I got asked the dentist upsell question again last week. It’s one that comes up regularly for me as a dentist, but I was surprised to hear it from some newly introduced mutual friends. An absolutely lovely couple. They were staying in the penthouse apartment in the same resort as me, own and operate a premium food business, and traded extra travel time and a night in an airport hotel to fly business on points.

I guess the real question is: if people appreciate the highest quality in every other part of their lives, why not in their mouths?

The problem with the pervading myth of the inevitability of losing teeth

Time and again I’ve heard “Doc, what’s the point of saving that tooth? My parents lost their teeth, I will too, I’d rather spend my money on a boat”. 

My question to you is: are your parents enjoying life wearing dentures that often don’t stay in well? Does it limit what they eat? Does it affect their speech or smile self-confidence?

I’m here to tell you the urban myth of losing your teeth because your parents did, is just that: a myth!  

There are three major factors that determine oral disease: 

1. How often you put sugary foods and drinks in your mouth daily

2. How often and well you brush your teeth

3. How often you visit the dentist for a checkup

You generally learn these habits from your parents. So you inherit bad habits, not bad teeth. 

The good news is you’re in control of you. You have an opportunity to learn from your parents mistakes. Dental disease, while the most prevalent chronic disease on the planet, is also the most readily preventable.  

By motivating you to visit a dentist every 6-12 months for a mouth check and teeth clean, dentists are not trying to upsell you. Dentists have a duty of care to help you prevent developing more costly oral health problems. The ones that mean you won't have money left for that boat, or may have to sell it, to pay to reconstruct something to chew with and smile with at family gatherings or business meetings. 

It costs good money spent on poor dietary and lifestyle habits to develop dental problems. You can choose to invest your time and money more wisely: see your dentist regularly, brush well and enjoy your boat too! 

Just like fast fashion, cheap dentistry falls apart quickly, but the legacy lasts a lifetime, like the environmental damage by synthetic materials

As long as you’re alive - breathing, eating, speaking and loving - you’re going to periodically need the care of a dentist to manage your mouth health. Dentists know that preserving tooth structure, along with gum health, is the most important aspect  to manage in a patient’s oral health, function and aesthetics over a lifetime. Think of us like accountants for your mouth.

The best way to preserve tooth structure is with the highest quality materials. These generally cost the most to construct and place, but they also generally last the longest. Clinical studies show the average survival rate of a composite filling  is approximately 60% over a 10 year period. The same restoration made from porcelain ceramic, or precious metal alloy is approximately 92% over the same period. Each time a restoration is replaced, more tooth structure is lost, meaning a bigger, more expensive filling is needed. So in a cost/benefit ratio analysis, it’s far more economical to place a porcelain or precious metal alloy restoration where indicated.

Dentists actually make more money from people who choose cheaper restorative options that need more frequent maintenance and upgrades over the lifetime of the tooth. Think full mouth rehabs costing ten’s of thousands of dollars - this is a late stage dental solution to long term accumulated dental neglect and failure.

So yes dentists are definitely trying to upsell you the better quality restorative solution for your teeth because we have your best long term interests in mind: we know we can ultimately save you money, teeth and pain by doing so. Like an investment portfolio, regular contributions build lovely compound benefits and returns in time. Plus, like most people, we dentists also get far more job satisfaction out of doing high quality work rather than compromised patch up work.

Besides, why wouldn’t you want the best quality money can buy for your teeth that have every potential to be with you for life? You’re likely going to live well into your nineties, surely you want something nice to smile at the airline cabin crew in business class with? You’re worth the investment in you!

The bizarrely associated symbolism of dentists with expensive cars and overseas holidays

There are approximately twenty thousand dentists in Australia. There are far more luxury cars on the road than there are dentists, and not every dentist drives a luxury car - I for one drive a Vespa scooter and use Sydney transport or car share companies when I need more. According to the Federal Chamber of Automotive Industries 2017 results, nearly 1.2 million new cars were sold in 2017, of which almost 125 thousand were luxury cars. The Mercedes-Benz C-Class was the second most popular mid-sized car on the market. Between 2012 and 2016 sales of luxury cars grew 68% across Australia. More than 1 in 10 vehicles now sold in Australia is a luxury car or SUV.

Many dentists working in Australia now come from an overseas background, with some family still located overseas. In the year to June 2017, just over 9 million Australians travelled overseas for holidays, or to visit family and friends, for business or other purposes according to Tourism Research Australia Outbound statistics. This figure has doubled in the 10 years from June 2006. The most commonly visited overseas locations by Australians were New Zealand, Fiji and Indonesia, locations that are often cheaper to travel to, or better value for money for a getaway than domestic Australian locations. 

While a proportion of dentists most certainly have a penchant for designer wheels or luxury travel, it seems Australians generally are increasingly drawn to purchase high end vehicles to drive and indulge in annual overseas travel. So really, are dentists that much different to the average Australian desiring comfort, connection and rejuvenation for themselves and their family? Probably not. And if dentists work hard day in, day out, doing a job well that most people wouldn’t want to do in a month of Sundays, surely they're entitled to enjoy quality purchases like other hardworking Australians too? 

If a dental emergency costs you your savings from your own holiday fund or mortgage overdraft, I’d highly recommend reading the Barefoot Investor or get professional financial counselling as a guide to setting up your finances better, so you can enjoy a more stress-free, debt-free lifestyle, whatever life stage you’re at. Blaming your helpful dentist is simply unfair.

The upsell intention is noble

Dentists deeply appreciate and value long-lasting quality and want you to enjoy it too. The dental upsell is real, but the intentions are noble. Unlike fashion, food, or entertainment, the terms "fast", "cheap", or "disposable" cannot be applied to healthcare, it simply doesn't work. The cheapest dentistry is preventive and that will cost you a daily floss habit and 1-2 dental checkups per year. I highly recommend upgrading to premium dental services as you like to do with flights, cars, holidays, entertainment and fashion. The difference being, it's a gift that just keeps giving. We all prefer to chat about travel and leisure experiences than medical and dental emergencies that ruin the best laid plans. Life is just better with sound teeth and a confident smile.

The best smiles come from a place of good self worth. Have the discipline to make the investment in your best self. You’re being sold the best in oral health so you can choose to enjoy the rest of your life as you desire!

By Dr Christine May, dentist, health writer, speaker, founder of FaceWell Teledentistry.  

*The information in this article is of a general nature only and does not replace specific advice provided to you following a dental consult with your own dental practitioner.