Why are Some (Most?) Dentists Con Artists?

EastWest Gal said:
I’ve never had issues with a dentist. Call me lucky. I called my dentist 10 years ago on a Friday night when I seriously cracked a tooth. Got a call back right away. We met on Saturday morning and he fitted me for a crown. No assistants, no ancillary staff. Him in his jeans, me in mine. Maybe $1000. Insurance covered some of it. The care I received was priceless.

None of us have had fillings for years and years, or major work ever. No root canals. DH has gum issues and gets more frequent cleanings. DS is nearly 31. He has never had a cavity, nothing except his every 6 month cleanings. He started with this dentist when he was seven.

In my last check up the dentist, hygienist, and I had a lively discussion about marketing of toothpastes, and the active ingredients. We also discussed their experience with tooth fractures, and that many are crack lines, like porcelain, which never cause problems. His attitude is: if it ain’t broke, don’t fix it. We have an honest dentist. Yay!
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And you are very lucky you can stay with 1 dentist the last one I had was since I was 10 so I really feel it now
 
EastWest Gal said:
We have an honest dentist. Yay!
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I've been lucky too with dentists, never have run into any of the issues so many report on here.

That said, if I was a dentist a physician of any specialty is not exactly the person I would pick out to try to fool.

Like a friend of mine is an airplane mechanic and takes his car to a dealership. They know his occupation and thus don't try any foolishness with him as he'd spot it from, well, 30,000 feet away.:angel:
 
UPDATE: I got my 6 month cleaning and exam a couple of weeks ago, and other than 3 pockets that are 5mm all my teeth are 2's with some 3's. Another clean bill of health from the new dentist.

If I were still at my old dentist I'm sure I would be getting the same dire warnings about how I need to get gum flap surgery. The b@stards!
 
My DW and I went to our dentist for a cleaning. They will not clean without a full exam and they insist on full bite wing every 2 years. I refused the xrays, and they said they would let it go only another 6 months. My wife of course needed their $65 worth of nitrous oxide, and while under the influence they talked her into full xrays, even though she was just there a few months ago, long story, where they charged her for a 3 crown bridge. So when we checked out, they insisted I needed to spend $650 on a night guard. Of course they found a dark spot under a crown for my wife and were insisting that she needed a new full crown restoration. They did not suggest anything less, BS.

I pulled out my old night guard and will try to soften it and reshape, as it almost fits. I have a $10 hot water formed night guard which would also work as well.

OH I forgot, this office was taken over by a new guy and they still have the Advantage plan for those without insurance........supposed to be a big discount but they start with a high price for work that is questionable to be needed.......
 
Qs Laptop said:
UPDATE: I got my 6 month cleaning and exam a couple of weeks ago, and other than 3 pockets that are 5mm all my teeth are 2's with some 3's. Another clean bill of health from the new dentist.

If I were still at my old dentist I'm sure I would be getting the same dire warnings about how I need to get gum flap surgery. The b@stards!
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+1

I've been battling this as well and wanted to report. The local practice that we were patients of were bought out by a larger practice. Suddenly, while we have been having routine exams and cleanings for over a decade, suddenly our pockets were deeper and we needed all sorts of expensive work to be done or the sky would fall. This happened to a friend, DW and then to me... basically the same script for each of us. For me they proposed $4,500 of work that because I was a "member" I could get for the bargain-basement price of $1,500.

Because of what had happened with my friend and DW, I was prepared and told them that I needed to think about it and get a second opinion.

Last week I had my first appointment with my new dentist. A couple 4mm pockets but all the rest were 1, 2 or 3mm. They did an exam and claening for $210.
 
pb4uski said:
+1

I've been battling this as well and wanted to report. The local practice that we were patients of were bought out by a larger practice. Suddenly, while we have been having routine exams and cleanings for over a decade, suddenly our pockets were deeper and we needed all sorts of expensive work to be done or the sky would fall. This happened to a friend, DW and then to me... basically the same script for each of us. For me they proposed $4,500 of work that because I was a "member" I could get for the bargain-basement price of $1,500.

