dental scams you've known and loved

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socca
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dental scams you've known and loved

Post by socca » Wed Jul 27, 2011 5:13 pm

Back when I was 31, I switched dentists because my former dentist was charging a few dollars above what my insurance company considered 'customary' for routine preventative care. My new dentist promptly claimed to have found 4 cavities (up until then, I had never had a cavity), and I let him fill all of them. I consider that to be one of stupidest things I've ever done. :) At the very least, I should have gotten a second opinion. Later, I switched back to the former dentist (an old guy - had been in the biz for many years), and he was surprised at all of my new dental work.

Flash forward to today. I'm 48 - no dental/oral problems of any kind during the last 17 years, except for some minor gum recession which has been stable the past few years. I recently went from being self-insured for dental work for being insured by AETNA, simply because they offered dental coverage as an addition to my medical coverage at the ridiculously low price of $10 / mo. Unfortunately, my dentist of the last few years doesn't accept insurance because he claims that the insurance payouts are too low. So, today I visited a new dentist who accepts AETNA insurance. This dentist claims that I have a cavity and periodontal disease, and wants me to undergo a pricey treatment. Have I heard this story before? :)

I'm heading back to my previous dentist for a second opinion. I may end up canceling the AETNA insurance and going back to being self-insured if my previous dentist disagrees with my new one.

Moral of the story: it's a jungle out there, folks! 8-)

dhodson
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Post by dhodson » Wed Jul 27, 2011 5:34 pm

its impossible to know if there is any real foul play at work here. Many people have some dental problems as they get older but not everyone does something about it. The degree to where it becomes an issue that you pay a dentist to do something varies from person to person and dentist to dentist in regards to recommendations. There seems to be very little agreement in that field about what needs to be treated and how or when and costs are completely whatever the market will pay. i personally have felt dental insurance to be worthless for my family since it is almost like prepaying for routine stuff and not enough of a discount on real problems. wish you the best with your decisions.

hicabob
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Post by hicabob » Wed Jul 27, 2011 5:53 pm

Nowadays most dentists have in mouth cameras and can show you the cavity - my dentist says the grapic image from the camera can work very well as a sales tool for a reluctant patient.

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Cloud
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Post by Cloud » Wed Jul 27, 2011 5:58 pm

socca, I agree with you completely. My dentist is great and I've been going to the same office for 40 years. My wife's dentist always wanted to do work on her so I had her switch 15 years ago to my dentist. She's had nothing but cleanings ever since and her teeth are fine. Her old dentist was a scam artist performing tons of unnecessary work.

kbrinaldi
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Post by kbrinaldi » Wed Jul 27, 2011 5:59 pm

If you grind at night, don't get the "custom molded" super expensive mouth guard the dentist recommends. They can run around $400.

Instead go to Rite-Aid or your local pharmacy and you can mold one yourself for $10-$15. Doesn't last as long, but the $400 one only lasts twice as long.

MWCA
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Post by MWCA » Wed Jul 27, 2011 6:09 pm

I like my dentist. They tend to push for things though. They want you to use the latest and greatest thing they went to a seminar for. Just like any other business they try to up sell.
We are all worms. But I believe that I am a glow-worm.

scouter
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Post by scouter » Wed Jul 27, 2011 6:39 pm

Many years ago our dentist bought a new "Panaflex" x-ray machine that x-rays your entire mouth in one 180 degree sweep. He immediately scheduled all patients to have one every year in addition to their regular bite-wing x-rays. It was obvious to me that this was driven by the desire to pay the machine off and get into the black with it.

I balked and would allow only bite-wing x-rays, every two years.

(Otherwise, he's a great dentist, but I haven't had a cavity in almost 30 years.)

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SVariance1
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Post by SVariance1 » Wed Jul 27, 2011 6:43 pm

My experience has been that dentists are very aggressive when it comes to doing extra work. Not sure why, I have not had the same experience with doctors.
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cheesepep
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Post by cheesepep » Wed Jul 27, 2011 6:59 pm

Never go to a periodontist for a cleaning unless you really have to. Going to a normal dentist is sufficient. I was "mandated" to go to one (recommended by my ortho) before by my orthodontist and despite having good teeth (admittedly not perfect), the periodontist wanted to do all sorts of (expensive) stuff on me.

