If you don’t have a dental horror story, then you probably know someone who does. Ever heard the classic, the ineffective novocaine shot? How about that time the endodontist answered his cell phone during a root canal?  Lucky patients know that a good dentist discusses treatment options, explains preventive techniques, works gently, produces the results they expect, charges affordable prices, and certainly does not answer his or her cell phone midprocedure. Some people even hit a pearly white jackpot. The Lombard resident Madolyn Rogas takes everyone in her family of seven to Dr. David Carlson in Wheaton. “He takes the time to explain what he is going to do—and why,” Rogas says. “He totally rocks.”

Rogas isn’t alone in her praise of dentists in the Chicago area. Nonprofit magazine Chicago Consumers’ Checkbook (checkbook.org) collected ratings from 5,000 dental patients and pinpointed 252 recommended general dentistry practitioners. Nearly two-thirds of these dentists were rated “superior” in overall performance by 95 percent or more of their patients. The chart on page 70 lists the top 40 recommended dentists.

Not surprisingly, lots of dentists fell short. Among those who did not make Checkbook’s recommended list, some received “superior” ratings from 60 percent or fewer of their surveyed patients. Many clients related bad experiences with one dentist before finding one they liked. Rogas’s former family dentist scraped her daughter’s chin during one visit, leaving a scab. Then he gave her the hard sell on services she didn’t want.

Pushing unwanted or unnecessary services was one of the most common complaints made by surveyed patients. Another one: high prices. But the worst complaints were about inferior work. One surveyed patient wrote, “[The dentist] recommended a root canal, and after it was done, the tooth could not be saved. I wasted $600.”

It’s worth checking prices for standard procedures. Most dental offices will give pricing information over the phone. When Checkbook’s researchers, without revealing their affiliation, called area dentists for prices, they found no correlation between price and patient ratings. Many high-rated dentists were also among the most affordable—but overall, the prices Checkbook collected (see the table for cost comparisons) varied widely.

Another key to containing costs? Discuss treatment options with your dentist. In a restoration, a nonprecious metal could work just as well as gold, and for any recommendation for major work, get a second opinion. Consult a dentist who is unaffiliated with your primary dentist, and make it clear that you want only a second opinion.

If you don’t have dental insurance—and you anticipate a lot of dental needs—you might be able to save hundreds or even thousands of dollars per year by signing up for a prepaid dental plan. Checkbook looked into a plan for a family with husband, wife, and two children. For routine care plus two topical fluoride treatments, three fillings, and a root canal and porcelain crown, enrollment in a prepaid plan would cut this family’s total costs for the year by $1,500 to $2,000 after allowing for the plan premium. But bear in mind that prepaid plans limit your choice of dentist, and savings only amount to $200 when routine exams, cleanings, and X-rays are all that you need.

Of course, the best way to save money (and avoid a tooth-tacular nightmare) is by practicing preventive care. Brush. Floss. And get a professional cleaning every six months. Those obvious basics will keep your pearly whites pearly. And that totally rocks.

Illustration: Matthew Hollister

Choosing specialists

A general dentist is your first line of defense, but who are all those other guys?

Endodontists treat the pulp of teeth, including root canal therapy.

Oral and maxillofacial surgeons specialize in surgery of the mouth and face, including removing wisdom teeth, removing tumors, doing biopsies, and performing cosmetic reconstruction of the face after trauma.

Orthodontists specialize in the diagnosis, prevention, interception, and correction of malocclusion (bad bite), as well as neuromuscular and skeletal abnormalities. They are best known for doing treatments with braces.

Pediatric dentists specialize in working with children from birth to 21 years of age, a period that usually gets patients through the time when dental growth ceases and the wisdom teeth are fully formed.

Periodontists (referred to as gum doctors) specialize in the tissues that support, attach to, and surround the teeth and the treatment and prevention of disease affecting these tissues.

Prosthodontists specialize in repairing and replacing teeth and oral structures, including especially complicated crowns, bridges, implants, and dentures.

Your general dentist will logically be your first source for a referral. You may also want to consider one of the specialists recommended by Checkbook based on its survey of general dentists in the Chicago area. A few of Checkbook’s recommended pediatric dentists and periodontists—those endorsed most often by surveyed general dentists—are listed in the chart.

Bills, Bills, Bills

Based on 252 evaluations in the Chicago area, Checkbook reports lowest, average, and highest prices for the most common procedures.

Which treatments are worthwhile?

Fluoride: recommended for children. Recommended for adults if there is a history of decay or periodontal disease.

Sealants: recommended for children as a long-term bargain. The picture is less clear for adults.

Gum disease: Don’t get surgery until you have exhausted nonsurgical alternatives such as scaling and root planing in combination with antibiotics.

Extraction: Avoid having a tooth removed if at all possible. It may seem economical in the short run, but it can cause larger long-term problems.

Bonding and veneers: Bonding resins (plastics) or porcelain veneers can be bonded to restore cracked, stained, or irregular tooth surfaces. But while less expensive, these solutions aren’t as strong as crowns.
 

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