We’ve heard the “four out of five dentists” phrase and the humor behind it. It’s not far from the truth. As dentists, we also have all been in rooms in which heated debates were taking place because there were one or two, or more, of us who were drastically departing from the consensus. This is likely becoming a more frequent scenario, given the explosion of dental technology and materials available to us today.

I recently had the pleasure of attending a respected study club gathering and the honor of meeting several accomplished dentists and specialists. We reviewed a couple of cases and the discussions ensued. I was reminded of the classic “what would you do?” question frequently asked among dentists in social circles. Naturally, everyone has an opinion. While there was a general agreement as to which direction the cases should go in, the typical response of “it depends on who you ask” also was starting to take shape.

Ask a periodontist to view the case, and he or she would like to solve the problem, or at least offer his or her thoughts, by working on the periodontium. Ask the orthodontist on the other hand, and the patient now has braces. The general dentist might have a diagnostic approach — place the patient in a temporary phase and evaluate the tissues and bite or other conditions before determining what needs to be done.

What is even more remarkable is that there are differences of opinions between the general dentists themselves or between the dentists within the same specialty. They may have had variations in their basic training just as general dentists’ skills differ based on their extent and type of continuing education. Moreover, a case might need to be completed ideally with the collaboration of several of the various disciplines all at once. If there’s internal disagreement on the approach, it can get pretty tricky to formulate the “ideal” treatment plan.

Can it get more complicated? Absolutely. Add to this pot of textbook recommendations another ingredient: a blend of patient limitations — the primary one being finances. So, in fact, what was supposed to be the ideal treatment plan beautifully crafted by stitching together the work of multiple specialties sometimes ends up fragmented or headed in a completely different direction.

If I was the patient, my “second opinion” would become more like a fifth or sixth opinion. Dentistry has evolved to be so multidisciplined that each branch has its role in a patient’s treatment. And we may all provide our individual insight on how to proceed with a case. That leads to a plethora of options patients might have to choose from, and that might not be a bad thing. I suspect four out of five patients would agree with me.

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