Does your dentist practice preventative dentistry?

[oslooskar]

32 minutes ago, ThaiBunny said:

Interestingly dentistry is the one branch of everyday medicine that relies on you having something wrong with you to make money. There's no equivalent to the general practitioner visit. Therefore there's no financial incentive for a dentist to do nothing

I went to the same dentist for ten years and she never worked on my teeth. In fact, she would merely examine them once a year and x-ray them once a year. However, she still made money off of me as the cost of having my teeth cleaned was $147.00 U.S. (4,515.80 Baht)

[Gecko123]

48 minutes ago, 55Jay said:

Get what you demand.  Demand it and you'll get it.  I think.  All in the delivery, so as to not put your dentist "professional" off with an attitude. 

 

Get the x-rays done and then ask, "What do you think?"  Which re-engages their professional aptitude again.  I know... all this managing of attitudes and educated bravado is tiring,  but that's the price you pay living in a place like this.  Not lecturing, you are well experienced here, and I always enjoy your posts and perspective. 

Thanks, 55Jay. But I gotta tell you I feel like I'm walking on egg shells sometimes because she's played the 'maybe you should find another dentist' card before, and if I had to change dentists, I'd probably end up down in Bangkok. I can't handle driving in Bangkok, so that would mean an 8 hour round trip bus ride (5 trips for a root canal/crown). That's what has stopped me from changing dentists in the past.

[Sheryl]

You aren't going to get anywhere trying to get your dentist to change her practices.

 

You need to change dentists.

 

Does not necessarily have to mean going into Bangkok. Where exactly do you live?

 

 

[chilli42]

Why is it the dentists responsibility to practice preventive dentistry?  It’s my life and my teeth ... it’s my job to practice prevention.  Just to add to this thinking, dentists are taught drill and fill in school, they are mechanics.  Preventive dentistry is mainly carried out by dental Hygienists ... which Thailand does not have.  I do agree that the dental profession in Thailand is oddly adverse to X-Rays.  Other than that quite good on all aspects of dentistry ... unless you have the bad luck to being cared for one of the dentists that graduated in the bottom 10% of their class

[Pumpuynarak]

21 hours ago, Gecko123 said:

Still hoping for more feedback on whether your dentist checks your teeth carefully and does x-rays during routine teeth cleaning/checkup visits. Thanks in advance.

99% of the time i have to suggest an X ray and i'm not convinced that a thorough check up is being carried out, my dentist in the UK when carrying out a check up would examine and record the results on my records for each tooth, a real professional imo.

[DavisH]

On 8/3/2019 at 11:49 AM, flyingtlger said:

No my dentist practices "eye gouging"!

Prices in Bangkok are the same as the prices back home.....

 

Where in Australia can you get a filling for 25 dollars or an extraction for 10 dollars?

[CharlieH]

First time I visited a Dentist here I had to stop them and ask "what about anesthetic" ? The reply "we only use if ask" !  - seems to be the norm that they won't do anything that involves a cost unless you ask for it directly.

 

I tried 3 different Dentists before settling on a 4th one I felt more comfortable and relaxed with how they operated. They did take X Ray too and seemed more thorough.

I find you have to be specific and tell them exactly what you want and don't expect them to do anything as "routine".

[Tomahawk21]

22 hours ago, Gecko123 said:

Still hoping for more feedback on whether your dentist checks your teeth carefully and does x-rays during routine teeth cleaning/checkup visits. Thanks in advance.

no x-rays but got me thinking i will say i want next time

[JimHuaHin]

I have gone to two private dentints in the Hua Hin area over the past 6 years.

 

The first was a mature Thai dentist who did generally good work, but did not practice preventive dentistry.

 

Over the past few years I have gone to a great young Thai dentist, who not only does excellent work, but he explains everything he is doing when he is working on me, and he does practice preventive dentistry.

