I'm a Dentist. Doing a Q&A for Dental Health Week

Hi Guys, been a member of Ozbargain for a many years now.

Some of you may know that I'm a dentist. I've given some input previously, but its Dental Health Week, so my clinic is doing a Q&A Session where you can ask whatever dental or teeth related questions and I'll try my best to answer. Its going to a a live stream on facebook format. But I would really love to have some questions beforehand to answer. Not really an ozbargain AMA in the traditional sense, but hopefully still helpful for some people.

So if you have anything you want to ask, or something you've avoided, or if its difficult to ask a dentist in person, (eg fear of going etc), feel free to ask me!

The facebook page is https://www.facebook.com/GlenmoreParkDentist/

Please comment on the link or below here and I'll do my best to answer in the live stream. The live stream should be taking place 7:15pm this Thursday.

Cheers!

EDIT 1: wow thanks for the great response. Probably way too much to talk about in one live stream, so I will pick the most interesting topics and overlapping questions and talk about them. Dental health week is all about education and starting a conversation.
With the other questions that I dont touch upon in the live stream (i dont want to drone on and on) I will try and answer them here when I have time later. Thanks again.

EDIT 2: Live stream is done and dusted. Please let me go home and type up some answers here for you guys.

EDIT 3: Alright, The video is up on the facebook page anyone wants to watch it. I think I covered the below topics:
- How often you should visit the dentist
- Whitening and DIY kits
- Charcoal toothpastes
- Electric vs Manual tootbrushes
- Airfloss/waterpik
- FLOSSING
- Mouthwashes
- Brushing before or after breakfast?
- Gum disease
- Root canal and alternatives
- Jaw pain and grinding
- Why does dentistry cost so much?

Thankyou to those who asked questions and watched the video and hope you can give us a 'like' or comment on the video. I have answered the ones I skipped below here in the comments. There have been some very useful discussions also below.

Comments

  • +17

    Why do you charge so much? :)

    • If he didn't he wouldn't be so attractive (as an electromagnet?)

    • Good question, was waiting for this one :) Will be talking about this.

      • +2

        Should of been a eye dr you could charge even more :)

        • +25

          Or an ENT and he could charge through the nose

    • -4

      Why do you earn more than doctors in the first 15 years of your careers

    • +15

      Dental overheads are ridiculously high.

      They need to pay for 3 staff to see you (Dentist, assistant and receptionist), any equipment and material with the word "dental" on it increases the price automatically by 5000%, rent, utility bills, indemnity insurance, marketing etc.

      Overheads are much higher than a GP clinic, all the materials and the initial equipment for practice fit-outs are very expensive. A dental chair costs anywhere between 20-50k, a machine to make in-chair crowns can cost 100k etc.

      All that plus they need to make enough profit to make it worth all the risks associated with medical/dental procedures.

      • +3

        well said. running a dental clinic costs so much. before the patient even sits in the chair it costs the operator at least $120 for the hour before they even have made $1 profit. not including the cost to do the procedure etc

        • Training to be a dentist is also a long and expensive process. Attending the mandatory continuous education courses can cost tens of thousands of dollars depending on the course and that's not accounting for lost revenue due to not being able to work.

          So everything adds up.

          • +1

            @[Deactivated]: It's worth it in the end, it's not uncommon for a dentist to make $300K. But, for what they do, it's well deserved.

    • +5

      Imagine staring into people's mouths all day…

      • +12

        This. Doctors and dentists deserve what they get payed, no way I could deal with sick people, or staring/reaching into strangers mouths all day. Plus the amount of education they have to go through and maintain.

        • We work in a field thats about 6cm circle. My continuing education for last 3 year cycle cost me $25k. I’d say its reasonable to be paid what we’re paid.

    • Dentists get paid by a % of what they bill for, with the surgery taking the rest.
      Because of this they dont get sick leave and paid holidays.
      Theirs also the fact that they have to get a doctorate and pay off an enormous debt.

      Source: My family is full of dentists.