I fell for the trick once but not again when I was asked to go again a few months later. I think my ortho and perio have some sort of profit sharing plan together.

dhodson
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Post by dhodson » Wed Jul 27, 2011 7:31 pm

SVariance1 wrote:My experience has been that dentists are very aggressive when it comes to doing extra work. Not sure why, I have not had the same experience with doctors.
I consider it more difficult for doctors to get away with such things. There are more established standards of care for most conditions and insurance wont pay for things they dont think is a requirement. Additionally, the environment from a malpractice and licensure standpoint makes it such that there might be more at stake to lose. As a disclosure, i am a physician so i want to point out that i could have bias even though i try hard to minimize it.

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norookie
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Post by norookie » Wed Jul 27, 2011 7:54 pm

:D I get a minimum of 2 diagnosis from Drs these days. Why would I omit DMDs? FWIW I stayed with one discharged .gov service Dr in private practice at a private hospital for a decade. That decade lessened my lifespan by a minimum of 1 decade due to that DRs incompetence and my trust. Do I tell my new MGH Drs this , yes. What comes around goes around, he's now battling health issue's. I cringe when I consider all the "troops" he's treated.
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Opponent Process
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Post by Opponent Process » Wed Jul 27, 2011 7:58 pm

still not sure about my ruptured & impacted wisdom teeth. my current dentist is agnostic, which makes me trust him, but doesn't help me make a decision.
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imagardener
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Post by imagardener » Wed Jul 27, 2011 8:02 pm

In the last 10 years going to the dentist changed, now it seems they've all taken sales classes and I'm the captive audience. My MD never upsells me like the dentist (3 different ones due to moves) and what's with the visits every 3 months? Ridiculous.

I had some necessary implants done 5 years ago and since then every new dentist acts disappointed that they weren't involved and looks for new things to do.

socca
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Post by socca » Wed Jul 27, 2011 8:10 pm

FWIW, my 'new' dentist works here:

http://www.aspendental.com/

I wasn't aware that there is any company trying to establish a national chain of dental offices until AETNA's website sent me to Aspen Dental, so I was curious to take a look at a typical operation. Does Aspen Dental want to be the McDonald's of dental care?

One curious thing: my dentist didn't make the diagnosis of periodontal disease, the hygienist did. And the way she did it was very clever: she assigned good numbers to most of my teeth/gums, and then said how wonderful my mouth was. Then, she claimed she 'forgot' a few of my teeth, and ran off a list of bad numbers. She then claimed that I need a $600 periodontal treatment for the bad teeth/gums. Forgive me for being suspicious, but it's possible that she was trying to win my trust with this approach. Well, it didn't work.

It's possible that Aspen Dental uses preventative care as a loss leader to sell dental services that clients sometimes don't need. When I asked to just schedule a cleaning and skip the special treatment, the business manager was adamant that I have the periodontal treatment. Remember, I'm not a patient, I'm a profit center. :lol:

BTW, I briefly had a dentist who provided magnified fiber-optic live video of my teeth & gums. Now, that's the way to go!! :)

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House Blend
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Post by House Blend » Wed Jul 27, 2011 9:07 pm

If a large university is nearby, I recommend looking into whether any dental faculty have a practice on the side. These are the folks with the expertise to train new dentists. And they aren't as focused on the baby-needs-a-new-yacht upselling techniques. If they were, they would be practicing full time instead of working in academia.

Worked out great for me.

rylemdr
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Post by rylemdr » Wed Jul 27, 2011 9:18 pm

My aunt is a dentist and she tells me they are very aggressive with sales. They have a lot of tuition to pay back after dental school and they make a lot less than doctors while having almost the same student loan burdens after graduation.

You know those toothbrushes and other freebies they give you after your appointment? Well they make money out of those too by charging it with the procedures they give you. :lol:

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burgrat
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Post by burgrat » Wed Jul 27, 2011 9:48 pm

cheesepep wrote: I was "mandated" to go to one (recommended by my ortho) before by my orthodontist and despite having good teeth (admittedly not perfect), the periodontist wanted to do all sorts of (expensive) stuff on me.