[DavisH]

22 minutes ago, Tomahawk21 said:

no x-rays but got me thinking i will say i want next time

I see no reason to xray unless you have problems with your teeth. For example, if you have cracked teeth with or without a crown, then bacteria can get down inside and damage the bone. That has happened to me. I had to have a crowned tooth extracted due to damage to the tooth and underlying bone loss. In the absence of any symptoms I don't see the x-ray as essential during checks. They aren't expensive so you could always ask for one. 

The best way is to brush and floss twice a day and use mouth wash. This minimises problems but may not be effective if teeth are cracked and allow bacteria into hard-to-get-at places. 

[lopburi3]

X-ray can find potential issues and if taken regularly show areas that are becoming worse.  My dentist always compares current with previous on her computer before making recommendations.  Believe this is especially important for those of us with issues/crowns/root canals and such (often no pain as indications of issue is such a case).

[Gecko123]

30 minutes ago, DavisH said:

I see no reason to xray unless you have problems with your teeth. For example, if you have cracked teeth with or without a crown, then bacteria can get down inside and damage the bone. That has happened to me. I had to have a crowned tooth extracted due to damage to the tooth and underlying bone loss. In the absence of any symptoms I don't see the x-ray as essential during checks. They aren't expensive so you could always ask for one. 

The best way is to brush and floss twice a day and use mouth wash. This minimises problems but may not be effective if teeth are cracked and allow bacteria into hard-to-get-at places. 

I know where you're coming from, but my latest cavity, which is now going to require a root canal and crown, developed between two back molars completely hidden from sight, and probably wouldn't have been detected even if the dentist had done a careful once over of all my teeth. I think the only way this would have been detected is with x-rays.

[Gecko123]

So this past Tuesday I went to this new dentist in the same clinic at the same hospital. I couldn't believe it, but the new dentist followed the exact same protocol as a dentist in the US would: checking every tooth, probing along the gum lines and bite surfaces, using a mirror to visually inspect the upper teeth, wingbite x-rays of all the side teeth. The first time this has been in 15 years despite me practically begging my prior dentists to do this at least five times in the past.

 

The bad news was that the x-rays turned up at least 3 additional cavities: one under an existing amalgam, one hidden on the back side of a furthest back tooth, and another one hidden from view as well. In addition, the huge cavity I wrote about earlier is likely so deep that a root canal and crown are no longer possible and will likely require a dental implant. Needless to say, I am definitely in the camp that periodic x-ray screenings are of value for catching problems early on.

 

So I've been trying to sort out why my old dentist basically refused to do this in the past. Did she dislike me as a patient and want to avoid finding other problems which would increase my contact with her? Did she simply not give a damn? Did she graduate from dental school and slowly over time develop her own style which didn't happen to include doing preventative dentistry? Was it because there are no "best practices" standards in Thailand, and no one was administratively checking what a given dentist was or was not doing? She never once said 'if you want to have this done, there are dentists out there who provide this service, I'm just not into doing that.' So I was shocked to discover that there was another dentist in the very same clinic who seems to be practicing preventative dentistry as a matter of course. My former dentist always made me feel like preventative dentistry simply wasn't practiced in Thailand. I have to say, I'm a little pissed right now because I've always tried to take care of my teeth as best I can and I feel like my overall dental health has suffered as a result of my former dentist's refusal to communicate what options were available to me.

 

At any rate, I've learned the hard way, that dentists who practice preventative dentistry are out there. I hope others can avoid the same pitfalls I experienced. I would recommend to people when contacting a new dentist to ask them at the very outset whether they practice preventative dentistry, what this entails, how often they x-ray, etc., so that problems such as this can be avoided and to try and get this in writing to make sure there are no misunderstandings.

 

Thanks again to everyone who responded to this thread.

Edited August 8, 2019 by Gecko123

[lopburi3]

18 minutes ago, Gecko123 said:

So I've been trying to sort out why my old dentist basically refused to do this in the past.

