Dr. Michaelangelo Aust

Think about what dentistry actually involves: a professional working inside your body as a matter of routine. Your physician checks your blood pressure, listens to your heart, places a thermometer in your ear — but a dentist has their hands in your mouth. That level of physical intimacy demands an equivalent level of personal trust and attention.

I've learned that the quality of care I can provide is directly tied to the quality of the relationship I build with each patient. When a patient trusts me — really trusts me — they're honest about their anxiety, their history, their fears. And that honesty allows me to design care that actually works for them. Personal attention isn't a soft skill in dentistry; it's a clinical necessity. If you feel comfortable enough to tell me the truth about your oral care, I can take far better care of you.

"Yes, I brush and floss every day." That's something I hear in almost every new patient consultation. And while I appreciate the sentiment, the oral cavity tells its own story — one that's often quite different.

Here's the thing I've come to understand after treating thousands of patients: the mouth is genuinely a window into your overall health. Gum disease is linked to cardiovascular disease, diabetes, and other systemic conditions. The state of someone's teeth and gums reflects not just their oral hygiene habits, but their nutrition, stress levels, medication use, and general health. I never judge what I find — I've seen every possible scenario — but I do take it seriously. More importantly, the patients who are honest with me about their habits, who follow through on recommended care, and who come in for regular check-ups consistently spend far less on dental care over their lifetime. Prevention is always less expensive than repair.

Many of the patients I see initially view dental care as an expense to minimize. I understand that. Quality dentistry isn't cheap, and the connection between dental care and overall quality of life isn't always obvious until you've experienced both sides of it.

Here's the equation I use to explain the value of dentistry to patients who are on the fence: take the body parts preserved (your teeth), add the daily functions restored (eating, laughing, speaking confidently), then divide by the cost of the procedure. That's your true return on investment. When a patient gets implants after years of hiding their smile — and suddenly starts going to events they were avoiding, eating foods they'd given up, engaging with people in a way they hadn't in years — that's not a small thing. That's a life rebuilt. The investment in quality dental care pays dividends that compound over a lifetime.

I once saw a patient who hadn't been to a dentist in years. He'd had a painful extraction done elsewhere, the fillings had fallen out, and he'd simply stopped going. By the time he came to see me, he was walking around with over $6,000 in compounding dental damage — and he'd been avoiding the dentist because he thought he couldn't afford care.

I gave him a comprehensive evaluation, built a treatment plan, and got him on a payment schedule of $90 a month. He was stunned — not just by the affordability, but by the fact that a dentist had actually sat down and explained his full situation to him instead of just patching one problem and sending him out the door. The lesson here is universal: small dental problems, left unaddressed, become expensive dental problems. A $200 filling left too long becomes a $1,500 root canal, then a $3,000 crown, then a $4,500 implant. Catching issues early — and addressing them — is almost always the less expensive path.

This surprises almost every patient I explain it to, but it's consistently true: dental insurance is designed to cover routine, preventive care very well — and major restorative work very poorly. The more catastrophic your dental situation (full-arch reconstruction, complex implants, significant bone loss), the larger the gap between what the insurance covers and what the treatment actually costs.

This is one of the core reasons Advancements in Dental Care operates as a fee-for-service practice. I don't want insurance reimbursement rates to dictate what materials I use, what procedures I perform, or how much time I spend with a patient. My patients pay directly for the care they receive — and in return, they get decisions made entirely in their clinical interest, with out-of-network company involvement in those choices. For patients navigating significant dental needs, I believe this is the honest, better approach.