    • +9

      I talked about this in the video, but three main things, people here have explained it really well
      1 - our costs are very high. There are registration fees, multiple insurances, i didnt talk about lawyer and accountants, but my yearly accountant bill is over $20thousand - i want to do it properly and not get audited by the ATO.
      2 - all the materials we use have a markup because it says 'dental'. Everything must be TGA approved, we cant just use cheaper stuff.
      3 - the government / medicare doesnt cover dental for normal adults (children from families on tax benefit A centerlink are partially covered by the medicare child dental benefits scheme)
      4 - I didnt talk about this but every 3 years we need to do 60hours of continuing education courses. These courses are expensive - a one day course can be $1000-1500. We need to do 60 hours of these.
      5 - I look at mouths all day and have people coming in miserable and telling me they hate the dentist and what I do to my face… its a tough gig sometimes and stressful and I think we deserve to be paid for this.
      6 - I have to pay a receptionist, a nurse and myself for your time in the chair.
      7 - sterilisation costs money. All the equipment needs to be serviced. The chair, xray unit, autoclave, compessor, suction all need yearly service and this is around $800-1000 PER UNIT to be serviced.

      again, some people will still say that its expensive etc etc.. but this is just where i'm coming from. We are not out to gouge you out of money, its just a fact that our running costs are very high and fees are not covered by the government.

      • +5

        Looks like you get overcharged with these services you require, you should consider Airtasker and a dude with a ciggy in his mouth may do it for $50 + extra $20 in hand? https://www.ozbargain.com.au/node/475388

      • +1

        Is the 60 hour requirement purely for attending courses? Is that just a part of your total professional development requirements? By comparison, as a chartered engineer we're required to undertake 150 hours minimum of continuing professional development to remain registered. And within that, we're required to undertake a minimum number of hours on various topics (technical courses, risk and business management, etc).

        Intuitively, 60 hours seems a bit low for a field where people's health and well being relies on the practitioner to be up with the latest.

        • +1

          60 hours is spread over a 3 year cycle. So every three years we need to do 60 hours. I usually do more than the 60 hours anyway as there is so many topics that you can spend time on learning.

  • +6

    What are your thoughts about Water Flossing (WaterPik) vs traditional flossing methods?

    Is it recommended for children who will require their parents to use the Waterpik (with their mouths open)?

    • Good question i'll talk about this and also the toothbrush question also. Thanks :)

      • What do you think of the Philips Airfloss?

        I tried and failed for years to build a habit of flossing daily. I even tried the single-use dental floss picks out of convenience. Being the geek that I am, I looked for a machine to do it for me. After examining the market, I settled on a Philips Airfloss. For the first time, I'm actually 'flossing' daily.

        My research indicated that a Waterpik would clean better, but is more cumbersome and messy to use. The Airfloss is clean and simple, and you can fill it with mouthwash. It was specifically designed for lazy people like me.

        • Agreed, I hate flossing, I get told to do it every time I go to the dentist… Which is often, apparently because I don't floss.

          Feels damn good when I do floss, then waterpick, then brush though. I just resent the extra 15 minutes of unpleasantness just before bed.

    • I do water flossing with waterpik everyday, but somehow my dentist still said it's not good enough, i.e still have plague etc. Maybe I'm not doing it right :(

    • +1

      waterpik and airfloss is limited benefit to most people. Unless you have dexterity issues etc and cant physically use floss then i wouldnt recommend you spend that money on a gadget with limited benefit.
      Mechanical cleaning is what gets rid of plaque between teeth.

  • +21

    Do you do appointments at 2:30 ?

    • -8

      There is a bridge bidding convention called Roman keycard where either the first bid shows 1 or 4 aces and the second shows 0 or 3, or the first shows 0 or 3 and the second shows 1 or 4. The first kind is known as the dentist kind (14-30 -> 2:30)

      • +7

        No idea what you're talking about but I'm pretty sure it's a woosh.

  • +6

    What's best… manual or electric toothbrushes?

