To Fill or Not to Fill? Our Practice Philosophy in a Nutshell

Happy December! We wanted to take some time to share our practice philosophy and how we make treatment decisions here at Potrero Hill Dental. It’s important for us that our patients understand our practice philosophy and how preventative and minimally invasive dentistry (and even medicine) is changing the landscape of healthcare and treatment recommendations today.

Dentistry as a profession has adopted a more preventative, minimally invasive approach in the past decade, especially here in the United States. As technology advances (just to name a few things: stronger dental materials, better diagnostic equipment, magnification and light aids for the dentist), we have significant improvements in our ability to diagnose and treat dental disease. Our goal with a minimally invasive approach is to conserve as much natural, healthy tooth as possible for the entire life of the tooth by focusing on education, prevention and restorative procedures that are based on “caries risk”. 

Caries risk is a measure of a patient’s susceptibility to dental disease, namely developing cavities. This assessment is made after a thorough evaluation of each individual’s diet, hygiene and history of cavities, both active decay lesions and the number of previous fillings. Based on this caries risk, we decide which cavities, if any, need to be treated. Not all small cavities need to be filled right away. The long term goal is to help our patients preserve as much healthy tooth structure as possible by implementing preventative or smaller procedures when needed. This can improve the patient’s dental health over time. It is also a significantly smaller financial burden than more invasive procedures down the road, such as root canals and crowns, which are needed when decay is more extensive.  

To get a little more technical – Dentistry as a profession used to be much more reactive and only treat problems once there was a larger problem. This made sense at the time since older silver fillings needed a minimum requirement of a certain depth and size to withstand chewing forces, sometimes necessitating removal of healthy tooth structure to achieve an ideal form. So, dentists often would wait until the decay was deeper to meet and justify the requirements of the filling materials. Nowadays, new bonding techniques and tooth-colored composite resin fillings allow for much smaller and conservative restorations, which ultimately result in the removal of less tooth structure. Since dental cavities are an infectious disease process caused by bacteria, we believe it makes the most sense to reduce the risk to healthy tooth structure by removing the infected portions of the tooth when the cavity has reached the dentin (or second layer of the tooth. We can go on (and on and on) about the technicalities here, but we’ll save you the dental anatomy lesson for now! Although we’re always happy to continue the discussion, just let us know.)

We understand it can be confusing and frustrating when different dentists come up with different treatment recommendations. Some diagnoses are subjective and there is a range of when to intervene and treat a tooth; thus, not every dentist may agree with our treatment recommendations. However, as technology advances and materials continue to improve, it is hard for us to justify leaving decay that will only progress deeper into the tooth and create the need for larger fillings, which can compromise the tooth’s structural integrity. We want to be clear – our goal is not to fill every small superficial cavity. We take a patient-centered, risk-based approach in developing treatment plans for our patients. For example, in a patient with excellent hygiene and low risk factors for cavities, we feel comfortable watching smaller, superficial cavities and look for ways to help remineralize or arrest the progression of decay. We have patients with teeth that we have been watching for years. On the other side of the spectrum, in a higher risk patient, we need to remove the bacteria and infected areas more proactively in order to achieve a healthy oral environment. When we say we take a patient-centered, individualized approach to our care, this is what we mean.

Generally, we find that the science and clinical evidence supporting minimally invasive dentistry is sound, and we apply this philosophy to our practice. Our primary dedication is to our patients and improving their oral health to the best of our ability. We would never recommend more treatment than we genuinely think is necessary or complete treatment that is more harmful to a patient’s oral health - it’s just not who we are.

Thank you for reading and we welcome the opportunity to discuss this topic in more depth with those who are interested!

We're home!

It's been a while, PHD blog!

Just stopping in to say that we are open in our new space in Potrero Hill. We had our open house in September, almost exactly one year from the date that the fire happened. 

Come visit us at our new home in the Potrero 1010 building between Boba Guys and the Mission Bay medical campuses! To schedule an appointment with us, please use our online booking system, call us at 415-890-4449 or email us at 

See you soon! 


Local 22 Protests

To our patients, colleagues and neighbors, 

Some of you may have noticed the signs, flyers and super-sized Grim Reaper from the Local 22 Carpenters Union protesting the construction of our new office space. First of all, we apologize for any inconvenience this may have caused you. We truly appreciate all of your loyalty and support these past 6 months as we traveled between temporary offices since being displaced by the fire in our original office in September. Since the beginning of this year, we secured a long term temporary location that has allowed us to see patients until we move to our new office back in Potrero Hill. We started construction in the new space a couple weeks ago, and then found out today we are the target of a very misleading labor union protest. 

We want to make it very clear that our professionalism, ethics, clinical work and our employee standards are not being questioned. Despite what the flyers and posters depict, Potrero Hill Dental has no labor disputes with any members of our dental team. Nancy and I stand by our practice and want to let you know what is going on. 

Local 22 is a local carpenters' union that protests both big and small businesses in San Francisco (see here) to use union carpenters. They are not happy that our general contractor, Barber Construction, who specializes in medical and dental offices in the Bay Area, does not use union carpenters/subcontractors in all of their projects, not just in San Francisco. In the words of the Local 22 field representative - "Our fight is not with you." Their fight is with all the general contractors who don't pay area standard wages aka union wages. Actually, at the root of it, their fight is with the SF Planning Department, who determines who is allowed to build in a given location(union vs nonunion). 

