Dentistry and medieval torture chambers were once one and the same.
When I was a kid, my dentist didn’t freeze before drilling – he’d just say “open wide for me” and started doing his thing. Patience wasn’t his strong suit – he’d get quite annoyed if you raised your hand indicating you needed a break. The guy liked to keep to a schedule.
Dental chairs in those days didn’t recline, so in addition to nerve pain, you experienced neck and shoulder pain. An oversized bright light blinded your sight. Ventilation was poor because dentists worked in windowless offices. An awful disinfectant smell attacked your sinuses and remain trapped there for hours. The only good thing about going to the dentist was you didn’t have to go back to school after seeing one. That’s how bad the pain was.
I’ve seen more than two dozen dentists in my lifetime, and I’ve had more than my share of traumatic experiences. There was the dentist in Montreal who I overheard had a cancellation following my appointment so he decided to do an entire root canal procedure in one sitting (they’re normally done in two appointments). The pain afterwards was so overwhelming that narcotics mixed with scotch offered no relief. I later learned the root canal was poorly done. I’ve since lost the tooth.
That’s the problem with dentistry – it’s difficult to know for certain how good your dentist really is regardless of their credentials. I saw an Upper East Side dentist who taught at Columbia and whose patients included a famous Wall Street executive. I thought I was getting top notch care but a crown he put on lasted only a few years. I’d already moved to California but it didn’t make a difference. Dental work comes with no warranties.
In fairness, the dentists I’ve seen don’t have fond memories of me. My dental procedures almost never went smoothly and required multiple follow-up visits and adjustments. A Toronto family friend forever regretted seeing me on an emergency basis; he told my mother than in his nearly three decades of practicing dentistry nothing ever went wrong until I walked into his office. It wouldn’t surprise me if the Canadian and American Dental Associations secretly circulated a North American-wide DNR order on me.
So, for years I just accepted that I was a bad patient, destined for the dental trauma that plagued both my parents in their later years and several of my relatives. Then I discovered Dr. Julien Chen.
I first saw Dr. Chen more than a decade ago on a visit to L.A. I developed an excruciating toothache and I asked a cousin by marriage, the daughter of a mega Hollywood actor, for a recommendation. She referred me to Dr. Chen, who fortunately was available on a Saturday.
That emergency visit was dentistry unlike I’ve ever experienced. It was the first time I’d received novocaine injections without feeling even a prick in my cheeks. The dexterity of Dr. Chen’s hands was something to behold, as was his chill demeanor. He had an amazingly calming presence.
I’ve since moved to Los Angeles and I’ve been under Dr. Chen’s care for three years. He’s done considerable work on me, as decades of bad dentistry requires that we get old together. Everything has always gone smoothly.
Dr. Chen’s honesty is praiseworthy. My last dentist in San Francisco said I required some $20,000 in dental work to restore my mouth to full health. Dr. Chen said the recommended program was excessive. Though he’s quite tech savvy and his office is state-of-the-art, Dr. Chen is cautious about embracing new technologies whose efficacy hasn’t yet proven to be better than conventional tools, such as laser drills. I’ve long suffered from excessive plaque build-up; Dr. Chen first prescribed four cleanings a year. However, after I embraced his entreaties to use a waterpik, he gave me a gold star and cut back my cleanings to three a year.
Unlike many general dentists, Dr. Chen doesn’t do extractions or root canals, despite a skillset and dexterity that I’m certain is in the top tier of his profession. Although quite lucrative, Dr. Chen prefers sending his patients to specialists who focus on these procedures. That’s a big chunk of change he leaves on the table.
Dr. Chen’s refers to specialists imbued with his integrity. One is Dr. Thomas Rauth, a Santa Monica endodontist who has forgone thousands of dollars not treating me. I had a problem tooth that Dr. Chen couldn’t conclusively determine would benefit from a root canal. Dr. Rauth also couldn’t establish 100 percent that I’d benefit from the procedure and opted for a “wait and see” approach despite having already scheduled me for a root canal. More than a year later, I scheduled a root canal appointment based on my mistaken belief that it was the earlier problem tooth causing pain. Turns out, it was the one next to it. Dr. Rauth again was left with a significant unprofitable opening in his schedule.
