How to find a good dentist to repair poor dentistry?

July 11, 2023 3:19 AM

After sketchy elective dentistry led to multiple infections, pulled teeth, and almost a year missing a front tooth, the final result is awful. How do I find the best dental cosmetics provider in my metro area?

So, after getting “a special set of extra deep gum cleanings,” i got two bone infections, had two teeth pulled and a bunch of skull/jaw removed. Fine, maybe it had nothing to do with the elective procedure, but I doubt it. The repairs took 8 months, and were well above insurance coverage, and I’m lucky enough to have great dental coverage.

Now my smile is awful. The color matching did not match…it is blue. I have a giant fang running well up into my gum line. There are huge gaps, which make me worry about keeping clean. I’ve never been beautiful, but I had a decent smile…now I look pretty bad. It’s a bit traumatic. Never had dental problems for 50 years before this.

How do I find the dentist someone who needs a professional smile goes to? Like a news anchor or hockey player? Hell, how do I find a dentist who is not trying to rip me off and is at least competent?

I’m in the south end of the Bay Area. There are rich people near me, they almost certainly don’t look like I do now.

posted by Abehammerb Lincoln to Health & Fitness (9 answers total)

I'm sorry this has happened to you.

I don't know your geographical area, but if the system is anything like where I am : if they dentists spend a lot of money on advertising, they're either overcharging or not getting new customers naturally.

The worst practice locally spends a lot (for a dentists) getting their name out in the media positively, and so when initially asking around, people recommended them to me, although I found out later not because of direct positive experience, but because 'they'd heard they were good' (from advertising).

However since then, multiple people I know directly have been massively overcharged / over-quoted for work that didn't need doing / been directly damaged the dentists outright refused to admit liability for. I now actively try to warm people away from them locally.

For me personally at that practice, although I didn't get major work done, their hygienist must have been a sadist as I've never so consistently experienced that much pain with a regular 'clean'.

I have no fillings, and fortunately good enamel, but I did have an upper wisdom tooth that never emerged, so knew I'd eventually need the opposing lower one removed.

I ended up getting a recommendation to a small private practice through someone I knew who used to work in medical insurance locally, and somehow I got enrolled (despite the practice typically not taking on new clients since). I had an excellent tooth removal treatment (anaesthetic was injected as the needle started, so I barely even felt the needle, etc.)
The hygienist there is also so much better.

The practice seems populated by very wealthy people, based on the waiting room, location, etc.
And even though the standard service price is about 50% higher than a 'regular' dentists, my total bill seems lower than it used to be as they're faster / better / more honest / don't upsell / etc.

I hope that info helps, even if indirectly.

I wish you all the best in finding an equivalent practice for yourself. I'm sure you know someone who knows someone who can help.
posted by many-things at 5:03 AM on July 11, 2023

I know two dental practices in the south bay whom I've found competent and honest, with kind and gentle hygienists (both practices were recommended to me by other patients.) But I've only ever used them for routine stuff, never the tricky remedial work you're talking about. I know a good guy in Santa Cruz, too. Memail me if you want the names.

I'm so sorry this happened to you. Re advertising, the practices I use do not advertise. Can confirm the only time I've experienced sketchy upsell was one time years ago when I was newly unemployed and looking to save money, I got a coupon in the mail for a $5 cleaning and of course when I got it they tried to sell me on a root planing or something, which no other office has ever suggested.
posted by fingersandtoes at 5:23 AM on July 11, 2023

Search for a dentist who has achieved their FAGD and/or MAGD on the AGD find a dentist site. That's the check box for Fellows and Masters. There won't be many, but the Bay Area should have at least a few.

These are the dentists who have reinvested their practice into continuing education instead of marketing. They tend to have nice enough boring offices full of knowledgeable staff rather than a slick waiting area or tvs in the ceiling, etc.

Anyway, find yourself your small list of FAGD/MAGD dentists, then google them/call them to see what they do in cosmetic dentistry. Go in for consults.

