A friend of mine—a healthcare practitioner—called me in tears a few years ago.
She hadn’t been to the dentist in over four years. When she finally made an appointment, her dentist handed her an $8,000 treatment plan on day one. All presented as urgent, with little explanation of how things had progressed or what she could do differently going forward.
“Am I really that bad?” she asked me. “Have I ruined my teeth?” There was also the shame: “I should know better!”
Here’s what I told her: After years away from dental care, the dentist you choose matters more than ever.
If you’re going to invest time and money after a long gap, you don’t want someone who just fixes problems. You want someone who helps you understand how you got here—so you don’t end up back in the same situation years from now.
Because here’s what usually happens: You avoid the dentist for years. Life gets overwhelming. When you finally go back, you’re hit with all this dental work, all of it “urgent.”
This is drill-fill-bill dentistry. And it’s everywhere.
After four or five years away, of course there’s going to be tartar, calculus, maybe some decay. That’s expected.
But here’s the question a good dentist asks: How long did it take to get this bad?
Without understanding the timeline and progression, how can they know what’s truly urgent versus what’s been stable for years?
A functional dentist slows down. They might ask: How did we get here? What’s changed in your diet, your stress levels, your sleep, your medications? Are you mouth breathing? What’s happening systemically?
More importantly: What kept you away for so long, and how can we make sure that doesn’t happen again?
They teach you—because the root of the word “doctor” is teacher.
They don’t just fix the problem. They help you understand what created it and how to prevent it from happening again.
That’s the difference between a quick fix and actual partnership.
Green flags (look for these):
- Asks about your diet and lifestyle before recommending treatment
- Willing to explain x-rays in detail and show you exactly what they’re seeing
- Discusses least invasive options first (can this be remineralized?)
- Asks about your timeline: “When was your last cleaning? When did symptoms start?”
- Says: “Let’s start with one thing and see how you do”
- Talks about your oral microbiome, mouth breathing, or systemic health connections
- Discusses filling materials and gives you options
Red flags (run from these):
- Immediately presents expensive treatment plan without discussion
- Reluctant to explain findings or gives only cursory overview of x-rays
- Multiple fillings recommended in the same quadrant, all labeled “urgent”
- Blames you for not brushing or flossing enough without asking about diet or what’s changed
- Pushes for immediate treatment when you just found out about the issues
- Uses only amalgam (mercury) fillings
- Never mentions nutrition, mouth breathing, or asks why cavities formed
Before agreeing to any treatment, ask…
“How long did it take to get this bad?”
This tells you whether the dentist is thinking about disease progression or just seeing a snapshot. If they can’t answer this, they’re not considering your full history.
“Do you incorporate nutritional counseling into your treatment plans?”
You cannot out-brush or out-floss a bad diet. If they don’t discuss nutrition, you’ll be back with the same problems.
“What’s the least invasive way to treat this?”
Early cavities—especially ones that haven’t broken through the dentin—can often be remineralized with nano-hydroxyapatite toothpaste, diet changes, and addressing mouth breathing.
“Can you describe what you’re seeing so I can understand it?”
Ask them to walk you through the x-rays. A good dentist welcomes this. If they’re reluctant or give you a quick overview without real explanation, that’s a red flag.
“What are the risks and benefits of this procedure?”
Any procedure has risks. You deserve to know what could go wrong and what you stand to gain before making a decision.
“Can we start with one thing first?”
It’s okay to say: “I want to do one filling and see how your work goes before committing to everything.” A good dentist says yes.
So, my friend got a second opinion—this time from a dentist in the Functional Dentist Directory.
Turned out she needed one filling and a deep cleaning—not four fillings and a crown.
But more importantly, the second dentist explained exactly what had led to the tartar buildup below her gum line. He walked her through the x-rays, showed her where the pockets had formed, and explained why a scaling and root planing was necessary after four years away.
Then this dentist asked: What changed four years ago? Why did you stop going?
The answer: Her father’s death. Months of caregiver stress. Living on coffee and granola bars. Barely sleeping. Her mouth breathing had gotten worse.
They created a plan together—not just to address the current problems, but to prevent them from coming back. Better nutrition. Addressing the mouth breathing. Supporting her oral microbiome.
That’s the difference.
If You’re Running on Empty
If you’ve been putting off the dentist because you’re exhausted, depleted, or barely keeping it together—I get it and you are not alone. Sometimes the problem isn’t that you don’t care or “know better.” It’s that you don’t have the bandwidth.
After 40 years in private practice, I’ve noticed that oral health is often a mirror of life circumstances.
When people’s lives are going well—stable relationships and jobs, manageable stress, good mental health—they tend to floss consistently, show up for cleanings, take care of themselves.
When life falls apart—death of a parent, divorce, job loss, depression, caregiving—dental care is often the first thing to go.
Not because people don’t care. But because things like flossing require bandwidth you just don’t have when you’re in survival mode.
A few things that have helped people I know who are in a challenging season of life right now…
If you’re so tired you can barely think straight, creatine has been shown to improve working memory and cognitive function when you’re sleep-deprived. I take 10 grams every morning and it’s genuinely made a difference in my ability to show up for myself.
If you’re under stress, you might be producing less saliva as a result—magnesium helps your body produce better saliva, which is your mouth’s natural defense against cavities.
If you’re dealing with bleeding gums or inflammation, CoQ10 and D3/K2 both have strong clinical evidence for supporting enamel and gum health.
None of this replaces going to the dentist. But it can help you feel less depleted while you figure out your next step.
Whether you haven’t been to the dentist in two years or ten, the dentist you choose determines whether you get a quick fix or a real solution. Find someone who thinks functionally, not just procedurally. The Functional Dentist Directory on my website is a good place to start. If that’s too big a step, consider seeing a myofunctional therapist.
And in the meantime: floss one tooth tonight (yes, just one). Chew xylitol gum after meals. Keep a toothbrush by your bed for a quick dry brush before sleep. Start some supplements that will bolster your saliva which will, in turn, support your teeth.
Something is always better than nothing.
If your dentist makes you feel ashamed, you’re in the wrong place. A good dentist says, “You’re here now. That’s what matters.”
– Mark
Further reading on my website: