This guide to good dental health provides information consumers need to realistically assess their dental needs and those of their children. Not only will it help you avoid or minimize dental disease, it will save you hundreds, if not thousands, of dollars for unnecessary and potentially harmful treatment.

Beginning with the premise that the best treatment is minimal treatment if it solves the problem, the author, a practicing dentist for more than 30 years, discusses guidelines and costs for common (and commonly expensive) dental procedures. He advises the reader on such topics as:

Proper home care and prevention
Frequency of X-rays and prophylaxis (professional cleaning)
Diagnosing and treating tooth decay and gum disease
Composite, silver amalgam, gold and porcelain fillings
Special precautions for children
Unnecessary extractions
Bleaching and veneering

In clear, easy-to-understand language, Complete Guide to Dental Health outlines the costs, benefits, and risks of alternative treatments, suggesting ways to save time and money on such procedures as orthodontics, extractions and bridges. An extensive discussion of the misdiagnosis of impacted wisdom teeth, overuse of general anesthesia, and unnecessary caps and bleaching warns consumers of how they may be injured financially and physically by dentists.

Most chapters conclude with recommendations to help you avoid being overcharged and overtreated. Charts provide information on a range of fees for common procedures. You are shown how dentists exploit patients with unnecessary treatment, upgrades and add-ons.

Suggestions on how to choose and evaluate a dentist will turn the average patient into a savvy consumer. With extensive information on how dental decay and periodontal (pyorrhea) disease occur, Complete Guide to Dental Health will help protect your teeth and your pocketbook.

Jay W. Friedman, D.D.S., M.P.H. pioneered in the development of quality standards for dental care, group practice and dental insurance. In addition to extensive clinical practice, he was a researcher at UCLA’s School of Public Health, a consultant to many state and national organizations, and is presently dental director of Universal Care, a California health plan.

Dr. Friedman has published over 50 papers in professional journals and a number of books on consumer health issues, including a Guide for the Evaluation of Dental Care and the first edition of Complete Guide to Dental Health: How to Avoid Being Overcharged and Overtreated, originally published by Consumer Reports Books in 1991.

Dr. Friedman graduated Columbia University dental school in 1948 and received a master’s degree in public health in 1962 from the University of Michigan. His career has spanned the entire transition of dentistry from the isolation of solo fee-for-service private practice to the proliferation of high volume group practices based on dental insurance.

He has been the recipient of numerous honors, including the Special Merit Award from the American Association of Public Health Dentistry.

Not many books have been written for the consumer about dental problems and diseases. A few attempt to explain in everyday language what dentistry is all about. Others are exposés of bad dental care. Most lead to the seemingly inevitable conclusion that in the end the consumer must rely on the competence and goodwill of his or her dentist, leaving readers with pretty much the same problem they hoped to solve by reading the book.

Though you will not be able to practice dentistry after reading this book, you will know more about how decisions affecting your dental health are made by dentists and others in the dental health field, and you will have a better sense of where and when your interests are being compromised in the dental care offered you. Recommendations are made to help you avoid unnecessary treatment, protecting both your dental and your financial health. You will be advised on how to be more assertive in demanding a role in managing your dental care. And, you will save the purchase price of the book many times over if you follow the guidelines for the frequency of examinations and X-rays alone. You will also save yourself and your family the physical, psychological and financial risks that go along with all unnecessary treatment.

Such advice is not always easy to follow. No matter how hard we work to improve our technical knowledge, we all become laypersons when we turn into patients. We want to and need to trust our doctors, much as children need to trust their parents when in trouble. Although intellectually we know that doctors are not infallible, emotionally we want to believe that they are, that they always know what they are doing and are capable of doing it. The most skeptical of us longs to leave such skepticism in the waiting room.

Dentists, like physicians and other health care providers, are better trained to treat disease, injuries, and disabilities than to prevent them. Some conditions are treated more easily than others. Relief for acute conditions, such as pain from injuries or infected teeth, is relatively easy to accomplish, but the more subtle chronic and degenerative diseases defy the dramatic cures that have given doctors their reputation as demigods. The fact is that neither medical nor dental science can cure every infirmity or restore every diseased and defective part of our anatomy to full use. We cannot reverse all the ravages of time, and there are situations in which attempting such dramatic reversals may actually introduce greater risks to health than treating the condition conservatively. Doctors need to protect their demigod status by promising too much, and we as patients want to believe them.

When you pay all or most of the cost of treatment out-of-pocket, you are more likely to participate in the determination of treatment based on the doctor’s recommendations, which may include a number of alternatives. These days, many people have dental insurance to cover at least part of the cost of treatment. As the amount of insurance coverage increases, the deterrence of cost decreases, and the decision-making process passes into the hands of dentists, physicians and review consultants at insurance companies. In effect, the doctor becomes the consumer of health care services, deciding what will be done to the raw material–the patient–in the office or hospital. This occurs even though dental insurance is seldom complete and large out-of-pocket expenses remain to be borne by the patient. There is a tendency to believe that if an insurance company will pay from 50 to 80 percent of the cost of a treatment, the patient would be losing out by not going ahead and having the treatment done. Of course, insurance payments to dentists are not gifts to patients. The money comes from all of us, as indirect wage contributions.

Certainly one does not question the value of emergency treatment that saves lives and reduces pain and suffering. But most treatment and expense in dentistry is not for emergency care. Much of it can be avoided by preventive behavior on the part of the patient. Nonetheless, we need periodic examination and treatment to discover and assess those conditions that cannot be prevented entirely. What we don’t need is the expense, the discomfort and the risk of FUN–functionally unnecessary treatment–that benefits not the patients but the doctors who provide it. This book, then, is about adequate and appropriate dental treatment and how you–the consumer–can arrive at informed decisions.