Q & A with Dr. G
Dr. Jonathan Golab Answers Your Questions
Here are some of the most frequently asked questions in my practice.
In order for us to provide above average care, we must charge above average prices. Each dentist charges what they feel they are worth. When dentists and offices focus on money rather than quality, they tend to have “high volume busy offices” that charge “undercut” cheap prices. The only way for them to do this is to have less experienced personnel who are paid less and use cheaper dental labs and materials. If, like us, you use an excellent private dental lab, excellent personnel and take the time to do things right, then the fees we charge must, by default, be higher. I would rather apologize once for my fees than a lifetime for the quality of my care.
This is a common question that must be answered diplomatically. “The less you know, the more everything seems normal.” In other words, if a dental office is too busy or too large, then it cannot be thorough. Dental diseases such as decay and/or periodontal disease go undetected and are neglectfully “watched.” We are a very honest, ethical and professional practice. We are small by design, seeing only a few patients each day. This allows us to be thorough, accurate and have time to discuss our findings with you. You want a “correct diagnosis,” not an “incorrect second opinion” so that you can become healthy as soon as possible. I feel it is more important to be honest and the bearer of bad news than to appease someone by being dishonest.
Dental crowns simply are easy to do. They take little thought or consideration. A dentist will grind teeth down to pegs, removing healthy tooth structure. Crowned teeth often require root canals afterwards due to the trauma. With inlays and onlays, the dentist does not grind down healthy tooth structure. Only what is diseased or broken is repaired. The tooth is not traumatized. Inlays and onlays are technique-sensitive and take more time and effort to perfect, so many dentists dismiss this procedure in lieu of a “faster and easier” crown. The dentists are doing what is easiest for them, not what is best for you. I think outside of the box and give consideration to what will last the longest, and what is truly best for my patients.
Dental and oral conditions can be understood only in relation to the whole body. Biological practitioners know that the health of the body reflects what goes on in the mouth. Unfortunately, most dentists do not embrace this type of dentistry. A biological approach is holistic- – a blend of clinical practice, sound scientific knowledge and the traditions of natural healing.
Too often, people view going to the dentist for their “routine” dental exam as just that, “routine.” But they shouldn’t. The health of your entire body is linked to the health of your mouth. Consistent research over the years has provided evidence that having gum disease puts you at a 2.6 times greater risk for heart attack, stroke and cardiovascular disease. And physicians are recommending that patients stay on a consistent, preventive schedule at their dentist.
GINGIVITIS (bleeding or swollen gums when flossing) is gum disease. PERIODONTITIS represents a more serious form of gum disease. Both of these may go unnoticed, may or may not bleed, and there may or may not be gum recession. Warning signs are very sneaky and insidious. Gingivitis and Periodontitis occur when soft plaque at the gum hardens into calculus. Bacterial toxins have begun damaging tissue. This can only be reversed by a dental professional.
Theoretically, if you keep your teeth in good health, you should live longer. Even if you eliminate all the known risk factors for heart disease, such as smoking, cholesterol and diabetes, gum infections are still significantly associated with heart disease and death.
How does all this happen? Gum disease is associated with increased serum fibrinogen. Fibrinogen is involved in blood clot formation, and as we all know, this increases the risk for heart attack and stroke.
Gum disease doesn’t stop there. It is also responsible for low birth weight babies, pre-term babies, pneumonia, and can cause diabetes to be more severe and damaging.
It should come as no surprise that the same blood that flows around your gums also goes to your brain, liver, heart, etc., so an infection in your gums travels through the body and can significantly impact your body systems and your life span. Eliminating or controlling the infection around the gums is not only important in saving your teeth, it could help to save your life. Doesn’t it make sense to keep your mouth and body as HEALTHY as possible?
It’s NOT “Just A Cleaning” ANYMORE.
No. My crowns/inlays include everything. I do not “add-on” fees. My competitors, though, may quote you a lower crown fee, but “forget” to mention that they also charge an additional fee for a “crown build-up,” adding $150-$300 to their crown fee. So their crown/inlays end up costing the same or more, but there is a distinct difference in the final product, so you may as well receive my quality for the same- -or maybe even less- – cost than my competitors.
WHAT TO EXPECT…
STERILIZATION OF INSTRUMENTS & SURROUNDINGS
Though you don’t see it, for each and every guest we:
- Sterilize every single instrument after every single person.
- Use mostly disposable, one-time use items.
- Wipe down the entire room, including lights, handles, drawers, countertops, hand pieces, pens, pencils, etc.
- Computer keyboards, mice, etc. have protective coverings that are changed for each and every patient.
Dentistry should not be done without this. This is a non-latex material that fits around your teeth to ensure that water, cavity bacteria, pieces of tooth, metal and mercury, etc. do not go down your throat.
PERIODONTAL (DENTAL HYGIENE)
We measure 6 areas on each tooth, utilize the latest techniques and are very thorough when it comes to your dental “foundation,” aka your jawbone and gums. Oral cancer examinations will be performed.
