Questions for Dentists and Periodontists

[CM]

Is St Louis University Center for Advanced Dental Education a good school?

If I went there (or to any dental school) for an opinion on periodontal care, would I receive an opinion from an experienced academic periodontist without a financial interest in the recommended treatment?

A surgeon's experience and annual volume with a particular procedure are important predictors of outcomes in most areas of medicine. Is this true for LANAP as well?

[Hatton]

bump

[nephron]

I don't think that you are going to get a straight answer, even from a recent graduate. There may not be a financial incentive to an extra procedure, but there they probably have the want to learn by doing more procedures incentive to do more procedure. The quality of work you get probably is highly dependent on the resident or fellow you happen to be assigned to. I used to go to my dental school for dental care as it was cheap and convenient, right next to my med school. I don't know why, but while I was there one day, they had on a flyer advertising their statistics how they took care of the most HIV positive patients in the region or nation. Made me bit uncomfortable. They did a bunch of fillings for me, and then the next dentist I saw said that they'd eventually have to redo all the fillings they did at the school because they used some temporary filling composite or something? Then I saw another dentist who never said anything about it and I still have the same fillings. I don't want this to turn into another anti-dentistry post, but I don't know how to get a straight evidence based answer in dentistry. I suspect that you are more likely to get one from a school then a private practice though.

[Debt Free DDS]

I'd like to think that they will be honest and do a great job. No one is without incentive. They need to make money too. The residents also want to get the experience. That being said, in my school I feel everyone was very honest and looking out for what's best for the patient is of the upmost priority.

[CM]

I'd like to think that they will be honest and do a great job. No one is without incentive. They need to make money too. The residents also want to get the experience. That being said, in my school I feel everyone was very honest and looking out for what's best for the patient is of the upmost priority.

Do you know if there is a significant learning curve with LANAP?

[Private Practice Dentist]

I think SLU is a good institution and they have a good periodontics residency. I'm not sure if they teach LANAP at SLU. It is only taught at a minority of Perio residencies in the US.

I have used the LANAP technique for close to a decade. The learning curve for the clinical procedure is not all that steep -- it is much easier than many old-school periodontal surgical treatments. The treatment planning and decision making is much more complex than the technical execution of the procedure. I believe this is part of the reason the procedure has become controversial amongst periodontists.

[2thFxr]

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[toofy]

Who gives opinions without financial influence?? If you go to Best Buy, do you think they will recommend a TV they don't stock??

[CM]

Who gives opinions without financial influence?? If you go to Best Buy, do you think they will recommend a TV they don't stock??

Is it too much to ask to receive a recommendation that is in the patient's best interest rather than the healthcare professional's?

An academic earning a salary that is not influenced by the number or type of procedures performed would have no financial interest in the recommendation. I thought that might be the case at a dental school, but I don't know how the professors are compensated.

[Molar Mechanic]

Generally dental professors don't practice in the school. They'll either be part time with the rest in private practice, or they'll practice in a "faculty practice" clinic. That clinic is probably fee for service.

Why are you worried about the dentist's financial incentives? We'd all make more money trying to threat every thing. Those darn pesky ethics and morals keep getting in the way though, so we just end up recommending what's in the patients best interest. I probably decline to treat 15% of cases that get referred to me as I believe it's unnecessary or has a poor prognosis.

[CM]

Why are you worried about the dentist's financial incentives?...Those darn pesky ethics and morals keep getting in the way though, so we just end up recommending what's in the patients best interest.

I worry that not everyone practices as you do.

[Dont_know_mind]

I would rather see someone in private practice than an academic setting, unless I had something very rare or serious. But then I work in private practice (not dentistry) so I might be biased.

I think everyone has incentives, in any setting.

[Tim]

Get over it. It is called up-selling. Happens everyday. The question is, are you being swindled? Probably not. FLP had a post about a toothache. With physicians, the “informed consent” form is type of joke. When in doubt, that’s why you get a second or third opinion.
Dentists and accountants have the same problem with physicians.
If you don’t trust the professional advice, your in the wrong place.

[Debt Free DDS]

Do you know if there is a significant learning curve with LANAP?

Not really. They will do a good job.