It could be a fear of excessive x-ray exposure if was being done by dentist in treatment chair (as is still done in shop type clinics).  Larger facilities now have operator take from outside a shielded room just as done for other x-rays.  

[Gecko123]

12 minutes ago, lopburi3 said:

It could be a fear of excessive x-ray exposure if was being done by dentist in treatment chair (as is still done in shop type clinics).  Larger facilities now have operator take from outside a shielded room just as done for other x-rays.  

The former dentist did seem to almost be afraid of x-ray exposure, even though she usually wasn't even in the room when the x-ray was taken and the clinic in the hospital had a separate x-ray room and had a protective wall for the technician to stand behind. When I asked to wear the lead lined garment I saw hanging on the wall, they kind of laughed at me and told me they only used it if a woman was pregnant.

[Sheryl]

It wasn't dislike of you.

There is indeed no administrative oversight if medical/dental practices in private hospitals. Doctors and dentists sre independent contractors with complete autonomy in how they practice. So there is always very wide variation.

The "mai pen rai" attititude in Thai culture extends into medical and dental practice to a greater or lesser degree depending on the individual practioner.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[lopburi3]

15 hours ago, Gecko123 said:

When I asked to wear the lead lined garment I saw hanging on the wall, they kind of laughed at me and told me they only used it if a woman was pregnant.

I am 77 and male but always get vest when having bitewings.  But this is at Vejthani Dentalis which was set up to University of Frankfurt Dental School standards.

[Gecko123]

10 hours ago, Sheryl said:

It wasn't dislike of you.

There is indeed no administrative oversight if medical/dental practices in private hospitals. Doctors and dentists sre independent contractors with complete autonomy in how they practice. So there is always very wide variation.

The "mai pen rai" attititude in Thai culture extends into medical and dental practice to a greater or lesser degree depending on the individual practioner.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

Thanks for that insight about hospital administration, Sheryl. One last thought I had on the issue of preventative dentistry was that if a dentist practices in an area where no one has the money for restorative dentistry (fillings, root canals, crowns, implants and dentures) and extraction is the most common remedy, maybe a mentality sets in that you use a tooth for as long as you can and if it decays you pull it out, so there's little point in screening for problems since many people couldn't afford to remedy the problem with restorative dentistry anyway.

 

P.S. I don't really think my dentist disliked me. If she wanted to avoid me, the way to do that isn't waiting until a root canal and crown treatment, which requires 5 visits to complete, is needed. The old dentist and I really bonded during my last crown and she really did do a lovingly careful job too.

 

It's still too early to give a glowing recommendation of my new dentist. The initial examination went well, but there are some communication issues which still need to be ironed out. She instantly started making faces at my Thai, but when I asked her if she preferred we speak English, I really struggled to decipher her English as well. When I asked her whether a dental implant was preferable to a denture, she kind of rolled her eyes like that was a stupid question. When I asked if there was any chance I could see the peridontalist today, she laughed like that was another dumb question. Maybe it was.

 

Anyway, my strategy is to go on a charm offensive with her. While waiting for the bill to be prepared, I did pay attention to how she greeted the Thai man who was her next patient and I saw that she greeted him in a similarly impersonal manner, so maybe rapport between patients and health care providers isn't as valued in Thai culture.

 

 

Edited August 9, 2019 by Gecko123

[Sheryl]

Again: where do you live?

 

I may be able to recommend a better place. There is no need to put up with this sort of thing.

[Gecko123]

The three major cities closest to me are Lopburi, Petchabun and Saraburi.

Edited August 9, 2019 by Gecko123

[Pilotman]

you are lucky if your dentist actually practices dentistry , at least as the West knows it. Maybe 'practice' is just the right word. 

[mindovermatter]

I go to Bangkok and prefer to use Thantakit Dental Center. Been to two other big dental clinics in BKK as popular as Thantakit but somehow chose Thantakit ever since as they are very reliable. I like the atmosphere. Very satisfied with their level of care and service each time.