I think it is wrong for insurance companies to try to “undercut” well-intentioned doctors. I know insurance companies do this when they encourage patients to see an “In-Network” doctor and “save 40%.” The “In-
Network” doctors cut their fees (I don’t think it is 40% but the insurance tries to get you to believe that) for one reason only: to make a deal with the insurance company to send them patients. This is a great deal for the insurance company, because they then have to pay less and make the patient, in the end, pay more of the fee.
BUT IN ORDER TO PERFORM DENTISTRY AT SUCH A LOW COST, THE DENTIST MAY MAKE MAJOR CUTS IN HIS OVERHEAD:
- Since the dentist is getting a much smaller fee, many times the dentist will “watch” an area of decay or a broken tooth because it is not financially worth the time to fix it.
- Since the fee for a crown is far less, the dentist cannot use a good lab and must then get the cheapest lab resulting in poor cosmetics, fit, seal, pain, and the bite is not right.
- Patients must be rushed in and out of the office, resulting in busy waiting rooms (many patients see that as a “busy, successful office;” I see it as a cattle call) and sometimes wait times are over an hour.
- Office personnel are quite often inexperienced, “entry-level” people, sometimes with no experience at all.
- Corners are cut, possibly even in the area of “re-using” used items to save costs, and cleanliness and sterility may often be compromised.
IF YOU HAVE DENTAL BENEFITS, HERE ARE SOME THINGS YOU SHOULD KNOW:
We believe that you deserve the best of care. That is why we always present you with the best dental solution possible to treat your personal situation. Some have dental benefits, but most don’t. If you have dental benefits, congratulations. You are very fortunate. Here are some important things you should know…
- Your dental benefits are based upon a contract made between your employer and an insurance company. If you have any questions regarding your dental benefits, or why it does not pay more, please contact your employer or your insurance carrier directly.
- Dental benefits differ greatly from medical benefits. In 1959, most dental benefit plans had a yearly maximum cap of $1,000. You’ll be surprised to know that presently, the average dental benefit plan has a yearly maximum cap of $1,000. That is $139.00 in “today’s” dollars. There has been no significant increase in the yearly maximum cap in over 50 years! However, dental insurance premiums have risen over 1200% in that same period of time. Dental benefit plans will never pay for the completion of your dental care. They are only meant to assist you.
- Many people receive notification from their insurance company that dental fees are “above usual and customary.” An insurance company determines their reimbursement (fee) level by surveying a geographical area (included in this survey are “Medicaid” government clinics, discounted dental clinics and managed care facilities, which have severely reduced dental fees that bring down the average), then calculating the average fee, and then further reducing the average fee by an additional 25%. So an insurance company’s “average, usual and customary” fee by their own definition is much lower than average! This helps them lower the amount they have to pay the doctor, and raises the amount that you, the patient, pay. Then, when the insurance does not pay for much, they blame the doctor, saying, “They are charging too high a fee! You need to go to our “In-Network” doctor.” It is very frustrating to me as I try to provide the best for my patients, and become somewhat demonized by the insurance companies. Any doctor in private practice will have fees that insurance companies define as “higher than usual or customary.”
- Many dental benefit plans deceptively tell their participants (you) that they will be covered “up to 80% or 100%” but do not clearly specify the plan fee schedule allowance, annual maximum or limitations. It is more realistic to expect dental benefit plans to cover between 30% and 50% of dental services. Remember that the amount a plan reimburses you is determined by how much your employer has paid for your dental benefit plan. If the employer selected a “cheaper” plan, then you are left to pay more of the cost yourself. You will get back only what your employer has put in, less the insurance company’s profit margin. If you are dissatisfied with this reimbursement, please speak with your personnel department/human resources director, who can provide you with a proper comprehensive dental benefit plan.
- Insurance companies do NOT cover many routine, state of the art, highly-advanced dental services. Our team members will gladly assist you in filling out the necessary forms to maximize your dental benefits and discuss your financial options. Excellent dental care is available with or without dental benefits. We hope you will choose the best that dentistry has to offer.
Dentistry is a profession that demands individualized care. As doctors, we have the responsibility of properly taking care of people and their families. We are not “selling a product or a commodity.” It is not a profession that should be involved with low quality, high volume sales.
Unfortunately, patients have no way of differentiating the quality of one doctor compared to another. So how, then, do you differentiate? You look for a small, private office- -one where quality, not quantity, is their main concern.
I only see one patient at a time. I do not run from room to room. I have one assistant and one hygienist to ensure that I stay true to my word. This also keeps me on time. Being late for my patients implies that I am “more important” than you, that I am disorganized or that I am too busy. I am not. I must be respectful to you in every way.
My fees are above average because I provide above average quality dentistry. This allows me to provide for you the most committed personnel, the latest technology, the greatest dental lab, and the knowledge gained from extensive continuing education. “Cheaper” dentists with average or below average fees provide average or below average care. This results in dentistry that does not look or feel great, and usually needs to be redone every 5 or 10 years. In the end, it costs you more in dollars, disappointment and pain.
I come from a long line of physicians and surgeons. Personal and professional ethics were instilled in me at a young age. I am proud of my parents and how their dedication taught me about what it means to be a doctor. It’s about trust.