For the seven metro areas we serve, for general dentists, our Ratings Tables list those who received 10 or more ratings in our surveys of area patients. (We primarily surveyed Checkbook and Consumer Reports subscribers, but also other randomly selected consumers we invited to participate.)

See your general care dentist for routine procedures (cleanings, most restorations), but consider a specialist for procedures such as oral or periodontal surgery, implants, extensive bridgework, and difficult root canals. Since general care dentists may also provide these services, weigh the pros and cons of using your regular dentist versus a specialist for them.

Our Ratings Tables also list dental specialists in our seven metro areas for whom we have received customer ratings and reviews, and indicate whether or not each was recommended most often when we surveyed almost all actively practicing dentists in the area and asked them to name one or two specialists they would consider most desirable for care of a loved one.

Keep in mind that these ratings are inherently subjective. For example, for the ratings from patients, because the relationship between a patient and dentist is very personal, a dentist our survey respondents liked may not be right for you.

Most dentists receive very high ratings from their patients, but there are differences. Many dentists were rated “superior” (as opposed to “inferior” or “adequate”) for “overall care and service quality” by more than 95 percent of their surveyed patients. In contrast, some dentists received such favorable ratings from 65 percent or fewer of their surveyed patients.

While most patients are satisfied with the results of their dental care, don’t assume all dentists are equally competent and careful—or that anyone holds dentists accountable for their work. Dentists in general are subject to little or no peer review.

When shopping for a dentist, also consider:

Don’t assume memberships and certifications matter much.

While all practicing dentists must be licensed, licensure doesn’t guarantee that they practice good dentistry over time. Although license renewal requires area dentists to periodically complete continuing education courses, it entails no check on the quality of care a dentist provides.

Don’t be overly impressed by a dentist’s membership in professional societies and associations. While some organizations require continuing education, most require only that a dentist be licensed and regularly pay dues.

But if you need a specialist, do check whether he or she has been board certified by the appropriate dental specialty board (for example, the American Board of Endodontics). This indicates that the specialist at some time took advanced training and passed a difficult exam; some boards require periodic testing for renewal of certification. Compared to medical doctors, relatively few dentists obtain board certification.

How often do you need cleanings and checkups?

The best thing your dentist can do is to help you avoid treatment. Among the best preventive measures are regular “scaling” to remove hardened plaque that accumulates on your teeth, and diagnosing and treating decay and gum disease as early as possible.

Ask your dentist how often, and why, you need regular office visits. Patients with healthy gums who accumulate plaque and calculus slowly may be able to go a year or more between appointments, while others should visit every three months.

Most patients should get a full set of dental X-rays every five years (more often if you have a history of periodontal disease or tooth decay). A limited set of X-rays (four bitewing images) should be taken more frequently.

Are you getting good self-care advice?

Regular flossing and brushing are the keys to your dental health. That’s why your doc or hygienist should thoroughly explain proper brushing and flossing techniques—and then have you demo what you are doing at home.

The dentist should also discuss available fluoride treatments and other preventive care, such as sealants for children’s teeth.

Are exams thorough?

During each appointment, your dentist should inspect the soft tissues of your mouth, tongue, lips, cheeks, and salivary glands to detect oral cancer. Your dentist should then examine your teeth for cavities and have you close your mouth and move your jaw from side to side to check your bite and jaw joints. Finally, he or she should check your gums with a metal probe to measure the depth of the pocket between your gums and teeth; two or three millimeters is normal.

Your dentist should also ask about bleeding, swollen, or inflamed gums; loose teeth; chronic bad breath; and pain when chewing or while eating sweets or drinking hot or cold liquids.

Does the dentist explain various treatment choices?

If your exam reveals dental disease, there may be many treatment alternatives. A tooth with a large cavity, for example, might be treated with a filling, by root canal therapy and a crown, or by extraction. Your dentist should explain the pros and cons of each treatment.

Because different treatments for the same condition differ in cost, discomfort, inconvenience, and implications for your long-term oral health, you alone—with information and advice from the dentist—must decide which treatment is right for you. 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 did your previous one—for instance, if suddenly many silver fillings need to be replaced or several teeth need to be crowned. This is an area where we receive frequent complaints.

If requested, the dentist should provide a written treatment plan (though there may be a fee).

Should you see a specialist or get a second opinion?

Before undergoing extensive treatment—and especially if a new-to-you dentist declares you need expensive restoration work—get a second opinion. Your dentist should forward X-rays and exam results to another practice for review.

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). Discussing treatments with the specialist, as well as with your general dentist, may yield a balanced appraisal. However, the situation is full of conflicts of interest. The specialist has an interest in recommending the sort of extensive and complex treatment he or she provides. The general practitioner, on the other hand, may never mention the option of using a specialist, rather than sacrifice the opportunity to treat you. As many dentists become increasingly hungry for business, these conflicts increase.

Our Ratings Tables will help you find dental specialists. Our list of top specialists includes the dentists mentioned most often when we asked dentists in the seven metro areas we serve to name one or two specialists in each of several dental specialty fields whom they considered most desirable to care for a loved one. (We will conduct a new survey of dentists in fall 2022.)

What guarantees are offered?

Few dentists guarantee their work for a specific length of time. Some guarantee work for only an approximate time period—and almost no dentists put guarantees in writing. Among dentists who do offer guarantees, about half offer a five-year guarantee for crowns and “about” two years or less for fillings. Ask candidates if they offer warranties for several common restorations, but don’t expect to get concrete guarantees.

If you do find a dentist who will provide a warranty on his or her work, get it in writing—including a description of the problem as it currently exists, proposed treatment, expected costs, expected results, and a specified period during which the dentist will replace free of charge work that proves to be defective. Remember that any warranty is subject to reasonable wear and tear, and that a crown might not be covered, for example, if you do something dumb like use your teeth to open a beer bottle.

What pain control options are available?

Researchers have found that nervousness or anxiety about pain has prompted about 30 percent of consumers to, at least once, avoid visiting a dentist for as long as possible. But given modern anesthetics and equipment to minimize discomfort, even the most sensitive patients should feel confident heading into the chair.

Your dentist should offer you a choice of anesthesia, and explain the side effects of each type. Patients who are extremely sensitive or anxious may request nitrous oxide (“laughing gas”). Others may get by with just a local numbing agent. Still others may want to avoid any numbness. Whatever you choose, your dentist should tell you how to signal if pain arises. Although the ratings in our survey for “being gentle” were generally very high, some dentists rated considerably higher than others—and a few received very low ratings.

Recently, more and more dentists use music or movies to help patients relax.