    • +1

      … and what kind of electric toothbrush is best? My research found three main types:

      – vibrating (pretty rubbish)
      – oscillating (e.g. Braun/Oral-B)
      – sonic (e.g. Philips)

      My reading indicated that the oscillating kind was the best at cleaning. What's your take?

      • mostly just used Oral-B but love it - mouth feels much better than regular tooth brush.

        • +2

          Have used all 3 types including a $200+ Philips Sonicare

          Went back to a $20 Oral-B Oscillating / Rotating cause I felt it worked better.

    • +4

      electric, specifically oral b. My strong preference is oral B. I use a cheap vitality one, but the more expensive ones last longer and batteries stay charged easier.

      • +2

        Why are you so cheap? ;) it's your profession, you should use what you recommend.

        • +1

          lol its really more the technique. if you brush properly the basic one works just as well. The more expensive one has fancy lights and bluetooth and tracking sensors and pressure sensors etc.. I personally dont need that stuff.

  • I haven't been to a dentist in like ten years but my teeth are fine. Except for one tooth where if I press with my fingernail near the gum it hurts a lot. Is that worth seeing a dentist over?

    • +38

      I don't need to be a dentist to answer that question: yes.

      • +1

        Lol

    • It'll cost you but it'll cost you 10 times more to go to the dentist later rather than now.
      Research for a good dentist & research the procedure they recommend.

      • Agreed. I've had major major dental pain thinking I'd deal with it later on. 2.2k. 3 hospital visits, ruined holidays, 7 drs/dentists. Though that one we didn't know it was dental.

  • +12

    Is it better for brush and then floss, or floss first and then brush?

    • Flossing removes the bits of food between the teeth. Once these little pieces of food and plaque are loose, the toothbrush will brush them away.

    • I always brush, rinse, floss, rinse? Don't know if this is right or not.

      • Yeah, this is how I was taught too….blew my mind when I found out people floss before brushing!

      • I've always been told by dentists to not rinse after brushing because you're washing away fluoride that would otherwise help protect your teeth. Just spit it out.

    • I brush first. But TBH makes no difference. Just floss.

  • Questions:

    • What's the standard cost of a checkup and clean before gross of any health insurance benefits for your practice and how much time do you allocate for it?
    • Are amalgam filings hazardous to your health?
    • Do you recommend using interdental brushes?
    • How should you keep teeth, gums and bones healthy?
    • Any of the negatives reversible e.g. receding gums, or best outcome is to maintain current level with good dental hygiene?
    • sorry i missed this question.
      - normal checkup and clean with xrays is around $230-260 depending on if you want fluoride. I usually book an hour for it as I spend time explaining things and talking you through the xray and intraoral photos we take, then the treatment etc. We are certainly not expensive compared to some places, but we are also not the cheapest dental surgeries that try and fit as many people in as possible. I dont like to rush things.
      - amalgam fillings are not hazardous to your health. I personally dont do amalgam but if you have them and they arent causing problems eg cracked or leaking then you dont need them replaced.
      - flossing is best but interndal brushes are still very good.
      - talked in great detail on oral hygiene routine in the video. Its simple. Diet and oral hygiene.
      - receding gums or gum disease can be controlled and stopped. the gum level can be maintained. If severe a periodontist can do gum grafting also. But dont leave it too late, early maintenance is key

  • +31

    Question: Why don't you answer the questions posted on this website instead of making us ask here and then tuning in on Thursday to your Facebook page for the answers?

    • Hear, hear!
      I'm busy at 7:15pm this Thursday. Why even post here?

      • +14

        I'm sorry you're busy during the planned live stream. It will still be viewable afterwards though.
        Reason I'm doing a stream rather than answering questions is that its easier for me to talk and explain things rather than writing out individual responses essay style. Some of the questions are related and overlap also.
        I'm posting here because I've been part of the ozbargain community for so long and just wanted some questions to answer and talk about. Hopefully some people appreciate what I'm doing and get some benefit out of it.

        • thanks for your assistance and contribution :)

  • +9

    Why can't you and your colleagues show us your face?