I fell for the trick once but not again when I was asked to go again a few months later. I think my ortho and perio have some sort of profit sharing plan together.
Cheesepep, the orthodontist is just covering his rear, liability-wise. The #1 source of lawsuits in orthodontics is undiagnosed periodontal disease. A periodontist can diagnose this, that is his specialty. If the orthodontist starts moving your teeth with braces and they are compromised because of periodontal condition (gum or bone recession), there is a risk of the condition worsening and even possibly the loss of a tooth/teeth. It is prudent to get clearance from the other specialist to assure that the condition is under control. This usually requires regular visits to the periodontist to make sure good health is maintained and the condition is not getting worse. Simply put, this is not a profit sharing plan, it's an "I want to make sure I don't get sued plan."

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White Coat Investor
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Post by White Coat Investor » Wed Jul 27, 2011 9:59 pm

imagardener wrote:In the last 10 years going to the dentist changed, now it seems they've all taken sales classes and I'm the captive audience. My MD never upsells me like the dentist (3 different ones due to moves) and what's with the visits every 3 months? Ridiculous.

I had some necessary implants done 5 years ago and since then every new dentist acts disappointed that they weren't involved and looks for new things to do.
3 months! Wow. I found it interesting that most dentists recommend every 6 months, but when I was in the military they had us come in once every 12, and they never seemed to have much to scrape off my teeth. I concluded that every 12 was fine.
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fishndoc
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Post by fishndoc » Wed Jul 27, 2011 11:16 pm

A few years back, my wife's dentist retired, and on her first visit to her new dentist, she was diagnosed with periodontal disease and referred to a periodontist. After about $2k of work, I later find out the periodontist is the new dentist's husband (different last names, and never mentioned by either of them).

Recently one of my neighbors went thru the same story with the same dentist and same referral - she was smarter, and got a second opinion before she allowed the periodontist to do the work. The second opinion: no periodontal work needed!

So, even physicians can be ripped off by other medical professionals.
We should have gotten a second opinion.
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moolman
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Post by moolman » Thu Jul 28, 2011 12:58 am

I'm a pharmacist but I work for a big insurance company. If a MD tried to charge for weird or unnecessary procedures, it's difficult to get away with it because a lot of it is actually audited by the insurance company, mostly nurses, and they will call, you give a bad reason, we as the insurance company is not paying up. Also, many plans are capitated, meaning the physican or physician group is getting a set amount of money for each patient every month, regardless of what the patient does or spends, so it's actually better if they do less for you in this instance. The more they do, the more money they lose, so you better insist on some things, if your MD is being cheap about it.

As for the dental side, have you noticed the yearly cap. Look at Delta Dental, $1500 max a year. A bad dentist can easily max that out and then you are on the hook for it, so it's pure cash for them at that point. More incentive to rip people off with the mysterious cavities, deep tissue teeth cleaning, extra whitening, etc.

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kramer
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Post by kramer » Thu Jul 28, 2011 2:53 am

EmergDoc wrote:
imagardener wrote:In the last 10 years going to the dentist changed, now it seems they've all taken sales classes and I'm the captive audience. My MD never upsells me like the dentist (3 different ones due to moves) and what's with the visits every 3 months? Ridiculous.

I had some necessary implants done 5 years ago and since then every new dentist acts disappointed that they weren't involved and looks for new things to do.
3 months! Wow. I found it interesting that most dentists recommend every 6 months, but when I was in the military they had us come in once every 12, and they never seemed to have much to scrape off my teeth. I concluded that every 12 was fine.
I think a lot of this depends on the individual's mouth chemistry. (hopefully a dentist can chime in) The worldwide standard seems to be closer to once a year (I have visited dentists in 4 countries). I have decided about once every 8 months is fine for me, and that is just because the price is cheap abroad. If I was stuck paying retail for dentistry in America, I might go closer to every 10-11 months. But apparently I am lucky in my mouth chemistry, no problems, no excess plaque build-up. So far, I have not had problems with bogus recommendations. However, I have always researched dentist choice via recommendations of others.

