Your Source for Six Month Braces and Porcelain Veneers

Wednesday, September 20, 2017

Who Is Running the Show at This Dental Office?

Michael Barr, DDS
Palm Beach Smiles is owned and operated by Michael Barr, DDS.  That's me.  I'm the chief cook and bottle washer, since 1994, at the same location in Boynton Beach, Florida.  As it stands, it is Florida law for dental practices to be owned by a dentist.

What is "Corporate Dentistry?"


But, that's apparently not always the case these days.  How so?  Maybe you've noticed a number of dental practices with multiple locations and a brand names that rhyme with Masspin, DownCare, or Page Dental.  There are others.  You have likely seen their TV ads.  These are large corporations that have dental clinics all over the state and even nationwide.

I call it "bus station dentistry."

These are massive corporations that manage to get around the state regulations by hiring dentists to pose as owners.  But, they aren't running the show.  Usually, these "owner dentists" are not working as dentists in those offices. 

Rather, they hire associate dentists (often new dentists) to see patients.  LOTS of patients.  They have production quotas for the associate dentists.  The dentists are often directed by the office manager (not a dentist) on treatment planning.  There is reportedly a lot of pressure to produce.  I've known dentists in these clinics that are seeing as many as five patients simultaneously. 

What happened to the dentist I saw last time?

Not surprisingly, these offices have a high turnover of dentists and staff.  There is a very good chance you won't see the same people six months later. 

Over the many years I've been in practice, I've seen many patients who have left these corporate dental practices disappointed by the lack of personalized service and questionable treatment plans. 

Jo-Ann - Office Manager
My purpose is not to claim superiority or cast aspersions.  It is simply to point out some differences between "corporate dentistry" and private care dentistry.  Patients should know who owns the practice.  Ask questions.  Who is the owner?  Where is the owner?  Does he or she see patients?  Is there a corporation that owns the office?  Where is the headquarters located?

 If the office staff cannot answer the question, you may reconsider being a patient there, in my opinion.  If the owner is an absentee figurehead, the same applies.

I admit to being a bit dismayed at what I see going on "out there." 

Kim - Registered Dental Hygienist

Where everyone knows your name...

Palm Beach Smiles is a private care practice owned by me, Dr. Michael Barr.  There are no outside corporate interests tell me what to do.   My only guide, day to day, is my professional training and experience.  What would I do if the patient was my family?  What is best for the patient?  I strongly believe that is the best and ONLY path.  I love what I do.  I want to keep it that way.  I could never take orders from "upper management" when it comes to treating my patients.  I love providing the best care possible for my patients.  It is important that my patients understand their condition and treatment options.

I like to think we provide the latest, proven dental care with "old school" service.  That means attention to detail.  It means seeing one
patient at a time.  It means getting to know our patients.  It means spending TIME with out patients, making sure they understand what is happening and how best to prevent further issues.  It means "being there" for our patients.  You won't find our reception area full of people waiting to be seen (like a bus station).  There is no "sign in" sheet.  We are expecting you.  Jo-Ann will greet you when you walk in.

Sandy - chairside assistant
I have been here since 1994.  My office manager, Jo- Ann has been here for 15 years.  Sandy, my assistant, has been working by my side for 18 years.  Kim, our hygienist, is our newest team member with 2 years at Palm Beach Smiles (but has 12 years of experience).  It's just the four of us!  Every time you visit us, it will be the same familiar faces.

If you'd prefer "old school" one-patient-at-a-time service where "everyone knows your name," please visit our website or give us a call.  You can visit our recently updated website at:  www.PalmBeach-Smiles.com.  You can even book an appointment right on our website!  Or you can give us a call at 561-736-2377.   We'd love to meet you! 

Friday, March 29, 2013

Dr. Oz at it again... Are your silver fillings making you sick?

Here we go again... with a debate that is 150 years old. Yep!  One hundred and fifty years old!  Dr. Oz had a show yesterday about silver fillings.  The implication was that silver fillings, which contain mercury (as a chemically-bound component), can cause illness.  This notion isn't new. But, it's never once been proven by any credible scientific studies.

