Go! Fight! Floss!

We’ve all got the traditional dentist gig down. A card comes in the mail. We make an appointment. A chatty hygienist brushes, flosses, scrapes, and buffs us before the dentist swoops in at the end to give us the final diagnosis. We find out what we need, see if insurance will pay for it, and make another appointment. Rinse. Repeat.

Now take a look at the new wave of dentistry—the Dental Health Coach. Think physical trainer for your mouth. Think taking responsibility for your own health. Think it sounds like a bunch of bunk? Think again.

In recent years, people have begun to realize that they—not their doctors or their insurance companies—are their own primary care-givers. Smart patients choose to see doctors out of network simply because they are the best. Alternative medicine, most of which comes out of our own pockets, is often a better option than the $15 co-pay. We understand that our bodies are our responsibility.

Even when it comes to our teeth.

Dr. Michael Schuster, founder and CEO of the Schuster Center in North Scottsdale, Arizona, first came up with the idea of dental health coaching as a young dentist in Dyersville, Iowa, a community where the farmers usually sent the boys to the dentist to have their teeth pulled when they were 18. After only two years as a dentist, Schuster was so stressed and busy he suffered a serious ulcer. He decided to change the way he practiced.

In 1971, Schuster created a pen-and-paper version of his Dental Fitness Program. Now a small but growing number of dentists around the nation are using its much higher-tech Dental Health Coach version based on the same principles of prevention and treatment.

Dr. David Clark is one of four local doctors who have turned dentistry into more coaching and less triage. He practiced as most conventional dentists do until he went through the Dental Health Coach program with his own dentist, Dr. Hal Stewart of Flower Mound, who has been using the model since 1993.

“A lot of patients would say their old dentist just says, ‘Yes, your gums are bleeding and we just need to keep an eye on that or brush better,’” Stewart says. “That’s supervised neglect. I keep track of the number of patients whose plaque scores are 90 or higher. That’s how I determine if my practice is successful. That means I’m doing my job.”

The scores, a vital part of the system, are like report cards for patients. But there’s more to the coaching program than figures. Here’s how things work at Clark’s office in Plano:

When I arrive, Clark and his assistant are the only people there. The office is emptied for new patients. We walk into the getting-to-know-you room and talk about my diet, my history, my dental needs and desires. Eventually, of course, we must go to the examining room because, newfangled philosophy or not, Clark must actually look into my mouth. He scores each of my teeth for gum health, giving me a score of one to 10 on each of four points on each tooth. One is the best. Anything over three is worrisome. He then looks at my plaque and gum bleeding, telling me what he finds at every angle.

At the end of my visit, Clark gives me the results. I scored a 97 on plaque control and a 95 on periodontal bleeding. (In the spirit of full disclosure, though, I’d seen my own dentist just two weeks before, at which time my mouth was whipped into shape.)

So what dentist in his or her right mind empties out the office for new patients and takes this kind of time getting to know and educate them? Dentists who, like Schuster’s disciples, want to do more than assembly-line repairs.

“I don’t want to spend my whole day fixing things,” says Clark, who sees 10 to 12 new patients a month, compared to the 50 or so traditional dentists see. “I want to be able to help people on a much higher level. Our new patient exam takes one and a half hours. We try to teach something of value. We’re so conditioned by the system to go to the dentist when we have a problem. I’m coming at you differently. We might still do that crown or root canal, but you understand it and it’s goal-driven.”

Plano resident Steve Zuehlke didn’t understand the coaching thing when Clark first tried to explain it.

“I didn’t quite see the association of the word ‘coach’ with ‘dentist,’” Zuehlke says. “It’s not like a football coach where you can say, ‘Line up, straight teeth.’” He’s into it now, though, after receiving his scores and a little training. “Dr. Clark is embracing the inter-relatedness of all different aspects of health. If he’s in someone’s mouth, he can say there are some things here that can make your teeth healthy, but we’re seeing some other things that we really need to talk about. It’s good to see that dentistry is going in that direction.”

To say that dentistry is going “in that direction” would be an overstatement at this point, though. Mark Powers is owner of the Kansas City-based Dental Health Technologies Inc. Eight years ago, he took what Schuster invented and devised a software scoring system called Structured Chart, used by about 200 dentists around the nation. Locally, Clark, Stewart, and Drs. Joseph Miranda and James McLaughlin at Travis Walk Dental Care use the chart and the Dental Health Coach model.

