When does a second opinion make sense?

• A large or costly plan, such as several crowns, an implant, or work on many teeth at once.
• Treatment that can't be undone, like removing a tooth or filing down a tooth for a crown.
• You can't see the problem. You've asked to see the X-ray or photo, and it still isn't clear what's wrong.
• A new dentist finds a lot that your last dentist never mentioned. New X-rays or changes since your last visit can explain it, but a second look is reasonable.
• Only one option is offered for expensive work, with no mention of alternatives or what happens if you wait. Sometimes there really is only one good option, and it's fair to ask why.
• Your health makes treatment more complicated, or the problem keeps coming back after treatment.
• You feel rushed to decide on something that isn't urgent.
• You and the dentist aren't communicating well, and you'd like to hear it explained another way.

Routine care, like a cleaning, a checkup, X-rays at the usual interval, or a small filling, rarely needs a second look.

Don't delay urgent care to get one. Pain, swelling, or signs of infection should be treated now. Trouble breathing or swallowing, or swelling that's spreading, is an emergency: go to an emergency room. You can get the urgent problem handled first and ask about the rest of the plan later.

Most dentists are used to second opinions. The American Dental Association's code of ethics asks dentists to consult or refer when another dentist's skills would help the patient, and to give patients copies of their records and X-rays when asked.

Still, few people get one. Consumer Reports found that only about a quarter of Americans have ever gotten a second opinion on recommended dental work. If you're unsure, you're in good company asking.

• Another general dentist for most treatment plans.
• A specialist who focuses on that kind of treatment: an endodontist for root canals, a periodontist for gum treatment, an oral surgeon for tooth removal, a prosthodontist for complex crowns, bridges, and implants, an orthodontist for braces, or a pediatric dentist for a child's treatment.
• A dental school clinic, where students are supervised by faculty dentists. Visits often take longer and often cost less.

The second dentist may offer to do the work. That's normal. If you'd rather hear from someone with nothing riding on the answer, say up front that you're only looking for an opinion, or try a dental school clinic. Either way, keep the focus on what they see and why.