    • +4

      Because they always look down in the mouth

    • +5

      will be showing my face in the live stream lol

      • +5

        Is that you Rob?

  • +27

    Do you know of any dentists named Phil McCavity?

    • +3

      My father had a dentist once called Dr Spittle. Of all the professions he could've chosen…

  • +1

    What's your opinion on having certain dental services become bulk billed through Medicare? A lot of people can't afford private health insurance.

    Do you think it would be helpful for the lower income population to receive certain non-cosmetic dental treatment on a bulk-billing scheme, similar to a bulk-billing GP?

    • +1

      There's the children's dental benefits scheme and I think there is something for very low income earners as well

      • +2

        Yes, there's a concession dental benefit thing, but it's so massively underfunded you have to wait about 2 years for a checkup. At least this was my experience in the past as a student.

        • Depending on your state, you can always go for Public Dental Services.

          If serious enough, and the line is long enough, people can be offered a voucher for treatment in a private dental practice (as long as the practice is accepting that scheme).

    • +1

      It would make a great difference to everyones oral health if medicare covered some portion of preventive treatments

  • +13

    Can you answer the questions here instead of the live stream?

    • he has the whole week to answer all our burning questions :D

  • +4

    Do you charge more for health insurance customers?

    • want to know as well .

    • We have the same fees for health or non health insurance patients. For some however that we are preferred providers for there are different fee schedules so you pay less gap.

      • Good to know. I used to have a dentist whose gap was suspiciously very similar to the fees for non-insurance customers.

        • some practices do some 'interesting/creative/questionable' things to claim as much back from your health fund, which means you dont pay a gap so they seem cheaper… but the result is that your health fund limit is maxed out and when you go get optical or physio, then your health fund doesnt pay out.

      • Charging the same unlike many other medical specialists, pathology clinics. Etc. Well done.

  • Hi Jasonlah,
    Thanks for taking our questions :)

    Can periodontal disease be reversed with good teeth care? Ive had xrays and dentist told me that I need to see a peridontal surgeon as the xrays showed visible lines to my teeth. I am on a waiting list to see the surgeon. Since hearing this news, Ive been extra strict on my dental care routine, brushing 3 times a day with electric toothbrush, flossing. I have heard that mouthwashes can kill good bacteria as well as bad bacteria is this true? If not, is there a mouthwash you can recommend for my teeths condition? Thank you so much for your advice

    • -1

      Good question, I will be touching on this topic in the video. Thankyou.

      • +3

        Hi again Jasonlah,
        Im wondering if theres another way we could access your video? I would love to see it but unfortunately, Im not on Facebook, Thanks again

        • +1

          You dont have to be on Facebook to see the video. You can just click above to our facebook page and say 'not now' when it tells you to log in to facebook.

  • +2

    1) What's the best thing parents can do to stop their kids getting in to trouble with their teeth early on?

    2) What age should kids first have a proper dental checkup (assuming nothing is obviously an issue that needs earlier attention)?

    3) I recently saw a dentist for a checkup who said I need to make a separate appointment for another dentist to do the cleaning. I was pretty taken aback by this. Is this a standard practice to go and get a checkup only to have to make another do do the regular cleaning? It sounded like a money printing exercise to me. Surely cleaning should be part of the annual checkup? What is your experience?

    • -2

      Really good questions, I will be talking about this in the live stream. Thankyou :)

    • This is something that should be taught at school. In a way to spark interest rather then scare. I damaged my teeth before I found out there is actually a profession called dental hygienist. I have been to quite a few and some are very good at it even I pay say 80 bucks it makes me so fresh when all the bacteria between gum and teeth are gone. Sadly anti social behaviour has made infection control the dearest part of it. Either I travel to a less social area for a good job or pay $160 for a clean that is $40 for the labour and $120 to protect the hygienist from undesirable infections.

    • 3) It makes no difference to your final cost as an 011/012 is your examination the 022 is your xrays if needed and the 114/121 is your clean and fluoride.