Kramer

Carl53
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Re: dental scams you've known and loved

Post by Carl53 » Thu Jul 28, 2011 6:15 am

socca wrote:Back when I was 31, I switched dentists because my former dentist was charging a few dollars above what my insurance company considered 'customary' for routine preventative care. My new dentist promptly claimed to have found 4 cavities (up until then, I had never had a cavity), and I let him fill all of them. I consider that to be one of stupidest things I've ever done. :) At the very least, I should have gotten a second opinion. Later, I switched back to the former dentist (an old guy - had been in the biz for many years), and he was surprised at all of my new dental work.
I had a similar experience over 30 years ago. Relocated, new job got dental employer paid dental insurance coverage, young new dentist found 4 small cavities which I allowed him to fil. A year later I switched to another older dentist, and he laughed as he exclaimed, 'who did this to you?'. Been with another dentist for 30 years in another town with never a cavity or any dental problem, just a couple of metal specks on my teeth that made somebody's loan payment.

MWCA
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Post by MWCA » Thu Jul 28, 2011 7:44 am

EmergDoc wrote:
imagardener wrote:In the last 10 years going to the dentist changed, now it seems they've all taken sales classes and I'm the captive audience. My MD never upsells me like the dentist (3 different ones due to moves) and what's with the visits every 3 months? Ridiculous.

I had some necessary implants done 5 years ago and since then every new dentist acts disappointed that they weren't involved and looks for new things to do.
3 months! Wow. I found it interesting that most dentists recommend every 6 months, but when I was in the military they had us come in once every 12, and they never seemed to have much to scrape off my teeth. I concluded that every 12 was fine.
If you have periodontal disease you need to come in more often for cleanings.
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dbonnett
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Post by dbonnett » Thu Jul 28, 2011 9:25 am

Because of periodontal disease/bone loss, I have cleanings every three months. Fifteen years ago it was thought that I would lose several teeth and require a plate. I opted against immediate extraction and decided to tough it out. My situation is stable and I still have the teeth and no plate.

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DA
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Post by DA » Thu Jul 28, 2011 10:04 am

I can't say that I've experienced any of these excesses.

I've gone to the same dentist for about 30 years. He's good and he's conservative. Yes, his fee is a little more than the insurance company's "reasonable and customary" number. I gladly pay it.

He's referred me to specialists a couple of times ... once to an endodontist for a complicated root canal, another time to an oral surgeon for a dental implant. Both experiences were good.

likegarden
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Post by likegarden » Thu Jul 28, 2011 10:40 am

Thanks for starting this thread. I came also to the conclusion that dentists are doing sales. I have 14 crowns and new dentists seem to see that as an opportunity to add more. I decided that I only get treatment when I have discomfort or pain. I will not get a rootcanal when I have no pain on that tooth. I will also not get any peridontal disease treatment when I have none of the criteria my insurance company lists for that.

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linuxuser
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Post by linuxuser » Thu Jul 28, 2011 11:54 am

My last dentist tried to scare me into getting a procedure called scaling and root planing. I had been seeing her for a couple of years and she had been trying to get me to buying an expensive electric tootbrush system from her. Then out of the blue, she tells me I needed this expensive procedure.

I immediately switched to a dentist that used to work for her and haven't had to do anything except get annual cleaning.


I also felt that I was scammed in college when the dentist I went to in the college town told me I needed a filling. I hadn't had a cavity in several years. Very suspicious.

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Yuba
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Post by Yuba » Thu Jul 28, 2011 12:02 pm

My favorite before switching dentists was the hygenist "discovered" a cavity under the top layer of my tooth by using some new fangled sonar type thing. So they needed to drill a hole to expose the cavity so they could fill it.

Sorry, not playing that game.

Rick dba Yuba

Rodc
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Post by Rodc » Thu Jul 28, 2011 12:29 pm

18 years ago my dentist thought a visit to a periodontist might be good due to receding gums. I did.

I had a bad feeling from the start: a whole sheaf of papers outlining my obligations to pay, agreeing to pay, what they would do if I did not pay... This in an upscale town where I doubt there are many payment issues unless people maybe feel they are being ripped off. Felt like I dealing with a used car salesman of the worst sort, not a professional.

He recommended a bunch of work, wanted me to agree to come back for cleanings and check ups every 3 months, blah blah blah.

I paid for the one appointment and never went back.

18 years later, no problems...
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Post by Fallible » Thu Jul 28, 2011 2:56 pm

I'm not so sure that dental "sales" are all that new. In the early '90s, a regular dentist told me I needed a new bridge because my gumline had receded. He got an insurance estimate for this very expensive work, while I got a second opinion. The second dentist said that while there was some gum recession, it was far from serious and a new bridge probably would not be needed for many years. It's now some 20 years later and no dentist I've had since then has recommended a new bridge.

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BigD53
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Post by BigD53 » Thu Jul 28, 2011 3:23 pm

When I told my dentist of 20 years that I was retiring, and would no longer have dental insurance, she suddenly recommended a flurry of various kinds of fillings/treatments, etc. :lol:

Oddly, she never suggested any extra work prior to that conversation. I always had a clean bill of health.

And the dental hygienist took me aside one day, and told me privately that it was unnecessary to have full-mouth x-rays twice a year (which they insisted I do, when I was insured.) He said having one routine x-ray every two years was more than adequate.

(and I thought only Plumbers were crooked! :shock:)

imagardener
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Post by imagardener » Thu Jul 28, 2011 4:14 pm

MWCA wrote: If you have periodontal disease you need to come in more often for cleanings.
I don't have/never had periodontal disease but they keep hoping :-)
I'll be canceling my next 3 month appointment.

Mysteryhunt
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Post by Mysteryhunt » Thu Jul 28, 2011 4:34 pm

On a similar note, anyone have recommendation on a good value/deal on teeth whitening that you have used?

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ElJay
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Post by ElJay » Thu Jul 28, 2011 5:39 pm

My dentist shows me the X-rays (scanned into a digital system) and I can see the dark spots which are cavities. He also has a camera hooked up to the computer which he can shove into my mouth to show other issues (e.g. a cracked tooth that will require a crown soon.)

He does want to sell me some sort of cancer screening light for my gums or something... I decline that annually.
Unfortunately, my dentist of the last few years doesn't accept insurance because he claims that the insurance payouts are too low.
My dentist bills me the difference between insurance and his fee.

likegarden
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Post by likegarden » Thu Jul 28, 2011 6:05 pm

Many years ago just fresh out of college in a big city in Europe I had some tooth ache and went to the wrong address, let a blue-blooded female dentist with 6 assistants fix my cavity, and they found 9 more, was an ordeal, but I learned fast. Those 10 fillings then, some probably into healthy teeth, provided future opportunities for redone fillings and probably crowns. My next dentist there knew what he was doing, corrected an underlying problem with a root canal and a crown, and that crown lasted for 40 years. Nowadays I was told that some crowns last only 2 years.

That seems to lead to some Bogleheadish concern : as a retiree, how many more fillings, crowns, implants, bridges, partial dentures, and full dentures will I have to endure over the next 15 - 20 years? As someone told me, at some date all teeth will get pulled and full dentures furnished. Until then consider the dental costs of a minimum $900 for a crown, 1250 for a root canal and 2,500 for an implant, and crowns and implants can fail, for each tooth. And there are 28 teeth, wisdom teeth not considered. Luckily my wife has very good teeth.

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Ricola
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Post by Ricola » Thu Jul 28, 2011 6:13 pm

I am also very uneasy about Dentists lately. My son went in for a 6 month and was told he had no problems. Eight weeks later he thinks he has hole or filling missing and we send him back. Now a different Dentist said his concern was unfounded, but he identified 5 cavities just on one side of his mouth and indicated that there could be just as many or more on the other side. He said this was due to not flossing. Our thinking was how could he get 5 cavities in 8 weeks. I asked to see the x-rays but the computer was not working well that day. We voiced our concern and to satisfy us they had him come into the office for another check by yet another third dentist. This dentist said he had none of the cavities identified by the last dentist, but did have 5 in other locations. Mind you this is all in the same office, they use multiple dentist and free lance dentist. The last dentist seemed to be clear enough that we went ahead and had the teeth filled but I am still very uneasy after this experience. I question how can 3 different dentist have 3 completely different diagnose of cavities? Is there a hole in a tooth or not? Is this science or not? :?:

Also another thing that makes me uneasy is seeing the dentist's cars parked in their named parking spaces. All black luxury cars with those extra pimp-my-ride wheels and stuff. :roll:
Last edited by Ricola on Thu Jul 28, 2011 6:22 pm, edited 3 times in total.