“The Dental Health Coach model is a highly participatory process, which puts the patient in control,” Powers says. “It still serves the comprehensive diagnostic needs of the best dental expert minds, but it focuses on getting the patient into power as quickly as possible.”

It would seem, however, that giving the patient control and seeing fewer patients would mean less money for the dentist. Not so, Dental Health Coach advocates say. More education often means more, very different procedures—often ones that insurance doesn’t cover.

“To practice this way, you have to tell your patients when they come in, ‘If you are driven by insurance alone, if all your decisions are going to be made based upon what insurance will pay for, you’re in the wrong office,’” Schuster says.

Take Trudy Taylor of Lewisville. Taylor suffered from a temporomandibular joint disorder, or “TMJ syndrome,” a chronic inflammation of the joint that connects the lower jaw to the skull. A dentist recommended breaking her jaw to fix it. Taylor searched the Internet until she found Stewart, who was able to reset her jaw with a brace and recap her teeth. He fixed her bite, thus fixing her TMJ disorder.

“It was a little upsetting when I found out our insurance wouldn’t pay for it,” Taylor says. “Of course, they would pay for some surgeon to break my jaw. I’d never heard of dental health coaching before. Now, I would never go to just a regular dentist.”

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The Best Dentists in Dallas
Our exclusive peer-based survey reveals the top 142 dentists in eight specialties.

D Magazine’s confidential poll was sent to more than 2,000 local dentists, asking them to recommend their peers in each specialty. We also made the ballot available online at www.dmagazine.com so those not included in our original survey could vote. Only dentists with a valid dental license were eligible. Finally, an esteemed panel of dentists, representing a range of specialties, reviewed the final list.

We admit these specialties may be broad in some instances. Also, if you have a dentist you like and trust, and his or her name is not on this list, we recommend you stick with your D.D.S. You may see his or her name on our next list of the Best Dentists in Dallas.

COSMETIC DENTISTRY
Lorin Berland, D.D.S.
Steve W. Cobb, D.D.S.
Ben C. Edmunds, D.D.S.
Jimmy Eubank, D.D.S.
Lee Fitzgerald, D.D.S.
Kenneth Hamlett, D.D.S.
Susan Hollar, D.D.S.
Kyle Keeter, D.D.S.
Tom McDougal, D.D.S.
David H. Wilhite, D.D.S.

ENDODONTICS
Justin E. Aurbach, D.D.S.
Karla Ham Bishop, D.D.S.
Paul Buxt, D.M.D.
Joy W. Field, D.D.S.
Hank Garrett, D.D.S.
James L. Gutmann, D.D.S.
John W. Ham, D.D.S.
Robert Hamilton, D.D.S.
William D. Henderson, D.D.S.
Carolyn A. Koenig, D.D.S.
John G. Kostohryz, D.D.S.
Hedley Rakusin, D.D.S.
John D. Regan, D.D.S.
Adrian J. Sampeck, D.D.S.
Joel C. Small, D.D.S.
David E. Witherspoon, D.D.S.
Paul Wong, D.D.S.
Jeffrey S. Woodson, D.D.S.

GENERAL DENTISTRY
Bernard Avendanio, D.D.S.
Todd Brownlee, D.D.S.
Kevin Bui, D.D.S.
Chris Cartwright , D.D.S.
Ashly Cothern, D.D.S., P.A.
John Cude, D.D.S.
Russell W. Fife, D.D.S.
John S. Findley, D.D.S.
Tiffany R. Finn, D.D.S.
Lynne S. Gerlach, D.D.S.
William H. Gerlach, D.D.S.
Jana Harrison, D.D.S.
Larry  D. Herwig, D.D.S.
Amy Horton, D.D.S.
Greg Hulings, D.D.S.
Lance K. Jones, D.D.S.
Michael Jones, D.D.S.
Jina L. Kaiser, D.D.S.
John M. Kidwell, D.D.S.
Edwin A. McDonald, D.D.S.
Louis Montanio, D.D.S.
James H. Reisman, D.D.S.
Kevin Seidler, D.D.S.
Carmen P. Smith, D.D.S.
A. Lee Steglich, D.D.S.

