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Choosing a doctor is one of the most critical decisions we make. Our lives may even depend on it. It can be a difficult and worrisome task, even under the best of circumstances. The doctor-patient relationship involves something that we value most, our health. This relationship has always been a sacred bond of trust, openness, and compassion and therefore remains one of the most important decisions we make.

A recent study indicates that more than 1 in 8 people changed their primary doctor last year. Although this may seem an unusual or alarming statistic, it largely reflects the times and current state of health care in the United States.

You may seek a new doctor for the following reasons:

Whether you are choosing a doctor for the first time or changing doctors, this process can be a daunting task. You must undertake the decision with care and planning so that the outcome provides the most fulfilling of relationships.

The best time to choose a doctor is when you don't need one. Don't wait until you or a loved one is faced with an illness or emergency to begin looking for a doctor. This only adds stress to the decision-making process and increases the chances of making a choice you are unhappy with.

Questions to Ask a Doctor

• Will the doctor treat all family members?
• Is the doctor covered by your insurance plan?
• Does the doctor provide care during pregnancy and perform deliveries?
• Does the doctor have staff privileges at a nearby accredited hospital?
• Does the doctor perform surgery? If so, what kind?
• Does the doctor encourage preventive medicine, such as routine checkups, immunizations, and follow-up tests?
• Does the doctor make emergency house calls for bedridden family members?
• Does the doctor have office hours that are convenient for your family, especially for those who work or attend school?
• What arrangement does the doctor have for a substitute when he or she is unavailable?
• What are the fees for the various services?
• Is the doctor certified by the American Board of Family Practice (or a specialty board of another area)?

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Cosmetic Dentistry

Tooth whitening

Tooth whitening involves the use of peroxide-based materials to whiten teeth. Most dentists use an in-office and/or at-home whitening system to achieve the desired results. Before tooth whitening, the patient must get all cavities filled, and the gums must be healthy. The in-office systems use 35% hydrogen peroxide gels coupled with a high intensity light to whiten the teeth. The gums need to be protected with some systems, and then gels are placed on the teeth. A laser or plasma arc light source activates the peroxide to oxidize stains on the tooth surface. In about an hour, the teeth become four to six shades lighter.

At-home systems most often use 10 to 20% carbamine peroxide gels to oxidize stains. The dentist makes impressions (molds) of the mouth, and then has soft mouth trays made. The patient is fitted with the trays, and then is instructed to place a thin ribbon of the gel into the tray and wear while sleeping. Most whitening occurs in one to two weeks. In difficult cases, trays may need to be worn for up to six weeks. I have found that a combination of in-office and at-home systems works the best, and routinely achieve between 12 to 15 shades of whitening. The procedure is safe when monitored by a dentist, and does not damage the tooth in any way.

White fillings (resin, bonding) or porcelain crowns (caps) and bridges will not whiten significantly with either method. Some patients will experience minor tooth sensitivity during whitening procedures. The dentist can remedy this by alternating concentrated fluoride with the peroxide in the mouth trays.

The cost of in-office whitening is between $500 and $1100, the more expensive end when a laser is used. At-home systems cost between $400-$800. Store bought bleaching systems are not as effective as dentist-managed systems. Unsupervised use of store-bought bleaching systems can cause painful sensitivity to untreated dental cavities. The mouth trays are not custom made, which can cause gum irritation, and the peroxides are not as strong or effective.

Porcelain Veneers

Veneers can be used to improve a wide variety of cosmetic dental problems. They can whiten stained or discolored teeth, close gaps between teeth, "correct" a crooked smile without the need for braces, repair chips and imperfections, and create a more attractive or youthful looking smile. The procedure usually involves removing only a thin amount of the outermost layer of the tooth, called the enamel. The dentist then takes molds (impressions) of the mouth. Temporary veneers are then placed for the patient to wear while the permanent veneers are being made. The procedure usually takes between one and a half and two hours.

Next, the laboratory carefully crafts the porcelain into veneers. In about two weeks, the veneers are ready for the dentist to fasten to the fronts of the teeth. This process improves the teeth's appearance and strength.

There is no doubt that veneers are an excellent option, but how about the cost? That largely depends on how many veneers are required to produce the desired results. In most cases, a minimum of six veneers are needed, and are usually placed on the upper six front teeth, from the canine (sometimes known as the eye tooth) on your right side, to the canine on your left side. Prices vary, but an average fee for most cases will run several thousand dollars (500 to 900 dollars per tooth).

Disclaimer:
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Gungho City(R), LLC, the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.