My mouth is thankfully very simple since I've had the benefit of high quality dental care my whole life, but I still am a snob about it and won't see anyone who doesn't reinvest regularly in continuing ed. It's my TEETH they are important, I want the best.
posted by phunniemee at 5:28 AM on July 11, 2023 [8 favorites]

I wonder whether the Stanford dental school would be worth looking into. They seem to have a number of professors who specialize in reconstructive surgery.
posted by FencingGal at 7:43 AM on July 11, 2023

In my experience, local subreddits are great for this sort of info because the pseudonymity of Reddit means people are less likely to self-censor their true opinions than they are on Nextdoor or Facebook.

I sometimes write round-up posts for my local subreddit where I tally/link all the recommendations for particular places and in most cases a pattern pretty quickly emerges from the data. Like I recently did a round-up of mechanics recommendations and out of 67 posts over 2 years, one particular mechanic got recommended at least twice as much than the runner up to the point where I put a TL;DR at the top of the post that said the answer is almost always Rising Sun Motors unless you've got an unusual vehicle or situation.

I use Google Sheets because I'm eventually concatenating it all into a formatted post, but if you're doing it just for your own purposes then you could simply search /r/bayarea for "dentist" then change the Sort to New and then go through the comments for each dentist recommendation post with pen and paper and write out
Dr. A |||||
Dr. B ||
Dr. C |||||||||
Dr. D |
Dr. E |||

Once you've gone through a few years of posts, you should be able to narrow it down to 3-to-5 top dentists to do further research on via reviews on Google Maps, Yelp, etc.

I just checked /r/bayarea and while there aren't a lot of hits when I search specifically for "cosmetic dentist," there are a ton for "dentist" -- it might be worth starting with a well-regarded general dentist who then refers you to a cosmetic dentist that they trust.

Another approach could be to search the archives of your local city publications (probably accessible for free via your library card, or you can temporarily buy a subscription to access their digital archives) for their "Best Dentists" articles or "Best of [City]" readers' choice awards for the dentists category. However be sure to read enough of the article to determine what their methodology was for picking the "best" people/places -- if no methodology is mentioned (e.g. we did a reader poll via our website) then the criteria was likely willingness to pay for an ad in their publication. Even when it's a reader poll, those can be heavily skewed if one place actively campaigns for it and the others don't. I would do another tallying exercise with a few years' worth of articles from different publications.
posted by Jacqueline at 8:25 AM on July 11, 2023 [2 favorites]

A guy I went to high school with is a dentist (not in your area otherwise I'd send you his way). Lemme ask him if he's got advice for "how to find a good dentist".
posted by EmpressCallipygos at 8:30 AM on July 11, 2023 [2 favorites]

My advice, as a dentist, but not your dentist, is to find a practice that specializes in perio-prosthetics, a niche specialty that will likely align with your needs. Based on your description, it seems that you've lost bone around your teeth, either as a result of periodontal disease or the procedures you've had already. This would account for what you describe across the board in various ways. That's the perio part, the prosth part would be to design a restoration or series of restorations that account for the bone loss, especially in the aesthetic zone, to give you the appearance you desire.
With all respect to phunniemee, the AGD is more specific to a certain style and agenda of restorative dentistry, and is not a blanket that covers every discipline in the field. Likely you will want a periodontist with advanced training in prosthetics. Many promote themselves through implantology these days, so it may take a careful search or several consultation type visits to find a practice that is right for you.
posted by OHenryPacey at 10:06 AM on July 11, 2023 [9 favorites]

I have had a lot of dental work done, but not cosmetic or restorative-after-botched-procedure. That said, I can strongly recommend Dr. Amy Guthrie in Los Altos as a general dentist and Dr. Timothy Wu in Mountain View as a periodontist. While I don't live in the area any longer and no longer see them, they both took excellent care of my genetically terrible teeth and were willing to give conservative advice when it was warranted, yet were not philosophically conservative dentists (I've had my own bad experience with a conservative old-school dentist that screwed up my mouth, albeit not as badly as yours).
posted by serelliya at 2:45 AM on July 13, 2023 [1 favorite]

In the Kitchener-Waterloo area, I'd suggest Enamel Republic for good dental treatment that is durable and lasts. The dentistry is painless at this kitchener Dentist. You can book on their website at https:kitchenerfamilydentist.com .
posted by Waterloobian at 8:42 AM on August 12, 2023