As soon as the author found out that the dentist wanted to drill out a huge cavity in one of the teeth he just hastily left the dentist room. In his own research the journalist has found out: too often he was right.

"Do you happen to know a good dentist?" Try asking this question at a house party. Or even better do not do it if you want to be invited by your host again, because conversations around dentists can last for hours, they make people feel depressed and can really kill any party spirit. I have recently tried it and as a result I had to send a bunch of flowers to the house mistress to get myself excused. Pure need has led me to ask such questions. I am a known dentists-whopper – because as soon as I feel the slightest doubt I flee the dentist’s room. And it was such a case recently.

Seemingly 95 % of all Germans are satisfied with their dentists’ performance. But I swear: there were 15 party guests and no one could assume that they were happy with theirs. Nobody could say: "yeah, I could advise you mine!" Instead the horror stories were told and quickly embellished with the dramatic details.

Take the example of my friend Malte: his new dentist has discovered that the newly laid inlays were put by error and caries was raging underneath as a logical outcome there followed five painful treatments and additional meetings during several months. Or take the example of Antje: because her dentist found out that the front teeth fell pray to the tricky caries and the inflammation already spread to other roots and was beginning to destroy the upper jaw. During several surgical operations the dentists managed to restore her front jaw but she was still worrying to death if her expensive implant would not fall out. In comparison with such horror stories my problems seem to sound trite. Of course I miss having a filling every couple of years and now I shall have to face having my first crown done but at my age of nearly forty I have the upper and lower intact and I have never lived through a root canal treatment.

In doubt against the tooth drilling

My philosophy is quite simple: when the dentist wants to begin drilling too many teeth one after another I flee the dentist room. Maybe it sounds cowardly and unreasonable, but I know have three witnesses who have confirmed: I was right. The mysterious problem is that I always fall upon a dentist who wants to drill at two, three or four teeth and assume that the cavities must be cleaned as soon as possible – but at the same time other dentists whom I checked did not find anything suspicious. And I had to check upon three other dentists before I detected the right one.

Partial crown from gold for 1000 Euro

But why did I turn out to be unfaithful to him after the four happy years, full of mutual trust? Well, because recently a big expensive filling fell out after only several months of being there. The filling left a deep abyss in my mouth into which my tongue was invariably falling. The dentist took a look at the debris and explained to me that I must have bit on a stone, but with there was nothing wrong with the filling itself. I had to believe him though I could not recall ever biting on a stone. But as he continued and said that I had to pay 1000 Euro for a partial golden crown out of my own pocket, then I began feeling uneasy. I called my insurance company and learned that crowns of such type did not usually cost even half as much.

I decided to get a second opinion and I had trust my colleague’s opinion about her dentist whom she had known for eight years. But as soon as I looked at the home page of the new dentist I had all ground to become sceptical. On the headlines I could see such phrases as "dental wellness" and "the well being effect", "aesthetic reconstructions“ , "bleaching effects". But then I felt myself very comfortable in her dentist chair; two pretty fairy-like assistants were waltzing around and the lady doctor gave me a wide smile, demonstrating her white blended teeth.

But then her assistant began the nasty dictation: "One eight C, one seventh C, one six C …"My heart began to beat quite wildly. "One" means the eight teeth on the right upper jaw, "C" stands for caries. How can it be, I have visited my dentist quite regularly the past four years and all six months I let him have a thorough check-up and everything was fine, and now this! As a summary the new dentist labelled 6 of my teeth as „in need of treatment“. Maybe I shall bring her to her senses if I inform her that I have always had problem with the stains, I thought. I told her that 20 years ago my then dentist categorized none of my teeth as needing immediate attention. "No, no I am absolutely sure that it is undoubtedly caries. Your previous dentist was right!", explained the lady doctor with determination, that allowed no further argument. "I have no idea why you previous dentist has seen it otherwise, it is as simple, I would go to court against his opinion. "Strange that she spoke of court, I would not think that far. "I must be honest", and now she looked at me again with her bright blue eyes which were showing pity, "I was a little shocked when I looked into your mouth. Such teeth … it does not suit your type. If you were my son, I would not let you run around in such a state."

I was about to believe her, but she went on. For my abyss for which I have actually come to her, on her opinion, it was not to be advised as I already had amalgam in my mouth. Instead she advised a polymer filling – of course of the latest generation – or a ceramic inlay. Costs: from 170 to 500 Euro, hence twice as little as the previous advice. I now found myself facing a dilemma: my treating dentist is a shameless businessman, but at the same time a renowned specialist. The lady doctor’s offer was a real bargain, but for that she wanted to drill out half of my jaw. It meant I needed a third opinion.

Patients must think critically

Then I found doctor Riedel. I thought that with him I shall finally arrive to a happy end of my dental story. It all fit in well into my pattern of a dentist-whopper as I am. He is member of the project "Quality Assurance of the German Dentists". It was him who had written the instructions for the overcritical patients and did not let a single dentist give expensive and senseless proposals. And, what was more important, he did not mind that he was already the third dentist to whom I came with my ordeal. On the contrary, he was showing complete understanding. "Unfortunately too many colleagues of mine overuse their patients confidence by offering them the overpriced treatment plans with lack of explanation and the exaggerated therapy measures."

After Doctor Riedel has taken a good look at my mouth, he left nothing intact of the suggestions of his predecessors. For my tooth crater neither the inlay nor the partial crown came into question, because the tooth simply did not have enough of its substance left. The only sensible solution was a crown and he could offer it to me for the mere 400 Euro. Thus I summarize: three dentists had four different opinions of how the problem has to be solved and the prices for the same problem varied from 170 to 1000 Euro.

Caries is relative

"How can it happen that three different dentists could have such different opinions on one and the same problem?", I asked him. With the caries diagnosis there is a big room of speculation, was the answer. "As long as the defect is on the surface of the enamel, it can mineralise by itself, but nobody can assume it for sure." This is the basic rule: if the enamel is still intact; then there is a good chance that the tooth will heal up by itself. By the routine check-up the dentist pokes the edges of the suspicious spot because if the enamel is broken the instrument gets stuck up.

By taking a decision about drilling the dentist must consider the patient’s discipline – if he comes regularly or if, for example, the patient will leave for one‘s year expedition, says doctor Riedel. Besides, it is very important to know if the patient really takes good care of his teeth. "When I have a feeling that the patient is to be relied on, I trust him and we decide to wait and observe the defect"- Riedel and his colleagues advise to weigh all pros and contras before starting any drilling. Because: If one begins to drill part of the healthy too substance will be lost and the tooth begins to succumb to other problems. To eliminate caries the dentist will touch the healthy tissues with the drilling machine.

Even if the filling was applied by all rules of the art the tooth is weakened. Though constant chewing pressure the tooth and the filling edges constantly interact and the edges get broken off. Thus the bacteria begin to immerse into the microscopic holes and it triggers off the new process of caries development. Five consecutive fillings in one tooth will inevitably lead to a crown; this is the rule of the thumb by all dentists. Now I torture myself with the question of who of the twelve – fifteen dentists whose service I used as an adult was wrong. My case was not an easy one: I often changed my addresses, I spent three years abroad and many of the dentists I visited only on one occasion and never returned.

However, I managed to get eight of the case histories in copies and gave them to Doctor Riedel for his analysis. Result: in eight cases he stated that the actions undertaken were not necessary. There is one silent witness: my upper seventh right. 20 years ago my then treating dentist suggested the urgent treatment which I refused. And – even now this tooth does not have any filling and does not show any sign of caries. Afterwards the other five dentists suggested immediate treatment of this number seven.