I haven't used silver fillings at Palm Beach Smiles in at least 15 years.  A long time ago, I decided to use composite instead.  It's more conservative (requires less removal of healthy tooth structure) and it's certainly more cosmetically attractive.  Who wants silver fillings that end up turning black?  Today, most people want white fillings (which are not completely without risks, either, by the way).

Silver fillings replaced by composite.  Actual Palm Beach Smiles case.


Dr. Oz's show was sensationalistic, which is what TV is all about.   Furthermore, the premises and "guidelines" were completely without any scientific basis.  Yes... I realize that Dr. Oz is a famous TV celebrity (whose training is in cardio-thoracic surgery), and I'm "just a dentist."  But, I dare say that I know more about dentistry than he does.  I am an expert on dentistry.  He is not.   Of course, he could find some dentists to be on the show to support the premise.  But, that doesn't make their arguments any more scientific or based in fact.  The real facts contradict their assertions.

Actual Palm Beach Smiles case.


We dentists serve two masters: Science and business.  If we were to focus on business, we should WISH that silver amalgam fillings have been deemed harmful.  It would make us all VERY busy (and wealthy).

Finally, my point is that the scientist in me cannot endorse the categorical or routine removal of of silver amalgam in order to cure or prevent medical illness.  I do understand that some patients would like their silver fillings removed for cosmetic purposes.   And, I'm happy to do it... as long as patients know the risks.  Removing and replacing fillings can be traumatic to teeth.  This can lead to other issues down the road that may require root canal treatment or crown restorations.

If you'd like more information, you can click on my webpage:  Should I have my mercury-silver fillings removed?

Large fillings may need to be replaced with crowns.



If you have any questions about your silver fillings, give us a call at Palm Beach Smiles in Boynton Beach.

Friday, June 1, 2012

You'll Shoot Your Tooth Out!

Just when I thought I had heard EVERYTHING... well you know the rest.  But, this one is new.


A man had a toothache and decided to SHOOT it out with his gun.  Of course, only a MAN would consider this.  Women are far smarter!

Maybe we shouldn't be surprised that the man was also drinking, and I dare say... lives in Alabama.  Oh, I'm going to get flamed for that!  It was probably his last tooth!  ;-)  Drinking and do-it-yourself dentistry don't mix!


Click here to read "Decatur man tries to ‘shoot out’ aching tooth."  



Tuesday, April 10, 2012

Dental X-rays "Tied" to Brain Tumors?

Here we go again. Another "study" warning of the dangers of dental x-rays was featured on a morning news show. I'm sure the other news programs will pick up on it quickly. And, dentists across the country will collectively sigh.

Here's a link to a report about the study.

Strange Science

What's most frustrating is that it's as invalid a "study" as any scientist could dream up. Real science does not rely on anecdote (stories). And, this study relies on interviewing the subjects and asking them to recollect how many dental x-rays they had since childhood. I'm shaking my head as I type this. They could have asked them to recall just about anything, including how many carrots they ate or how much time they spent under fluorescent lighting.

Real scientific studies rely on HARD DATA, not what someone remembers from their childhood. By asking questions that rely on anecdote, I could fashion a "study" to prove just about anything.

Some basic tenets of science are:
  • "Multiple anecdotes are not data."
  • "Correlation does not equal causation."
As mentioned before, anecdotes / stories cannot be considered when creating a study to prove cause and effect.

The second quote above means that because two things are related or happen together, it does not mean one caused the other.  "Correlation does not equal causation."  It bears repeating, because it's true.

Just the FACTS, Ma'am

Unfortunately, this type of "popular science" creates tremendous headaches for dentists and endangers the health of our patients.  Today's dentists have gone to great lengths to reduce radiation exposure while maintaining optimal diagnostic capabilities.  And, dentists order x-rays based on a number of factors including individual patient histories.