Bobalude
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Post by Bobalude » Thu Jul 28, 2011 6:17 pm

kbrinaldi wrote:If you grind at night, don't get the "custom molded" super expensive mouth guard the dentist recommends. They can run around $400.

Instead go to Rite-Aid or your local pharmacy and you can mold one yourself for $10-$15. Doesn't last as long, but the $400 one only lasts twice as long.
How long does the Rite-Aid one last?

I got the $400 (or more) custom molded one. Insurance thankfully paid for 100% of it.

It is excellent quality and fit (no free play/sliding around. I can see it lasting several years if taken care of properly. I get a new one every year but it's always in still in great shape and I don't necessarily "need" a new one.

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Post by tripleb » Thu Jul 28, 2011 6:52 pm

From a business standpoint, the term is "asymmetric information" whereby one party, in this case, the dentist, knows much more than the other party, the patient. Thus, the patient is at risk of getting screwed.

It's interesting that this thread came up today because I just had a thought about dentists myself. I am highly untrusting of dentists, and believe they are screwing themselves out of a market, industry-wide, by these practices. The less people trust dentists as a whole, the less people will be willing to go to dentists for non-necessary procedures, and the less money dentists will make, and the more dentists will have to push unnecessary procedures to make ends meet, which causes the cycle to further itself.

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Post by 3CT_Paddler » Thu Jul 28, 2011 7:00 pm

Ricola wrote:. I question how can 3 different dentist have 3 completely different diagnose of cavities? Is there a hole in a tooth or not? Is this science or not? :?:
It goes to show that experts in most fields, even in the medical field, are anything but infallible.

Here is a book excerpt from a medical doctor about overdiagnosis...
http://www.doctoroz.com/videos/book-exc ... age=1#copy

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Post by BC_Doc » Thu Jul 28, 2011 8:16 pm

Interesting thread. Readers Digest (surely up there with the New England Journal of Medicine) did an article on inter-dentist variability with respect to diagnosing dental decay several years ago. The magazine sent its poor reporter on something like 15 or 20 visits with different dentists all across North America posing as a new patient. The variability between dentists in terms of diagnosing cavities and need for dental work was huge.

The lesson from the article, and from this thread (above posts), is that if you have a gem for a dentist, keep him or her close.

I had the reverse of this problem after a cross-country move. My prior dentist, whom I have a great deal of respect, for diagnosed me with a cavity just prior to a move. He suggested I have it looked after by my new dentist in the community I was moving to. The prospective dentist subsequently examined me an said "no cavity." Six months later, the "cavity free" tooth abscessed and I required a root canal (by a different dentist!). The lesson again, I believe, is find a competent trustworthy dentist and keep him or her close!

socca
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Post by socca » Thu Jul 28, 2011 8:32 pm

socca wrote:Does Aspen Dental want to be the McDonald's of dental care?
Although I was joking when I wrote this, perhaps I wasn't so far off the mark. This is from the Aspen Dental website:
Target demographic
  • + Middle Income Blue Collar
    + Seniors
http://www.aspendental.com/about.real.estate.html

Why would these folks be going after blue collar workers instead of white collar workers like me? How would a dentist go about specializing his or her practice based on the socioeconomic class of the patient?

