We’ve all been in that awkward moment. A new patient has some dental work that doesn’t look so great. Maybe it’s a crown with open margins that needs to be replaced or maybe it’s just a restoration that doesn’t look very esthetic. What should we say to the patient? First, let’s look and why you shouldn’t start bashing the other dentist…
(1) Never judge a dentist’s work until you’ve worked on that patient
Poor anatomy on a composite resin restoration? Funky contours on a crown? We may secretly judge work that is mediocre and pat ourselves on the back for having better skills. But don’t count your chickens until they’ve hatched. Now it’s your turn to do some dentistry for Mr. Johnson and HOLY CRAP he has a massive tongue, tiny mouth, and an ocean of saliva. Oh, and don’t forget his severe gag reflex. And he can only be leaned back halfway or he gets dizzy spells.
Now you’re looking at that mediocre dentistry and marveling at how great it looks.
You might think that bad-mouthing another dentist makes you look like a hero to the patient. Sometimes that’s true. If the patient left their dentist because they were angry or had some discomfort, then they might enjoy hearing you bashing the other guy for a while.
But it’s bad karma. I don’t want to build a relationship with a new patient based on negativity. Plus, we aren’t perfect. Some day in the future that patient may be upset with something we do for them. If we have a history of harsh criticism of dental work between us, then that criticism will turn on us.
(3) It may be unethical
The ADA’s Principles of Ethics and Code of Professional Conduct clearly states that claims made about the quality of another dentist’s work must be “justifiable.” If we state something about another dentist’s work that cannot be backed up clinically or if we even imply mistreatment simply because we would have done things differently, we may end up on the wrong side of an ethics hearing.
So what do we make of all this? If there is a functional problem (e.g. open margins) then we have an obligation to tell the patient what we see. If it just doesn’t look good but is otherwise acceptable, then I recommend keeping that opinion to ourselves unless the patient is unhappy with the cosmetics.
When I do have to tell a patient about functional problems, I simply state what I observe. If the patient asks about the quality of the work, I will do everything in my power to not implicate wrong-doing on the part of the dentist. I’ll say things like:
“I’m sure the dentist did everything they could to make this perfect. But sometimes our treatment doesn’t work and we need to make it right.”
Here are the exceptions: (1) a dentist has clearly demonstrated gross incompetence or negligence, or (2) there are continual instances of faulty treatment from the same dentist. In these cases, it is best to bring the matter to the attention of the local dental society.