James Row DMD, PC
Serving Redmond Bend Prineville Madras

Our Approach

Now that I have told you about our mission to provide "General & Implant Dentistry at its Best ... for the Smart Consumer ... at a Whole Lot Less," let me tell you how we accomplish that mission. The following  discussion boils down how we approach your dental care, and why.


 "An ounce of prevention is worth a pound of cure."  Nowhere is that more true than in oral health.    Most patients' impression of prevention is limited to dental hygiene: namely, sound home care habits and routine cleanings by the hygienist.  But prevention is bigger than that, encompassing every aspect of dental care aimed at saving the oral tissues (teeth, gums, jawbone) that support oral function ... (biting, chewing, speech) and appearance (not just your smile, but support for the lower half of your face)! So a better word to describe what's at the heart of our approach to dentistry is "Preservation." Preservation both protects what you want to keep and maintains the foundation that you need for rebuilding what you have lost, or are at risk of losing. How to put that message in everday terms? Well, I have experienced all too often that appointment when a patient has solid teeth removed because he/she has lost virtually all the bone support for them due to periodontal gum disease;  or a patient who loses a "cracked tooth"  because the fracture that was "being watched"  has now extended between the roots of the tooth, necessitating extraction, when the propagation of the fracture could have been prevented by proactively restoring the tooth with a crown.  Another example: "Don't worry about saving 'em, Doc; I can always have 'em pulled and get implants!"  But implants require ample healthy "blocks" of bone to be placed in.  By the time the patient wants to fall back on implants as a last resort, the requisite bone anatomy for an implant(s) is often attainable only  by relatively expensive grafting procedures - or may not be attainable at all!

So preservation is the cornerstone of dental care, and plays a key role in every exam, consultation, treatment plan, and procedure, whether it is categorized as preventative, restorative, or cosmetic dentistry.  


Before any dental work is performed, it is planned ... thoroughly.   Treatment planning is preceeded by careful diagnosis of the problem/condition and is done with an eye to several considerations:

Preservation - does the procedure not only stop a disease process, address a durability issue, or restore lost function, but does it help prevent their recurrance, or the occurance of another detrimental condition?

Safety - can we place an implant without impinging on other structures, like nerves, sinus, nasal cavity, or even an adjacent tooth? Can we do a bridge without overloading available anchor teeth?  Does our choice of treatment square with the patient's medical conditions, or will our results be compromised or prove unattainable .. or even worse, present a health hazard to the patient... given their local or systemic biology?

Function/Effectiveness -  to what extent can we restore or preserve everday functions of  biting, chewing and speech? How lasting will our cosmetic improvements be? Is a "good Plan B" preferrable to an "iffy Plan A" (such as removing a tooth and placing an implant rather than performing a root canal and crown when the long term durability of the tooth is questionable)?

Aesthetics - although the visual impact of dental treatment (even if it is only what the patient sees when he/she brushes her teeth each morning) rarely is not a consideration, the extent to which it factors in can differ widely. It's obvious that the aesthetic demands of a downtown real estate agent  are typically greater than that of a oil roughneck working offshore.  What is not quite as straightforward is, within every patient's parameters of time, cost, and effort, the results that everyone envisons. Clarifying treatment options and intended results before starting to work is crucial.

Cost -  I never encourage a patient to proceed with treatment they cannot afford. Even as I present the range of treatment options,  I make no bones about recommending the best option for long term preservation of oral function and appearance, and I will encourage a patient to consider carefully their investment in dental care.  But the patient determines what is affordable, and it's our job, within the parameters set by the state dental board,  to skillfully and respectfully deliver the very best results their decision allows.

Involvement - of all concerned.   It is essential to me and my staff that you understand your dental situation, the treatment options available, the risks associated with those options, and have your questions/concerns thoroughly addressed before any treatment is commenced.  The dental community knows this as PARQ: Procedures, Alternatives, Risks, Questions.  Our idea of taking PARQ seriously is to conduct visually, as well as verbally, oriented consultations. If a picture is worth a thousand words, reviewing a  Dental CT scan...with 3 dimensional information...with you can be invaluable. I know that sometimes reviewing treatment options seems like too much information, and the patient responds by saying "you're the doctor; do what you think is best!"  But it is critical for patients to understand and participate in their treatment choices. To that end, please understand that my staff and I don't mind explaining it as many times as you need to hear it: ask all the questions you want, and avail yourself of the educational resources on this website and elsewhere in the process.  Let's make sure we are all on the same page with what we are trying to accomplish!


We strongly encourage them, whether I am providing one, or we are recommending our patient seek one by another doctor.  Although many patients seeking a second opinion from me express concern about the validity of the treatment recommended by the primary dentist, my experience is that their dentist's recommendation is usually well within the acceptable range of treatment options (what we call in dental lingo "The Standard of Care").   This underscores the fact that in dentistry, a bonafide multidiscipline profession, there is often more than one right answer.  The second opinion allows a patient to explore the breadth of solutions without denigrating either practitioner.  If I confirm the primary dentist's diagnosis and treatment plan, we typically recommend the patient return to that dentist for ongoing care. When our patient is seeking a second opinion, we forward their records (xrays, chart notes, treatment plans) at no charge (the only exception to this is the Dental CT scan, since our  free implant consultation has occasionally resulted in individuals "seeking" our services only for the purpose of getting a bargain on a typically expensive x-ray procedure. 

The bottom line on the second opinion issue is that the patient's comfort and confidence are at the top of our list, and our efforts are honestly geared towards promoting that.


While I don't skimp on materials or technology, our practice is a "lean" operation. If you see us hustling around the office it's because we don't hire two people to do one job. And although we have "nice digs," we don't have a 300 gallon saltwater aquarium for patients to stare at ( I left that behind in Hillsboro). Our practice is comfortable, cordial, and effective ... it's not a dental "spa." By being efficient business-wise, we keep our fees low. By equipping ourselves with state-of-the-art technology and capabilities, we provide premium care. By being "regular folks" who are good at providing excellent dental care at exceptional value, we aim to maintain the patronage of "regular folks" who are like-minded in their approach to dental health.


That was lot to read and think about, and I appreciate your putting forth the time and effort to do it. We are eager to answer your questions, meet (and, yes, it's not unusual for a patient to say "wow, that turned out better than I could have imagined") expectations, and have a mutually rewarding association spanning many years. Please give us a ring at 541-526-0019 or drop us an email at DrRow@live.com, and let's get started!

Cordially,  James Row DMD


View More