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Dentistry/peiro maintance


QUESTION: Hi, I am 66 years and have an insurance program that has lead me to many different dentist..over the years, they keep dropping this discount program.
I just went to a new dentist and saw the hygienists..she says I need a perio maintained program....when I said I did not want this and just wanted a general cleaning she refused ...said that is what she recommends and thats that..the doctor had said my gums looked good...I have been told I need this before and refused. Every time I go to a corpatate dentist, great expressions and dental one this is there recommend but every private practice I have gone to, over 5 , did not mention any problem...It just seems strange to me that all this comes from the corparate type offices...I use ora md on my teeth and feel it really helps..I floss , water pic and electric brush...
so...I can a hygienist refuse to clean my teeth,I realize she thinks this is the best course, but I do not...should I talk to the manager or just go somewhere else....thanks for you time, sanford

ANSWER: Dear Sanford,

Yes a hygienist can refuse to clean your teeth, just as you can refuse to pay for a periodontal maintenance.  The reason for this is that if you have gum disease, a simple cleaning (cleaning of your teeth ABOVE your gumline) does not address the chronic infection under your gums.  In fact, if you have infections under your gums, a simple cleaning above the gumline can cause the infection under your gums to spread, to go more deeply under your gums, and to spread to more distant areas like your blood vessels, heart and brain.  I wouldn't want my hygienist to be responsible for doing this to you.  So we constantly check and re-check our patients for gum diseases, and we treat it when we find it.  If a patient refuses our treatment recommendations, then we have the right to refuse their treatment demands if we believe we will be doing them more harm than good.

If what you want is just your free cleaning, then you need to keep chasing down dentists who will do this for you, until they drop your plan, because they are becoming poor from doing free cleanings.  And while you are getting your free cleanings, remember that your gum disease, if you have it, is getting worse.  And your overall health will get worse before long.

You are an adult.  Once you are informed, what you do with that information is up to you.  Just think about how many people smoke, despite the package label that says "SMOKING WILL KILL YOU".  We don't always do what is best for our health.  In fact, we usually do what is NOT best for our health (smoke, drink, overeat, watch too much tv, play too many video games).  As a doctor, it is my responsibility to guide my patients toward things that are better for them.  I can't force them to take my advice.  I can only hope they do.  And by doing, they will live longer, healthier, happier lives.

---------- FOLLOW-UP ----------

QUESTION: I understand that and appreciate that I have been told..My  point was the 5 other dentist I have gone to do not mention this a matter of fact my pockets depth have improved since I was first told of this, 3 years ago..I do not believe the 2 corprate dentists,My gums use to bleed with flossing and now they do not, my gums are nice and pink...teeth are not seperateing..even this dentist said my gums looked good....
I asked if I could come every 6 months instead of 3 and my hygenist said ok..she recommenced every 3 months but would do 6..if she was so ethical why agree to that?
I agree that if I do have a problem I need treatment..I just do not believe i do...I have gotten 5 other opinions that say I have no problems.Who am I going to believe.I just do not want to pay for something I do not need.Thanks for  your time..

ANSWER: I absolutely agree with you that you should not pay for something you don't need.

But I'll bet that, over the past week, you've paid for several things that you don't need.  It's just that these things were not purchased at the dentist.  Cigarettes?  Soda?  French fries?  Just to name a few.  And I've got a list of over a thousand things, most of which we don't need, yet buy and pay for anyway.  Just not at the dentist.

For over 30 years, I've been telling the dental community that we either do not market ourselves well, or we don't market ourselves at all.  This is what makes Coca Cola so popular (plus a lot of sugar).

But I digress.

I wish I could help you with your problem.  But, of course, I can't without examining your teeth and gums.

Come visit and learn about what's going on inside your mouth.  Sad thing for gum disease is you can't feel it until your teeth become loose or painful.  Then it's usually too late to keep them.

---------- FOLLOW-UP ----------

QUESTION: WOW..lets see what I have been told so far:
Ignore second or 3rd. opinions,get all the procedures you can..don't want those dentist to starve with all those free cleanings...
Get procedures even if you don't need them..all dentist are honest and have  your best interest at heart...right.

And by the way there are plenty of early warning signs for problems...
Bad breath,which I don't have, bleeding gums, don't have, receideing gum and gaps which I do not have
You might have 30 years but you sure do not listen very well..
I have met plenty of great dentist, that explain and listen to your needs..but corporate dentist always just look out for the bottom line, MONEY...sorry to have wasted your sure wasted mine..good luck and live long...

I'm sorry if you found my words offensive and a waste of your time.

I certainly cannot provide you with a periodontal diagnosis from here, based solely on your report of pink gums, no bad breath, no bleeding gums, and no receding gums.  I would need to examine your radiographs and measure depth of loss of gum attachment, or lack thereof.

Rather than waste your time on me, why have you not simply gone back to one of those 5 dentists who will provide you with what you wish?

I apologize for wasting your time.


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Howard Finnk, D.D.S., P.A., CEO


I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.


Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center ( On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (, I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.

American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)

"How To Save Money At The Dentist" Going to press soon.

Bachelor of Arts and Sciences in Psychology from Wayne State University Doctor of Dental Surgery from University of Detroit College of Dentistry Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida

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