There was a Jaguar parked in front of the Aspen Dental office, but I have difficultly believing that it is owned by my 'new' dentist, who is a sweet young thing who looks about 15 years old. She called herself a doctor, so I guess she is ... :D

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Post by OnFire » Fri Jul 29, 2011 4:10 am

My wife is a dentist, and I agree that it sounds ridiculous that you can have three different diagnosis from three different doctors in three weeks. I know that cavaties are basically a non-money maker. A dentist gets laid peanuts (about $40) for a half hours work filling a cavity. The real money is in the root canals ($800), crowns ($1000), partials and implants ($1-3K). I'd say 1-2 check ups a year is sufficient. Again, these are loss leaders. My wife gets about $30 for a routine 15 minute check up/cleaning. It's hardly worth her time to perform unnecessarily schedule check-ups. Then again, she works in a relatively poor area with a large immigrant population where there is no shortage of people who need work. She also happens to look like she's 20, is bilingual, attractive, brilliant, and personable. Her schedule is constantly full, so she has no need to up-sell anyone.
I didn't know that there was this much outright fraud in dentistry. I am aware of a relatively high percentage of number of dentists with low skills. I had one dentist for 25 years, and my new one for five. (I love my new dentist. Literally. = )
I agree with the advice of finding one through referrals of friends/family, and to hold on to the good ones once you have found them.
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socca
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Post by socca » Fri Jul 29, 2011 6:21 am

Yesterday, I did a little recreational reading on periodontal disease. This hardly makes me an expert in the diagnosis and treatment of this disease, but it does give me a feeling for what a dentist / periodontist would be looking for.

http://www.nidcr.nih.gov/OralHealth/Top ... isease.htm
How do I know if I have gum disease?

Symptoms of gum disease include:
• Bad breath that won't go away
• Red or swollen gums
• Tender or bleeding gums
• Painful chewing
• Loose teeth
• Sensitive teeth
• Receding gums or longer appearing teeth
I don't have any of these symptoms except the last, and my degree of gum recession (which is minor and only associated with a few teeth) has been stable the past five years, as I pointed out to the Aspen Dental hygienist.

This morning, I examined my gums in the mirror with a flashlight. All of my gums appear bright pink and healthy. No sign of inflammation, no bleeding, no pain. Why did Aspen Dental want to put me on an aggressive round of antibiotics when there is no sign of infection?

I've decided that what I experienced on Wednesday was criminal malpractice and insurance fraud. Furthermore, Aspen Dental's refusal to deliver a standard cleaning must violate in spirit (and perhaps in letter) whatever agreement they signed with AETNA to become part of AETNA's network.

As I said before, it's a jungle out there ... 8-)

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DesertOasis
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Post by DesertOasis » Fri Jul 29, 2011 9:28 am

My dentist recommended scaling and planing because of some deeper than normal pockets between my gums and teeth. Since this is an expensive procedure and he was outside of my insurance network, I told him that I decided have this done at an in-network dental office to save a good chunk of money. He later contacted me to tell he would charge me the in-network rate if I had the work done at his office.

I am going for a cleaning every three months even though to me my gums appear to be very healthy. I would rather err on the side of caution when it comes to dental health.

Dagwood
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Post by Dagwood » Fri Jul 29, 2011 1:23 pm

socca wrote:Yesterday, I did a little recreational reading on periodontal disease. This hardly makes me an expert in the diagnosis and treatment of this disease, but it does give me a feeling for what a dentist / periodontist would be looking for.
socca wrote:
This morning, I examined my gums in the mirror with a flashlight. All of my gums appear bright pink and healthy. No sign of inflammation, no bleeding, no pain. Why did Aspen Dental want to put me on an aggressive round of antibiotics when there is no sign of infection?

I've decided that what I experienced on Wednesday was criminal malpractice and insurance fraud. Furthermore, Aspen Dental's refusal to deliver a standard cleaning must violate in spirit (and perhaps in letter) whatever agreement they signed with AETNA to become part of AETNA's network.
So you did some internet reading, and some self-examination, and although it sounds like you are neither a dentist nor a lawyer, you have reached the conclusion that your dental office engaged in activities amounting to criminal fraud and medical malpractice. This type of thing is Exhibit A as to why dealing with the general public is just so much fun . . . .

I would also add that while any dentist is in business to make a living, just because he or she profits from performing work does not mean that the advice has no merit. The appropriate approach would be some normal skepticism and a second opinion. But then again, oftentimes with certain folks there is a line drawn between someone asking you to spend money and that person being a thief of some sort. This type of thinking is typically the refuge of people who want to, at all costs, avoid spending money. That's fine, just don't dress up that person's cheapness as someone else committing fraud.

