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  • Dr. David Alfaro

Peeeww Peeeeeww

Dr. Dave, Dr. David Alfaro, Vancouver and Richmond Prosthodontist, General Dentistry

So I was at the dental conference last weekend, and just like I usually do, I skipped most of the self and product promoting podium talks and wandered the exhibit floor looking for stuff for the office. I needed a LASEEEERRRRRR. I have been using soft tissue lasers forever, but I did not have one at the new practice, so it was on the shopping list.

If you guys haven't been to a tradeshow like this, it really can be a nightmare. There were over 12 000 people and hundreds of exhibitors. I try to just walk in the middle of the aisles and avoid eye contact. The attention is nice, but I kind of feel like the woman in that "American Girl in Italy" photograph.

I finally see the laser that I was looking for and I make my approach; total slimeball sales rep, but...I wanted this laser so I played along with his banter. He is going over the features of this laser and he tells me, "oh, and I will throw in the 4-hour online training for free. You can call yourself a Certified Laser Dentist!"

I say, "excuse me? There is no such thing as a certified laser dentist."

And he was kind of shocked. I reviewed with him that in BC we can only be "certified" as general dentists or specialists, which was nerdy and rude of me, but morally necessary. There is no such thing as a laser dentist.

Let us talk about advertising once again.

I am sure that you are starting to see a trend in the topics I write about, but it is because I am pretty sour at the way that advertising has taken over my profession.

Shady advertising is confusing to the public.

Dr. Dave, Dr. David Alfaro, Vancouver and Richmond Prosthodontist, General Dentistry

My brother has a PhD and is one of the smartest people I know. He loves gadgets. A couple of years ago he told me that he had been going to a "laser dentist" and that the doctor also makes the crowns in his office. I say, "excuse me?" No!No!No!No! Brother!!!!

I look up the doc, and he is advertising himself as a "laser dentist" that does "pain free" and "needle free" dentistry. That is unethical and against the college regulations......

Randomly, I end up meeting the doc at a later date and we start chatting and he finds out that I am a prosthodontist, and he tells me, "oh yea, I never refer to you guys. I have done a couple of sinus lifts in a study club and I place a couple of implants a year. I do everything Cerec. My lab bills are way lower than yours."

Dr. Dave, Dr. David Alfaro, Vancouver and Richmond Prosthodontist, General Dentistry

This kind of attitude kills me. A sinus lift is a crazy difficult procedure and is not something that you do from time to time in a study club. Dental implants are similar; you need proper training and routine practice and exposure to the long term maintenance of the prosthetics in order to truly understand how to manage them. Do not even get me started on in-house milling.

But this is what is going on out there. The dental conference even had live-surgery sinus lifts and immediate implant placement and restoration, complete with a song and dance. No joke. They were dancing to disco music!!!! Why????? Totally unprofessional.

Dr. Dave, Dr. David Alfaro, Vancouver and Richmond Prosthodontist, General Dentistry

Do you want your general dentist to watch a surgery on stage, performed by someone who has done hundreds if not thousands of them, who is up there because an implant company paid a large sum of money, and think.....hey! I can do that in my office too!!!?

No way.

This is just straight up wrong, but people are either unaware of the complications that can happen with advanced dentistry, are blinded by these aggressive marketing schemes, are convinced that referring patients is costing them money, or want to learn everything to become a "jack of all trades"..... so they take on challenging cases in their practices.

And the public doesn't know.

How do you know if you are seeing someone who has received adequate training in a procedure?

Let me tell you, in dental school, students are just learning how to use handpieces, are just learning to tell dentin apart from enamel, and definitely do not get adequate training in dental implants or orthodontics to truly be able to do it upon graduating. Dentistry has grown so much that there is just way too much to learn and not enough time; some programs really only have about 18 months of clinical training. That time flies by.

Dr. Dave, Dr. David Alfaro, Vancouver and Richmond Prosthodontist, General Dentistry

The reality is that dental students graduate with the bare minimum skillset required to go out there and do basic dentistry, without maleficence. Some recent graduates are humble about it and understand that dentistry is actually quite difficult and slowly work up to challenging cases. Others come out overconfident and start doing complex endodontics, oral surgery, invisalign; everything.

That is... until they own their own practices and start seeing how much remaking and redoing and retrying stuff costs, and what it does to the confidence that patients have in them. Fumbling around while attempting something new or difficult in order to keep the treatments "in-house" is not a good business model.

A dental practice is not a place to practise.

How do dentists gain experience in advanced dentistry?

Study clubs. Courses. Lectures. Weekend programs. Cruises. Or just trying and learning as they go.

Or....they enter a university level specialist training program and really learn the details of advanced dentistry, including the history and current research, and then focus their practices on a subset of all of the clinical skills that are required of our practice. Specialized dental care.

Dr. Dave, Dr. David Alfaro, Vancouver and Richmond Prosthodontist, General Dentistry

So don't be fooled by gadgets and gimmicks; general dentists are general dentists; specialists are specialists. Being a laser dentist is not a real thing. Doing invisalign or six month smiles does not make you an orthodontist. If there is no microscope in the office, they are not doing endodontics right. There is no such thing as a dental implantologist.

Do not be fooled by advertising techniques or posters with pretty smiling faces!

If you need dentistry beyond basic surgery, fillings, crowns and bridges, consider a consultation with a dental specialist. Every good dentist should have a network of specialists that they collaborate with and will gladly refer you, even if it is just for a second opinion. I frequently get referrals from doctors who want me to take a second look, and then we work through the case together. The patient gets the best care that both of us can provide!

Doesn't your smile deserve a specialists attention?

Thanks for reading.

Dr. Dave

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