Nancy and I are confident in our partnership with Barber Construction, who built our original office on Vermont St. We pay fair market-value for their expertise and we continue to use them because they have worked with the same subcontractors for years and have great relationships with them. Specifically, our millwork subcontractor, whose exceptional carpenters make our cabinets, is family-owned and operated, and the family has even volunteered many extra hours to help us salvage our office from the fire damage. Further, Barber Construction has a very specific knowledge on dental build-outs and knows how to deal with dental specific plumbing and equipment issues, which is not the case with any contractor. 

We sincerely feel that the Local 22 protesters have misplaced their efforts, targeting a struggling small business. Despite our conversations with the union representative to explain our situation, the union doesn't care that we are a new small business trying to bring a health service to a neighborhood that does not currently have easy access to dental care. They also don't care that we are struggling to rebuild our dental practice after a devastating fire only 6 months after we opened. It feels like someone is kicking us when we are already down. 

To be completely transparent, Nancy and I have put everything we have into our practice. We are small business owners, not part of any larger dental chain or franchise that would prioritize profitability over patient care. We are the first dentists in our families -- our parents were immigrants, teaching us by example that hard work, honesty and determination were what we needed to succeed. We don't come from wealthy families or from a dental business background, and we have a significant chunk of our student loans left to prove it! 

At PHD, we put our patients and our employees first. Our dental team is our most valuable asset, and we respect and value each member of our practice -- that is why we have an incredible dental team that has supported us, even through moving in and out of five different temporary locations and dealing with scheduling curveballs. Local 22's signs about labor disputes are highly misleading -- we have no labor disputes with any of our employees. They are just as stunned as we are to be the target of these protests. 

If you have any questions or concerns about the protests, please let us know. We are happy to discuss with you. At the end of the day, despite all of the negative events this past year, our goal is the same as when we first opened this business, which is to provide high quality and honest dental care to the best of our ability - and that is what we will continue to do. 

Thanks for reading!


Jane and Nancy 

Office update

Happy holidays from Potrero Hill Dental! We are back on our feet seeing patients in a temporary office in 490 Post St., near Union Square in downtown San Francisco. To schedule an appointment with us, please call us at 415-890-4449 or email 

We hope to be back in Potrero Hill by early spring 2017. Thank you for all your thoughts and support during this rebuilding phase! 

Fire in office building

We are so sad to share news that on September 21, a fire broke out in the condo unit above our office. Thanks to the quick response by SFFD, no one was hurt and there was no fire damage to the office. However, due to the water damage the office suffered, we will be closed until further notice. We apologize for any inconvenience this may cause, and we are doing our best to contact all patients who are currently scheduled to make appropriate changes. We can be reached via email at

Potrero Hill Festival 2015

We had a great time at the Potrero Hill Festival last Saturday! There was a great turnout, and meeting all the neighbors makes us very excited to open in January. 

Both the Sonicare Diamond Clean and the Zoom In-office Whitening treatment went home with some lucky wheel spinners! 

A special shout out to our support group - We couldn't have done it without you guys! -- Tim (Jane's husband), Richard (Nancy's brother) and Nick (Nancy's fiance). Thank you!

Why a Dental Office in Potrero Hill?

Sometimes in life things happen by chance - and that is exactly how we found our future home.

I was looking for a space to build a dental office in the Bay Area for about a year, but when a potential space fell through, I took it as a sign and put my search on hold for a few years to focus on my family.

Fast forward to a few months ago, my fiancé Nick and I were headed to Aperto for dinner (had to get my spicy Tagliolini fix, yum!). I saw an online posting for a vacant retail space on the Hill -- it wasn’t on the market yet, but something about it caught my eye. Since we were a little early for our dinner reservation, we took a detour to look at the space.


The office space was gorgeous -- floor-to-ceiling windows with the unique charm and character of a San Francisco building. The minute I stepped out of the car, I knew this was the place I was waiting for. My boss used to tell me that when you find the home of your future office you will just know. I didn’t believe her- but at that instant, I knew. And Nick knew, too. I remember looking at him and saying- “This is it, this is what we have been looking for!” So excited about the prospect, I texted Jane immediately. We were going to meet for breakfast the next morning and without hesitation she agreed to go see the office afterwards.

The next morning, at 8:01am, I called the landlord and left a message. While Jane and I were at breakfast, he called back and told us there was a need for a dentist in Potrero Hill and that he was available to show us the space in 30 minutes. We scarfed down the rest of our food and hurried over to meet him. I don't remember much from that moment, except that the minute he opened those doors, we couldn't stop grinning from ear to ear. 

Not only was the space beautiful and perfect for our office, we knew we had found a great partner and advocate in our landlord. He is not the typical landlord - he is a down to earth, friendly guy and his sincerity showed through when he told us his one main requirement was he wanted a tenant who could serve the community. The building had not changed tenants since 1920, when it was the neighborhood butcher shop, then grocer, then convenient mart. Since there is no dental office in Potrero Hill, we mutually felt it would be the perfect fit.  Not only did we find a location we love but we found a place that is underserved within San Francisco- an ideal space for us to be able to focus on what we originally went into dentistry to do - help, care for, and improve our patients’ oral health.  

I think we took the landlord by surprise based on how fast we moved after that. We were determined to make it our future home and got all our ducks in line to make it happen. Now, 4 months later, I’m happy to announce we are 2 months into construction and ecstatic to join such a tight knit, friendly, and loving community. We have been met with nothing but support from family, friends, and neighbors and we are so excited to be able to say that Potrero Hill Dental will be opening its doors to the community this winter!

- Nancy