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Christine_NM
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Post by Christine_NM » Fri Jul 29, 2011 2:15 pm

Periodontitis can be fully reversed with scaling, 3-month cleaning, and diligent home care. The results are remarkable. But it takes a long time, about 2-3 years.

Some of you were probably scammed, but others may have been started on a regimen that would have helped if you had stuck with it.

I have a wonderful dentist who can do anything that needs to be done. He was referred to me (or I to him, not sure which) by another dentist whose skills were not so complete. It costs a lot, but if you do your part at home virtually any problems can be resolved.

BTW, those "bright pink" gums should be light pink. The deeper or brighter the color, the more inflamed they are.
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likegarden
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Post by likegarden » Fri Jul 29, 2011 2:39 pm

I am with socca. I have no complaints with my teeth, though was asked to have that periodontal work done. I was told that I have bleeding gums, have never tasted it, hygienist said they are bleeding now (after her cleaning), I said you poked them with your tool, etc. It got really silly. I understand this is not a one-time affair, but you need to have it done every 2 years.

When retirees have multi-million $ portfolios, no problem, let the dentist, periodontist and hygienist make your teeth happy, but most people do not have that much and have to reason out the need for dental work.

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Christine_NM
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Post by Christine_NM » Fri Jul 29, 2011 2:54 pm

Bernd -

No, you don't need scaling every 2 years. Insurance will not pay for more frequent scaling. But if you stay with 3 month cleaning for 2-3 years, and diligent home care, then one day the hygienist will say, there's no bleeding this time. Then you can go to 4-month cleaning.

I think home care is key. If you never let up on it, you won't need scaling again.
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DA
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Post by DA » Fri Jul 29, 2011 3:30 pm

Bernd wrote:Until then consider the dental costs of a minimum $900 for a crown, 1250 for a root canal and 2,500 for an implant, and crowns and implants can fail, for each tooth.
You forgot one ... root canals can fail too, even years after the initial procedure! The retreatment is more expensive than the first treatment.

socca
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Post by socca » Sun Jul 31, 2011 11:15 am

Dagwood wrote:The appropriate approach would be some normal skepticism and a second opinion.
I agree that I'm not qualified to accuse Aspen Dental of medical malpractice or insurance fraud, so I retract those accusations. However, after examining my teeth and gums and finding everything as it has been for the last five years, I became angry. Was my anger justified? Maybe not - perhaps my opinion that nothing has changed is faulty. Where does healthy skepticism become unhealthy skepticism? I don't know. However, my experience of 17 years ago makes me exceedingly cautious.

I earlier claimed that AETNA's $10/month price for dental coverage is (IMO) ridiculously low. Here is my justification for this characterization:
(1) AETNA's competitors in the medical insurance field usually charge around $25/month for dental coverage;
(2) My previous dentist - the one who doesn't accept insurance - charges from $99 to $129 for a cleaning and examination. The exact cost depends upon how much work the dental hygienist has to do.

With self-insurance, my annual cost for preventative dental care was about $200 / year using my previous dentist. I like to have a cleaning and exam twice per year, and my overall good oral health makes my teeth a relatively easy cleaning job for the hygienist.

I don't understand how AETNA can possibly cover 100% of a participant's preventative dental care cost while charging only $120 per year. Here are some possible explanations:
(1) AETNA is offering a teaser rate to attract new dental plan participants. The cost per year will rise substantially down the road.
(2) AETNA reimburses only a (small) fraction of what it takes a typical dentist to provide preventative dental care. The dentist is expected to make up his or her loss with non-preventative dental services.
(3) AETNA receives some kind of direct or indirect kickback (payment for order flow) for directing dental plan participants to a particular dentist.
There may be some other explanations I haven't considered.

I would rather pay more for preventative dental care if this reduces my dentist's incentive to recommend unnecessary (and expensive) procedures. So, my current inclination is to return to my previous dentist and cancel my AETNA dental coverage.

Thanks for letting me vent. :D

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