I can tell you before you read this that some of you will not like what I have to say. And that’s okay. If opinions were universal, there would be no opinions.

I’m going to tell you the story of my practice, the decisions that I made, and how I made those decisions. And those decisions impact every patient who decides to see us or decides not to see us.

I am not perfect. I, like you, want to be right every time. After all, you are investing your hard-earned time and money with me. I want to make sure that I’m doing the best for you to warrant that trust. So I want to give you the options that I would offer to my family or anyone that I know and trust.

If we have an agreement, we go forward. If we don’t, we part company.

That’s okay.

nce I’ve told you what I think you need, I stick to that treatment plan. If there is something that occurs in my office that I didn’t anticipate, I rectify it. There are some things that I can’t predict 100%, such as whether you will need a root canal, but even then, I try to predict even that so that you are not surprised. And if something that I, or one of the doctors working in our practice, did that needs to be redone, we do it at no charge. I do my utmost to give you all the costs up front so that if you need an additional x-ray or additional post-operative attention, you’re not “nickel and dimed” in our office.

Okay, so that’s the personal part of the office. Why even tell you that, particularly if you’re not a patient of ours? It’s because you may want to know the decisions I made to get where I am today. At one time, I wanted to serve a larger part of the community, the part that relies on dental insurance.

You know what? That was the least satisfying time of my career.

Here I was, developing the treatment plan that would best fit the patient, and then there was this entity called “dental insurance “ that got in the way of that relationship. Insurance would second guess, would lose x-rays, would say that we didn’t do something when we knew we did.

They would delay predeterminations of benefits so that when the predetermination finally came through, the patient would forget what I had said and we had to educate all over again. And the motivation to do the dental work was often gone by that point. Talk about frustrating!

Years ago, I decided that I would become the periodontist who did major cases. There are not that many who want to do that kind of work. It involves a major commitment in time, in training, in expense, and of course, all of that is transferred to the patient. There are some patients who want this level of care. There are some who don’t.

Interestingly, I thought that would have to do with the income of the patient. Boy was I surprised. It had to do much more with the desire of the patient than it had to do with income.

There was John, the nighttime security guard, who was almost a recluse because he couldn’t stand being in the dental chair and let his teeth rot away. He couldn’t smile, couldn’t chew, and was in pain most of the time.

Finally, he summoned the courage to come in. Even on a security guard’s salary, he decided to make his teeth a priority. He’d had a bad experience as a child. We had to help him get past that before he could even consider dentistry. Now, he’s happy. He’s changed his life and would spend the money all over again and has said that on numerous occasions.

Then, there are also the commercials and marketing that I have to create or respond to. There are numerous commercials that say that you can extract teeth, place implants, and place teeth all on the same day. We do it too and have done it for years.

But it is not always the best solution for people.

Periodontal disease can be treated if it is diagnosed and treated properly.  We save a lot of teeth. Yet these facilities don’t give you that option. We do.

There’s Steve who came into our office, asking us to take out his teeth and put in dental implant-supported teeth just as in the commercials. And I looked at him and told him that he didn’t need that, that we could save his teeth and give him a better result than we could with dental implants. And we did. And he’s thrilled with the result. People tell him that he looks fifteen years younger.

It goes the other way too. Patients come into me with a treatment plan from another facility. Usually, I don’t look at that plan. I  want to come to my conclusions independently.

I do the examination and determine the appropriate treatment plan. Then the patient shows me the other facility’s plan. And I look at it, shrug my shoulders, and tell the patient that in my opinion he or she doesn’t need all of that treatment.

You see, part of seeing us is judgment, of knowing when to do and when not to do treatment.

So my decision to become a “high-end” dentist/periodontist had to do not with income. Our income margin is far less than a bread and butter dentist.

It had to do with satisfaction, of outcomes, of life-changing experiences. And that was where I wanted to be. I dare say that Dr. Matt and Dr. Furtado chose the same for the same reasons.

Talk about unique. Where will you find an office where the specialist and general dentist work side by side?

Some people will complain about the cost of dentistry. I understand that.

For those people, there are more minimal services they can purchase. After all, partial and full dentures are far less costly than dental implant-supported teeth, far less costly than fixed bridgework, take a lot less time to do (you know that you’re paying for the dentist’s time, correct?), and require less staff, lower lab bills, and in my experience, less comfort and more risk to the adjacent teeth than the solutions that we provide.

If you want to spend less money on dentistry, you buy lower level services.

That’s not where I want to be, and I frequently refer the patients who want that to those providers who do lower level services. Those patients are not a fit for my practice, but they are a fit for others.

That does not mean that you have to be a disaster case to be a patient in my office. We have fantastic people in our office and in our referral network who will help you in every aspect of dentistry to give you the best that we can even if you don’t need major work.

If, however, you are a disaster case, we have solutions to that disaster that may cost some money but will get you to the point where you are no longer thinking about your mouth and your teeth.

Some of you reading this think about your teeth constantly. The goal is to get you to the point where you are more creative in your thinking because your teeth are no longer a problem.

What does that take?

It takes study. It takes hiring and training the best staff. It requires continuing education for our doctors with the best teachers in the nation. It takes investment in technology. The Perioscope, the dental implant treatment planning software, the CT scan, the ability to use your own blood to accelerate healing through the process called “PRF,” the in-house 3D printer to made surgical guides, the ultrasound technology to check the stability of your implants, the full stock of dental implants, and the training to use all of these take time and money.  

If we do it the way we know it should be done, that takes time before and after work, and yes, even on weekends. When our patients have a problem, and that is not often, we are available for those patients 24/7.

So, that’s the way that we have designed our practice. And doing that, we need to charge fees to cover the expenses, to pay our staff, and to pay our doctors. But for us, we know that what we are doing is the best that we can do.

Whether it’s staff or instruments or laboratories or equipment, we seek the best.

That’s what some people want. For them, we are a good fit. And if that’s not what a person wants, we aren’t a good fit.

So when someone asks us, “Why does it cost so much?” I hope that helps you understand why.