The truth is that dental x-rays are the LOWEST source of ionizing radiation from medical AND natural sources.  A series of four check-up bitewings is the same as a 2-hour flight in a passenger jet.  Likewise, the radiation you receive by living inside a concrete block house (most modern houses in Florida) for one year, is about the same as you get from a Full Mouth Series (18 films) of dental x-rays.  A chest CT scan is 700 times the radiation of a dental x-ray.  These are verifiable, measurable facts.

Dosages of radiation from various common sources (measured in "millirems"):

1 dental x-ray: 0.5 mrem

2 hours in an airliner: 2 mrem

1 dental panoramic x-ray: 3 mrem

Living in a concrete house / per year: 7 mrem

A full mouth set of x-rays (18 films): 9 mrem 

Chest x-ray: 10 mrem

1 pack of cigarettes per day / year: 36 mrem

Chest CT scan: 700 mrem

Whole Body CT scan: 1000 mrem

My Hands Are Tied

Ultimately, we cannot... neither ethically nor legally... treat patients without appropriate x-rays as part of an examination that meets the standard of care.  In our current system and environment, patients cannot consent to negligence.  In other words, a patient cannot sign a "waiver" and refuse x-rays.   If a diagnosis is missed, or incorrect treatment is rendered as a result of not having x-rays, the dentist WILL be held liable, regardless of any signed "waiver."  That's reality.

A patient does have the right to refuse TREATMENT.  But, they can't sign away their right to a proper DIAGNOSIS by the doctor.  X-rays are done for diagnostic purposes.  If we miss a diagnosis by not taking the proper x-rays, we will be hung out to dry... every time.  That's our reality.  A patient cannot legally consent to negligence.

But, even more important than that, patients may SUFFER from undiagnosed issues.

Don't Wait Until It Hurts!

I'm surely glad this patient didn't refuse x-rays.  She didn't know or feel this very large cyst that was destroying her jaw bone.  No symptoms.  No pain.  But, it's a very good thing we caught it.


In my opinion, it was grossly irresponsible, if not reckless, for the "Cancer" journal to publish this so-called "study."

Talk With Your Dentist

My suggestion is to have an open dialogue with your dentist.  He or she has your best interests at heart.  Getting medical or dental advice from TV (or even the internet) can be dangerous to your health.  Find a dentist you trust.  Trust is the foundation of the doctor-patient relationship.

One more tenet of science is that a VALID study must be REPEATABLE.  One study... even if it's a good study (this one is not)...  cannot be used to draw solid conclusions.  The study has to be repeated (usually by someone else) and have the same results.

American Cancer Society Responds (to me)

Finally, I have personally been communicating with the American Cancer Society, which publishes the journal, "Cancer."  I expressed my concerns and they have responded.  I won't paste the entire conversation here, but it's VERY puzzling why they would publish this laughable "report," when their Chief Medical Officer, Otis W. Brawley, M.D., said regarding this study, “We need more data before we can even begin to state there is a relationship between dental x-rays and these tumors."  It surely begs the question:  Then WHY did you publish it???

I won't speculate on what agenda(s) may be behind the release of this report.  Dental x-rays shouldn't even be on the "radiation radar" when compared to even natural sources of ionizing radiation.  But, ultimately, you don't want to risk your health based on "factoids" regurgitated by the talking heads on TV.  Ask your dentist questions.  He or she should be able to address them with scientific facts.

Sunday, January 15, 2012

Palm Beach Smiles is mobile!

No, we haven't rented an RV and taken our dental act on the road. We have a new website designed specifically for mobile (smart phone) users. It's easy to use, and it's fast!

You can visit by clicking Palm Beach Smiles mobile website.

Or if you have a QR code reader app on your smart phone, you can scan the code right here from your computer screen. Very cool! Try it!

Wednesday, April 27, 2011

Smile Makeover Video Testimonial

Check out this patient testimonial. Carol had been unhappy with her smile for many years. Be sure to see the before & after photos at the end of the video!