Dental profession’s rules on advertising hit raw nerve
Ihad just finished having my teeth cleaned when I ran into Dr. Murray Knebel in the lobby of his dental studio — Sierra Centre for Dental Wellness in southwest Calgary.
After a friendly chat, I mentioned to Knebel that I had a friend who got a crown recently and was very unhappy. After visiting her dentist on three separate occasions, she went through untold pain and ended up with a substandard crown with a metal base, which looked ugly and left her tooth very sensitive.
What a difference from my experience at Knebel’s state-of-theart office. When I got a crown at Sierra Dental, it took one hour for the entire process with a $120,000 machine called Cerec 4, skilfully operated by Dr. Frank Giesbrecht — one of the seven dentists working at Knebel’s office.
My crown was digitally designed. A piece of ceramic perfectly matched to my regular teeth colour was placed into a special piece of equipment where you can see the crown being cut by lasers (cooled by jets of water) right before your eyes. It was like something from a science-fiction movie — only this is a reality. The crown is then popped onto your prepped tooth and you’re done. No fuss, no muss and no pain. The look is so seamless and the sensation so normal, I can’t figure out which of my teeth has the crown anymore. I received a regular crown at a different dentist’s office years ago — which was like undergoing three torture sessions (and ongoing pain and sensitivity) as a result.
“Why don’t you advertise that service, Murray?” I asked Knebel, next to the calming fireplace in the waiting area.
“You don’t even mention it on your website,” I continued. “I was trying to show that friend of
These advertising rules may be good for lesser dentists, but they’re bad for consumers. That doesn’t sound very ethical.
mine who needs to get another crown what I was talking about and I couldn’t find any information about it,” I added. “You should have a video on your website showing the crown getting formed right before your eyes.”
Knebel kind of shrugged. “The Alberta Dental Association’s code of ethics doesn’t let dentists share any information with the public that differentiates us from our peers,” he explained.
“I don’t understand,” I said. “So a consumer who wants to find a dentist who can design, prep and install a crown with the very top technology can’t do so?” I asked, incredulously.
Knebel and his partner and marketing director, Desirae Jaenen, nodded in unison.
Those are some ethics, eh? Ethics that protect lesser dentists with older technology from having to compete with on-the-ball modern dentist offices. Ethics that mean patients don’t get the full information and therefore must endure more pain and three visits instead of just one for a lesser outcome.
Knebel, for instance, refuses to use any metal fillings or any crowns made with nickel in them because in his view, they are less bio-compatible. However, the ADA has no problem with those metals being used, despite the high numbers of people allergic to nickel, for instance. As a result, Knebel is not allowed to advertise the fact that he won’t use those less-than-ideal metals.
Incredulous, I got online and found the code of ethics of the Alberta Dental Association and College and Knebel is right.
From the Alberta Dental Association and College’s code of ethics, section B4.2, a dentist: “shall not utilize advertising or promotional activities to publicize the equipment, material, or techniques used in their dental practice if the advertisement or promotional activity expressly represents or implies that such equipment, materials, or techniques are superior in quality to those of other dentists, or implies that superior results are achievable or that superior dental care is provided.”
Thus, no mention of the one- hour crown procedure on Sierra Dental’s website because that “implies” superior equipment and results. After all, who can argue against a one-hour visit being superior to three separate one-hour visits?
Colleen Wetter, legal counsel for the ADA, said the 16-page code of ethics is clear about what dentists can and can’t do.
“A general dentist can advertise the services they provide and they can advertise the products that they use,” Wetter said.
But the code of ethics clearly states advertising the one-hour crown or bridge procedure would imply superiority.
“I’m not going to make any re- sponse to any specific advertising questions that you have,” Wetter added.
Wetter’s answer is confusing. If Knebel can point out that his office has the Cerec 4 machine but — and here’s where the drill hits the nerve — he can’t explain the benefits of the machine or how it makes getting a crown or a bridge an entirely different experience from the vast majority of dentist offices, that would be of little help to a patient.
In other words, consumers don’t really get to shop around and learn how one dentist’s office differs from another dentist’s office. After all, most people have no clue what a Cerec 4 machine is or does. Context needs to be provided as well.
Currently, some dentists in Alberta advertise and are left alone by the ADA because no one has lodged a complaint. Knebel and many other dentists as well, are not so lucky. Someone keeps complaining about Knebel and the other dentists at Sierra Centre.
Knebel, however, is starting to fight back. He has received numerous letters ordering him to remove various statements on his website after a person lodged nu- merous complaints.
Knebel even had to hire a private investigator to find out who was lodging these complaints. What did the private investigator find? That the name given on the complaints doesn’t seem to be a real person. The address the complainant provided doesn’t belong to the person whose name appears on the complaint. It seems as though the ADA is not properly investigating the veracity of the complainant.
Most recently, Knebel was ordered to remove unsolicited client testimonials from his website, that gush about how Knebel’s work has changed or enhanced their lives.
“We agree with much of the principle behind the code of ethics on advertising,” Knebel says. “It wouldn’t be right to say, for instance, ‘I’m the best dentist in the city,’ but I should be able to tell people what kind of fellowships I have, how many hundreds of implants I have performed, that kind of thing. It’s objectively verifiable information. That should be OK.”
Clearly, while well intentioned, the ADA’S rules about advertising need to be pulled out by their roots and rewritten to allow consumers the right to know the facts about their dentist’s expertise in various areas and how the equipment they have may improve their outcome or cut back on the time they are forced to sit in the dentist’s chair.
A dentist who has thousands of hours of accredited training in orthodontics, sleep apnea, headaches and implants, should be able to share that objectively verifiable information with consumers. But that might make other dentists, not so inclined to spend the extra time and thousands of dollars on upgrading, look bad by comparison.
When you drill down into the ADA’S code of ethics, what becomes obvious is that these advertising rules may be good for lesser dentists, but they’re bad for consumers. That doesn’t sound very ethical.