cases in School Dental Programs. They can help to arrest Pit and Fissure Caries.” Urban dental practice

None of the dentists responding to our survey thought that dental sealants should be avoided completely.

How do you use dental sealants in your practice?

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In this survey of dentists, 68% say they are in favor of children’s sedation dentistry. Note that when we asked the same question in 2010, only 52% were in favor.

“It requires extensive training and case selection is very important,” warned a pediatric dentist.

Jim Du Molin and Julie Frey discuss what dentists think about pediatric sedation dentistry:

“At our office, an MD anesthesiologist provides sedation while I perform the dentistry,” said a Missouri dentist.

“I have been doing all forms of sedation for over 30 years,” said a Texas periodontist. “Young children are very brittle and administration requires advanced training for the safest outcomes.”

“It’s the only way to treat some kids,” sighed a Georgia dentist. “I sure am thankful that I can refer to someone who does it as I would not want the liability and stress myself!”

It’s important to remember that kids are dental patients too! And sedation dentistry is a real boon to many dental patients.

Do you have any further thoughts on pediatric sedation dentistry?

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