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Due to some insurance changes we switched our children (ages 9 and 16) to a different dentist last year. The new dentist is a pediatric dentist who only sees children. Our prior dentist was a general family dentist who saw the whole family. Our prior dentist is a bit old-school: he does everything himself and seems very thorough, with routine cleanings typically taking 45 minutes to an hour for everything including X-rays if needed.

I was pretty surprised that the pediatric dental cleaning appointments seemed very short. I timed our last one. The hygienist spent a total of 9 minutes polishing and flossing my daughter's teeth, followed by less than 5 minutes with the dentist who did an inspection and applied fluoride.

Is it fair to judge the new dentist based on the duration of the cleaning? My initial reaction is that it can't possibly be as high quality or effective as our old dentist. But then again, our old dentist is certainly outside of the normal curve of typical dentists, maybe we are just accustomed to his lengthy and perhaps over-the-top thoroughness. Maybe he is more thorough than he needs to be and is pushing the cleaning past the point of diminishing returns.

If it is fair to judge based on the duration of the basic cleaning procedures, how long should it take? If 9 minutes is too short, what is appropriate...15? 30? Are there accepted standards of practice for what constitutes "good enough"?

I understand each situation is different and calls for different degrees of cleaning. But this is a pretty "normal" case where the child has good brushing/flossing habits and is going in for cleanings every 6 months.

  • I had the same experience. First Peds dentist took a good half hour and now the new one is done in 20 mins. There is no use of special scrapers, etc. She just polishes once we walk in and we see the dentist for 10 mins and we are out! Just does not seem right compared to how much time the old dentist spent. – user24680 Oct 4 '16 at 13:36
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If you plotted a graph with the x axis as Time spent and the y axis as Quality of care, you would not get a straight line on a continuous incline. Too little time is not good, but there is not a direct corellation between time spent and quality of care, nor would it likely be a bell-shaped curve.

Are there accepted standards of practice for what constitutes "good enough"?

No, nor should there be. The variables are too numerous and the average consumer of health care* is not familiar enough with all of them to make such a call. Some factors determining time spent (in this case) are:

  1. efficiency: dental hygienists are experts at cleaning teeth, doing it all day every day, meaning the time spent achieving the same result will be far less than a better trained person doing it less frequently.

  2. Degree of tartar accumulation: The less there is to clean, the faster it will go.

  3. Number of carious teeth: the fewer, the faster.

  4. Degree of gum sensitivity (should be low in children).

  5. (Degree of apprehension in patient x degree to which care taker caters to/recognizes apprehension) divided by amount of skill caretaker has in preventing/alleviating apprehension.

Her next cleaning may take twice as long if she's stressed, or had a lapse in her good daily hygiene, or if she develops cavities, of if she sees a relatively inexperienced/new hygienist, etc.

*I hate the term consumer in health care. But it is what it has become. Your evaluation of the quality of care given should rest with factors such as number/nature of complaints lodged against this dental practice, professionalism in all its members, hygiene in the office, recommendations for money-making procedures (e.g. dental x-rays) not exceeding recommendations of the professional organization (x-rays being a real concern in pediatric practices), word of mouth of long-standing patients, continued maintenance of your daughter's excellent oral health, etc.

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