Every hairstylist that I have ever had has said to me at the first appointment, “I’m a perfectionist.” Oh good, I would think, I need somebody with a little OCD and will spend that extra time making sure that every strand of hair is lined up like rows of soldiers in a military parade. That’s what we want to hear from a hairstylist when we get into their chair for the first time. We like it when our lawyers describe themselves as aggressive and our accountants call themselves detail-oriented.

So what do people expect of their dentist? A very popular phrase for dentists is, “I’m very conservative.” I have used this phrase to the wild delight of patients. They nod their heads vigorously and punch their fists in the air. Patients love hearing this. And dentists revel in this brief shower of love. But what does this mean?

The primary reason why dentists declare that they are conservative is to establish trust. The statement implies, in a professional and diplomatic way, that they will not do any unnecessary work and act in the patient’s best interest. Great, thinks the patient, this dentist won’t be digging for gold in my mouth and pushing those crowns, like my last dentist! But what does it really mean to a dentist to be conservative?  In addition to acting in the patient’s best interest and not doing any unnecessary work, being conservative also means that I practice the following tenets:


Prevention, Not Intervention

The best way to avoid sitting in the dentist’s chair is to take care of your teeth. At home, that means eating a healthy diet rich in whole foods (vs. processed or packaged), brushing twice daily, and flossing your teeth. It means wearing a mouthguard when playing contact sports and not using your teeth as tools. At the dental office, it can mean one or more of these services: scaling and root planning (if you have periodontal disease), x-rays, sealants, fluoride varnish, prescription fluoride toothpaste, nightguards, extraction of wisdom teeth, and braces.

Yes, braces! Some people have so much crowding of their teeth that it can actually be hard to clean the teeth and it becomes a risk factor for cavities. Other people have bites that are chipping their front teeth and reducing them to little nubs.

Do these treatments at the office cost money? Yes, they do, but the cost of prevention is way lower than the cost of a single filling or crown.


Keep Problems Small

Many patients are surprised when I diagnose cavities after looking at x-rays or inside their mouth. But it doesn’t hurt! Well, most cancers don’t hurt either at the time of diagnosis. By the time you do feel a cavity, you are looking at a possible infection, root canal, and a crown.

I explain to my patients that dental problems are not like the problems you might have in your body. If people twist their ankle or experience back pain, time and rest can possibly heal that pain. With your teeth, it’s like mold on strawberries. It grows, it spreads, and sucks the life out of that juicy berry.


Ideal Treatment Saves Time and Money

Back to the patient who is so relieved that finally, a dentist won’t be pushing crowns on her… There are some very good reasons why a dentist will recommend a crown for your tooth. If the stucco is crumbling on your house, you wouldn’t just throw some paint over it, would you?  The number one reason for that is that your tooth is just too weak and broken down to support a filling. Over the years, I have tried to save my patients money and “be conservative” by doing these huge fillings that span all five surfaces of the tooth. Guess what. More than half of them eventually broke (either the tooth or the filling) and went on to become crowns.  Fail.  Expensive fail.

If you have questions about your treatment, ask your dentist. A good dentist will always take the time out to listen to your concerns, explain their diagnosis, offer you alternatives (no treatment is always an alternative), and give you the prognosis for those treatment options.


Dr. Nancy Zeis is a practicing dentist at Zeis Dental in Bloomington, Minnesota.