Inside Dentistry
April 2019
Volume 15, Issue 4

You Get What You Pay For

With technologies such as intraoral scanning and computer-aided design, clinicians can now get the information that they need to make treatment decisions in ways that require less steps and traditional clinical expertise. Although this new level of predictability has allowed us to provide patients with better, more efficient long-term outcomes with a reduced chance of error, it has also opened the door for companies to offer a whole new class of "direct-to-consumer" dental treatments, such as whitening, clear aligners, and snoring and bruxing appliances, that patients can pursue without the involvement of their dentists. Understandably, this makes many of us very uncomfortable. So, how do we proceed in this environment and best advocate for our patients' oral health?

One of my patients who explored the cost of Invisalign treatment and found it unaffordable confided in me that he had elected to proceed with direct-to-consumer clear aligner therapy. I reminded him that it's his mouth, his time, and his money, so it's ultimately his decision, but emphasized that I would only be a referee in the process and could not endorse it.

It's easy to jump to condemn direct-to-consumer dentistry, but we can't make appropriate judgements until we have more robust data on the outcomes. For now, it's best to keep an open mind and proceed with caution. If you don't embrace the potential, you'll appear combative, and your patients may perceive that you care more about your profits than their outcomes and lose trust. That being said, it is also important for us to advise our patients that we can offer better results with in-office and dentist-provided at-home treatments. Educate your patients about the risks that accompany the advantages and let them make the decision-don't make it for them.

In this regard, we can't abandon our patients who undertake their own dentistry, but we have to take steps to protect them and ourselves. Proper documentation and disclosure are essential to differentiate between the results of our treatments and those that our patients pursue on their own, especially if we are asked to "fix" a result of a patient's self-treatment. Again, caution is key.

By giving our patients all of the appropriate information and supporting them in making their own oral health decisions, we are providing the patient-centered care that they expect in today's market. Instead of seeing direct-to-consumer dentistry as an obstacle, we can view its products as chances to drive treatment acceptance for the more effective therapies that we can offer to our patients. It's not a threat to our practices-it's an opportunity to build trust with our patients.

Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Adjunct Professor
Department of Operative Dentistry
University of Iowa, Iowa City, Iowa

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