Since the
advent of predictable dental bonding and tooth colored restorations the game,
the rules and the field changed overnight. The ability to provide esthetic, as
well as, functional changes for patients was a boon to dentistry. Gone would be
the days of big silver fillings or full metal crowns, patient now expected and
were entitled to fillings, crowns, and veneers that could mimic tooth structure
so well that when properly done, were indistinguishable from the adjacent
natural teeth.
Like any business, competition
drove the market and dentists who were behind the educational curve regarding
cosmetic dentistry would become obsolete dinosaurs until that learned and
developed the ability to provide quality cosmetics. Where would they learn
these new technologies and techniques that haven’t even been invented yet while
they were in dental school?
Continuing education in the form
of new “institutes” for higher learning was born. The need for dentists to
acquire the skills to do comprehensive cosmetic dentistry was fueling an
industry led by the manufacturers of these new products, encouraging us to use
their products. The continuing education advantage was great for dentistry;
more educators were sharing their knowledge and lifting the level of dentistry
a patient could expect.
But once again there was a cost.
The typical “institute” charged thousands of dollars to learn their techniques
for this or that. Required dentist to take time out of their practice, travel
to their facilities, book flights hotels etc… Great opportunities to learn and
hone your skills but this tremendous cost had to be absorbed somewhere. The
fees for these procedures would go up.
In the fifties through the
seventies, a typical dentist may go to his local society meeting or study club.
Occasionally they would go to the ADA convention. Now, I and many other
progressive minded dentists I know go to meetings, seminars, and training
classes as much as once a month. And it is not unusual for quality dentist to
log 200+ hours of CE a year. That is a lot of time away from the office and
expenses that have to be made up. Yes it allows dentists to stay current and
provide patients with the best possible care, but there is a price.
Cosmetic dentistry is not cheap.
Prior to “white fillings”, nearly every filling was done with dental amalgam,
which is 1/10, the cost of composites and related materials. Crowns made of all
ceramic materials that can match natural teeth, or porcelain veneers used in
many smile makeovers are very time consuming and lab technicians whom are
qualified to deliver the results patients are expecting have to charge larger
fees for the demands placed on their work. The lab costs go up, the fee goes
up.
The dental laboratories have
evolved. In the days of yore, the dentist worked with a one man lab that was
down the block. Now large labs are the only ones who are able to afford the
extremely expensive CAD CAM milling machines for the modern ceramics we now use
and they must make large investments in technology year after year. This cost
rolls down to the dentist and subsequently down to the patient.
Modern dental patients have high
expectations for cosmetic dental procedures and we are obligated to meet them. But
this high level of esthetics is very expensive to deliver, and when dentist cut
costs by using “cheap labs” and inferior materials, or simply they have not
gone out and invested in the right technology or education to improve their
skills patient become disillusioned with the promise of cosmetic dentistry they
see in magazines and in the media. So those of us who want to deliver the
quality results that patient are so happy for, we know our fees need to reflect
the costs we have incurred so we can remain profitable to continue doing so.
Thomas Edison once said he was interested in making a lot of money with his
inventions, so he could afford to continue creating more inventions.
