Corporate dentistry places the goal of maximizing profit far above all other goals, including that of solving oral health problems for patients. This has real-world effects on the health of those patients.
It essentially works like this--
Corporate dentistry entices patients with low fees for any given procedure. Then, they over-diagnose and over-treat. Patients actually end up paying more. In money--and in health.
-The corporate dental definition of the dental pulp is "a small piece of oral tissue that can be readily turned into cash." Endodontics is performed with the thinnest of rationales, or often with no rationale at all, in the name of production quotas. In contrast, a *bespoke* dentist strives to keep the dental pulp alive, in cases where there is no infection or intractable pain.
-Corporate dentistry fabricates periodontal probing depths in order to perform scaling and root planing on all new patients, many of whom do not need it (and will be harmed by it). Over time, this of course makes it more difficult to have treatment discussions with patients who actually have periodontal disease, as the profession's credibility is harmed.
-Teeth that could be restored with direct restorations of moderate size are crowned instead. Crowns are extraordinarily useful when indicated to save a tooth and keep in in function. I wonder, though, how many tons of human tooth enamel are sacrificed in the U.S. each year by corporate dentistry, not because the teeth in question were severely compromised--but because the fee for a crown is eight to ten times higher than the fee for a direct restoration.
Corporate dentistry also treats doctors, hygienists, assistants and business staff as interchangeable, temporary and disposable. Production quotas are the driving metric.
A truly *bespoke* dentist, in contrast, considers this metric to be the most important: "How much difference did I, and my staff, make for this patient who stands before me?"