Finding a dentist to maintain your pearly whites

Dentist visits rank right up there with taxes and death among most people's inevitable but least favorite activities.

But the oral-care argument is strong: Spend time in a tooth pro's chair and you'll probably stay in better health and avoid costlier, more painful dental problems in the future. Combine it with diligent self-care and you'll be smiling for years to come.

If you need a good dentist, Delaware Valley Consumers' Checkbook can help you find one. Our independent nonprofit surveyed more than 11,000 Delaware Valley-area consumers about their experiences with local dentists. Among hundreds who received at least 10 ratings, many were rated "superior" for "overall care and service quality" by more than 95 percent of their surveyed patients. In contrast, others got such favorable ratings from 60 percent or fewer of their surveyed patients.

Until July 5, Checkbook is offering free access to its ratings of area dentists to Inquirer readers through this link: Checkbook.org/Inquirer/Dentists.

If you don't carry dental insurance, you need to check prices. Checkbook's undercover shoppers found big fee differences. For example, for a routine examination and cleaning for an established adult patient, prices among surveyed dentists ranged from $85 to $236; for a one-surface composite filling on an adult molar, prices ranged from $65 to $294; and for a new porcelain crown for an adult molar, including post and core, fused to high-noble metal, prices ranged from $925 to $2,096.

Ask about specials and discounts. Some practices will offer specials on certain procedures. Others advertise low-priced packages for new patients. Some will offer discounts to special groups, such as senior citizens, students, fire or police professionals, and more.

You don't have to forsake quality to use a dentist who charges low fees. Checkbook found many dentists who receive high ratings for patient care also charge below-average fees.

More important than anything the dentist can do for your mouth is what you can do for yourself. Your dentist or hygienist should thoroughly explain proper brushing and flossing techniques, and offer tips on selecting a toothbrush, floss, toothpaste, and other supplies. Equally important, the dentist should periodically have you demonstrate your brushing and flossing techniques so that he or she can suggest improvements.

If a dentist recommends a treatment, always ask for a full description of all the alternatives. There is often more than one treatment option for the same condition. The dentist should be willing to describe the pros and cons of all of them, so you can make your decision based on cost, discomfort, and inconvenience. You'd expect a roofing contractor to explain fully the pros and cons of repairing vs. replacing your roof; you should demand the same from a dentist — and in terms you can understand.

Keep in mind that because various treatments require more or less of the dentist's time — and therefore higher or lower charges — the advice may be colored by self-interest. Be suspicious if a new dentist recommends far more treatment than your previous one did — for instance, if suddenly many silver fillings need to be replaced, several teeth need to be crowned, or your gums need extensive surgery.

This is an area where Checkbook receives frequent complaints from surveyed patients. To help you decide on a treatment, your dentist should fully describe the condition of your mouth and the corrections needed. It's good practice for the dentist to provide a written treatment plan (though there may be a fee). If the proposed treatment is extensive, consider getting a second opinion from a specialist. While general dentists often refer patients to specialists for difficult root-canal treatment (endodontist), gum surgery (periodontist), moving multiple teeth (orthodontist), or removing impacted teeth (oral surgeon), as some dentists become increasingly hungry for business they are trying to tackle these tasks on their own. Not all are qualified to do so.

Check your health plan for dental benefits, especially for dependents younger than 19; the Affordable Care Act mandates pediatric dental coverage on individual and small-group medical plans. Some Medicare Advantage plans include dental coverage, and many "consumer-driven" and "high-deductible" health plans let you set aside funds for dental work.

If you don't have dental coverage but know you'll soon need costly dental work, consider joining a dental discount plan. Checkbook found that such plans often yield significant savings. But be aware that many top-quality dentists — many rated highest by Checkbook — don't participate in these programs.

Consider asking for a warranty. Few dentists offer written warranties; more should — at least for major restorative work such as bridges and crowns. Even if a dentist won't provide a written warranty, discuss your expectations and get him or her to agree verbally to replace work that fails much sooner than normal, assuming that you care for your teeth properly. Regardless of what agreement you have in advance, don't hesitate to ask for a free replacement if a restoration doesn't last as long as it should.

Delaware Valley Consumers' Checkbook magazine and Checkbook.org is a nonprofit organization with a mission to help consumers get the best service and lowest prices. It is supported by consumers and takes no money from the service providers. You can access all of Checkbook's ratings of dentists free of charge until July 5 at www.checkbook.org/Inquirer/Dentists.