Then there is Dr. Richard Ting, a Santa Monica oral surgeon who has performed multiple extractions and other surgical procedures on me. I’m confident in saying that Dr. Ting is the kindest and gentlest oral surgeon in the history of the specialty (you’ll see what I mean if you meet him). He has the patience of Job and yet works with considerable speed. The only pain I ever experienced under Dr. Ting’s care are the bills I was handed on my way out the door.
Dentists and dentistry deserve considerably more respect and reverence than they get. Tooth pain is said to be more painful than childbirth (obviously I can’t speak with authority on this claim) yet the profession has mastered procedures to make dentistry a pain-free experience.
I know of no other profession that advocates practices to the financial detriment of its practitioners. Aggressively promoting regular dental hygiene isn’t good for business. The ADA actively supports the fluoridation of community water, which has been proven to reduce cavities. Compare the ADA to the financial services industry, which has successfully fought the implementation of a rule that would require firms to put the interests of their clients first.
Here’s how you know if you have a great dentist: If you still dread going. I regard my visits to Dr. Cheng as an opportunity to watch Netflix and get caught up on my sleep. I wish I could say the same about visits to my accountant.
Dr. Julian Chen
2730 Wilshire Blvd #300
Santa Monica, CA 90403
Dr. Thomas Rauth
1234 7th St #3
Santa Monica, CA 90401
Dr. Richard Ting
2020 Santa Monica Blvd Suite #530
Santa Monica, CA 90404
The Atlantic’s Unfounded Smear of Dentistry
ADDENDUM: After writing, but before posting, this commentary, Atlantic published this article denigrating the dentistry profession and implicitly imploring readers to be wary of their dentists’ treatment recommendations. It’s a questionable piece of click-bait journalism based on innuendo, not facts.
The article offers scant evidence to support its sensationalist headline, “The Truth About Dentistry. It’s much less scientific – and more prone to gratuitous procedures – than you might think.” The writer, Ferris Jabr, found just one dentist who certainly appears to have performed excessive and questionable procedures, but the damning allegations are made by a dentist who bought the questionable dentist’s practice and sued because it wasn’t as legitimately lucrative as he believed. Lawsuit allegations are typically rife with inflammatory allegations.
Jabr takes dentistry to task for not being as evidence-based as medicine, and notes that some widely held beliefs such as the need for twice-yearly cleanings have no scientific underpinnings. Jabr doesn’t cite the percentage of Americans who heed this counsel, but common sense suggests that it’s quite low. According to Dr. Louis Sullivan, the former Secretary of Health and Human Services under George H.W. Bush, oral disease remains the most common chronic condition in American children and adults.
As for dentistry’s lack of evidence-based research, it’s an issue the American Dental Association has recognized, which is why the ADA established its Center for Evidence-Based Dentistry in 2007 without any legal or regulatory pressures. Jabr quotes Montana dentist and defeated Republican legislature candidate Jane Gillette as saying, “we’re kind of behind the times, but increasingly we are trying to move the needle forward.” Not exactly a comment I’d expect from a profession looking to duck and ignore criticism.
Jabr also cites Dr. Jeffrey Camm, a Washington pediatric dentist who published an industry article expressing concern that dentists were possibly overtreating patients. Yet even Camm told Jabr, “I really think the majority of dentists are great.”
Jabr naively glorifies medicine as being evidence-based and not prone to unnecessary procedures. I once represented one of New York City’s consistently top ranked otolaryngologists who told me that most sinus surgery was unnecessary (his specialty was repairing damage caused by these unnecessary surgeries). Dr. John Sarno, a respected authority on rehabilitation medicine, argued that most back surgery is unnecessary.
Ophthalmologists perform hundreds of thousands of Lasik surgeries every year despite the considerable risks involved with the procedure. The medical profession is endemic with doctors who don’t disclose lucrative health care and drug industry ties.
If Jabr’s article is the worst that can be said about dentistry, the profession is overwhelmingly dominated by angels.