ORAL/MAXILLOFACIAL SURGERY
John W. Allen, D.D.S., M.S.D.
Colin S. Bell, D.D.S., M.S.D.
Douglas J. Dingwerth, D.D.S., M.S.D.
Arlet Dunsworth, D.D.S.
Derek Ellis , D.D.S., M.S.D.
Edward  Ellis III, D.D.S.
Ramsey M. Fanous, D.D.S.
Arthur W. Fields , D.D.S., M.S.
Max D. Finn, D.D.S., M.D.
Harold O’Dell Marshall Jr., D.D.S.
Kevin McBride , D.D.S.
George A. Nail, D.D.S., M.D.
Lee P. Oneacre , D.D.S.
Miro A. Pavelka, D.D.S., M.S.D.
William Phillips, D.D.S., M.D.
Kirk E. Scott, D.D.S., M.D.
Larry R. Stewart , D.D.S., M.S.
Gil Triplett, D.D.S., Ph.D.
William R. Walstad, D.D.S.
Craig E. Williams, D.D.S.
Larry Wolford, D.M.D.

ORTHODONTICS
Terry B. Adams, D.D.S., M.S.D.
C. Moody Alexander, D.D.S., M.S.
James Archambeau, D.D.S.
J.C. Boley, D.D.S., M.S.
Patrick Brady, D.D.S., M.S.
Monte Collins, D.D.S., M.S.D.
Jason B. Cope, D.D.S., Ph.D.
Linda A. Crawford, D.D.S., M.S.
Mark S. Geller, D.D.S., M.S.D.
Gayle Glenn, D.D.S., M.S.D.
Hilton Goldreich, D.D.S., M.S., P.A.
Greg Greenberg, D.D.S.
James Dean Jensen, D.D.S., M.S.D.
Patrick Ohlenforst, D.D.S., M.S.D.
Michael Ragan, D.D.S.
Petra Schubert, D.D.S., M.S.
Patricia A. Simon, D.D.S.
John R. Valant , D.D.S., M.S.D.

PEDIATRIC DENTISTRY
Tipton J. Asher, D.D.S., M.S.D.
Donna J. Barefield, D.D.S., M.S.D.
Brian D. Collins, D.D.S.
Kelli Ettelbrick, D.D.S., M.S.
Tammy Gough, D.D.S., M.S.
Ray Hamby, D.D.S.
Joseph A. (Andy) Harris, D.D.S., M.S.D.
Dane Hoang, D.D.S., M.S.
Lara Kirstin Holly, D.M.D.
Jeffrey D. Holt, D.D.S., M.S.
Jeffrey C. Jaynes, D.D.S.
Diane Lide, D.D.S.
Robert E. Morgan, D.D.S., M.S.D.
Michael Plunk, D.D.S., M.S.D.
Paul I. Rubin, D.D.S., P.A.
Harold V. Simpson, D.D.S.
Terri Train, D.D.S.

PERIODONTICS
Edward P. Allen, D.D.S., Ph.D.
Stephen Bass, D.D.S., M.S.
Patricia L. Blanton, D.D.S., Ph.D.
Farhad E. Boltchi D.M.D., M.S., P.A.
Brad Crump, D.D.S., M.S.
Mark Glover, D.D.S., M.S.D.
Marshal D. Goldberg, D.D.S., M.S.
Ellen Hall, D.D.S., M.S.
Hilton Israelson, D.D.S.
Elizabeth D. Jaynes, D.D.S., M.S.
Marshall V. Johnson, D.D.S., M.S.
Frederick E. Olden, D.D.S., M.S.D.
Jacqueline M. Plemons, D.D.S., M.S.
Ronald S. Stukalin, D.D.S., M.S.
Thomas G. Wilson Jr., D.D.S., P.A.

PROSTHETIC DENTISTRY
Bruce M. Barbash, D.D.S.
Ali Bolouri, D.D.S.
Jesse T. Bullard, D.D.S.
Rowan Buskin, D.D.S.
Thomas A. Ding, D.D.S., M.S.
Steven J. Fuqua, D.D.S., M.S.
Perry V. Goldberg, D.D.S., M.S.D.
Peter Hazim, D.D.S.
Frank L. Higginbottom, D.D.S.
David C. Hildebrand, D.D.S.
Susan K. Hummel, D.D.S., M.S.
Amp Miller III, D.D.S.
Larry L. Pace, D.D.S., M.S.
Stephen M. Parel, D.D.S.
Carolyn K. Parker, D.D.S.
Luis Perez, D.D.S., P.A.
Eric Schorn, D.D.S.
D. Greg Seal, D.D.S.