      Whether the dentist does it on the day, or the dentist just does the 012, 022 on the day and reschedules/delegates the 114/121 to the hygienist/therapist bears no difference to your end cost.

      If anything the hygienist may provide you with a more dedicated clean of 30-40 mins whereas our time is worth more and you’d be lucky to get 10-15 mins with the dentist for a clean realistically.

      A hygienist doing your clean is relatively standard practice at any busy practice.

    • No sharing of saliva with under 2 year olds!

      It is the biggest risk factor for the child to develop decay later in life.

      After two years their oral bacteria stabilises, and they are much less likely inherit the parents harmful bacteria

    • touched on this in the video. Diet and oral hygiene basicall.
      If you need a separate appointment for cleaning, ask why this is the case. It depends on the individual circumstance. I usually do cleaning on the same visit but everyone is different and its not one size fits all.

      probably visit before age 4 i would say. You can bring them in earlier for the kids to get used to the environment. The last thing you want is to wait until the child has a toothache and needs a tooth pulled on their first ever dental visit.

  • Should I get my teeth whitened overseas (Vietnam)? If so which type would you recommend?

    • check youtube and save the travel money!

    • I use salt and baking soda and bit of vinegar to clean my teeth ( tarred by coffee ). After some 10 days my teeth look perfectly clean and white. Try my way and cause no harm. Am I right Dr.Jasonlah ?

      • +3

        Thetiger, vinegar is really acidic, and with the abrasiveness of the salt it can prematurely wear away the surface of the tooth. If its removing surface stains that easily it is most likely abrading or acid etching away the surface layer. I would strongly advised against this. If you want a good toothpaste that will whiten and not abrade the teeth or damage then I would suggest Colgate optic white toothpaste. Expensive but it works, and is not any more abrasive than normal toothpaste.

      • My dentist recommends using baking soda mixed with small amount of water into a paste, and lightly smearing on teeth after regular teeth cleaning 3x a week, leaving on overnight (not brushing it on, too abbrasive). Apparently helps with stains, and attached bad bacterial of the acidic environment they need to reproduce, or something.

    • Whitening is so cheap here in aus why would you fly overseas for it? I talked about going overseas for treatment in the video a bit also.

  • +2

    Who's that 1 dentist who doesn't recommend?

    • +3

      He's currently running away from colgate and oral b

  • +6

    Could you do this as a standard AMA instead (or as well)?

    • +6

      Depending on how the live stream goes, I will try to answer the questions here or do a transcript.

      • +1

        Thanks. In that case:

        1. Any real reason why I can't just see my dentist 1x / year rather than 2x / year? I don't have private health care and pay the full amount, so I'm currently doing every 9 months despite the "See you in 6 months" at the end of each session.

        2. Any reason not to just by a bottle of one of those 3% hydrogen peroxide things at the chemist and dilute it 50% for whitening (used like mouthwash)? 1.5% hydrogen peroxide seems to be the active ingredient in most whitening products anyway.

        • I touched on both these in the video also.
          1.5% hydrogen peroxide will literally do nothing.
          We use 37% in chair whitening, or 6% or 9% for take home kits.

  • If my dentist has completed a crown and there a margin between the crown and my original tooth, would you recommend me do a new crown?

    Thanks :)

    • a margin is the join line between the crown and the tooth. Depends on if the margin is flush or if there is a gap. You should go back to your dentist if you are unsure

      • yeh my original dentist saids its fine cause its sealed.

        I went to get 3 other opinions from 3 different dentist - 2 say redo and 1 saids not to touch …

        (In General - as i know you cant see the xray) If there was a big margin, would their be a high chance of bacteria getting to my original tooth and decaying it? as its not properly crowned?

        Thanks so much for the input

        • +1

          if there is a gap in the margin that will allow plaque and bacteria to stay there I would be a bit wary. Again hard for me to comment over the internet. If no symptoms you could leave it, but if the crown is new, and there is a gap in the margin from day 1 I would be a bit concerned.

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