Because of what had happened with my friend and DW, I was prepared and told them that I needed to think about it and get a second opinion.

Last week I had my first appointment with my new dentist. A couple 4mm pockets but all the rest were 1, 2 or 3mm. They did an exam and claening for $210.
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My dentist put me on 5000 ppm fluoride tooth paste ($25/tube - but lasts 3 months.) Got all my "pockets" back in line AND left my jeans pockets almost full. I'm not a dentist, so check with your professional, but I'd suggest maybe try that first (YMMV.)
 
pb4uski said:
+1

I've been battling this as well and wanted to report. The local practice that we were patients of were bought out by a larger practice. Suddenly, while we have been having routine exams and cleanings for over a decade, suddenly our pockets were deeper and we needed all sorts of expensive work to be done or the sky would fall. This happened to a friend, DW and then to me... basically the same script for each of us. For me they proposed $4,500 of work that because I was a "member" I could get for the bargain-basement price of $1,500.

Because of what had happened with my friend and DW, I was prepared and told them that I needed to think about it and get a second opinion.

Last week I had my first appointment with my new dentist. A couple 4mm pockets but all the rest were 1, 2 or 3mm. They did an exam and claening for $210.
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These bogus diagnoses are an area that is ripe for the Attorney General of umpteen states to look into. It's not even debatable that people are getting conned out of thousands of dollars on a daily basis. Furthermore, half the time the patient is put under and isn't even aware what is being done to their teeth. It's possible that you could be told you need gum flap surgery, wake up with some stitches in your mouth and sore gums and who knows what was really done? Maybe they knocked you out, put in some stitches, and woke you up two hours later. Then, at your next exam 4 months later, MIRACLE! All your pockets are 2's and 3's!
 
I visited a new dentist today for an overall evaluation. I am aware that my mouth needs restoration work. I had another evaluation done just a month prior, so I wanted to compare recommendations.

As she wrapped up, she gave me her recommendations - most of which aligned with what the other dentist had recommended - with the following exceptions:

(1) One of my crowns that sits on an implant, is loose and wiggly. The prior dentist recommended a whole new crown.
The new dentist: let's tighten it first, that may be all it needs. If that doesn't work, we can do a crown.
(2) The prior dentist recommended bonding on my two front teeth - due to some chipping there, for aesthetic purposes.
This dentist said - well, we could file the teeth slightly to even them up - or we can do bonding, but be aware, the bonding chips too - so you will still have chipping issues. I asked her why she thought he recommending bonding - her answer? "because repairing chips on natural teeth or bonded teeth is a way for dentists to make money".

Ok, so differences can be expected I guess, but I'm wondering how much of dentistry is the art of making money vs. the science of keeping teeth in as a good shape as possible, for as long as possible.
 
Just a side comment, before gum surgery, I would recommend reading the work of Dr. Jorgen Slots, periodontist and researcher out of LA. Not telling anyone what to do, just suggesting a reference that could end up saving you bunches of $$ and time and pain and whatever.
 
While on the topic of dentistry, any thoughts as to whether one type of crown material is better than another? zirconium vs. ceramic/metal and of course, good old gold for the back teeth. I am not aware of other materials.
 
I will check out the gum surgery recommendations thanks.

IDK about crowns but I hope someone is able to help. My dentist said my ceramic metal crown was not "the good kind" but its 15 years old and not causing issues so it seems pretty good to me! I kind of thought "the good kind" might be the one that earned her money rather than it already being there.
 
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SunnyOne said:
While on the topic of dentistry, any thoughts as to whether one type of crown material is better than another? zirconium vs. ceramic/metal and of course, good old gold for the back teeth. I am not aware of other materials.
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I had the pleasure of having two crowns last Fall.
One on a canine tooth because I tripped, fell, and broke it. My dentist did the ceramic/metal because it was a front tooth and he said that was easier material to match the color of my other teeth. It does match my teeth perfectly.

Then a month later I had a back molar chip due to a large cavity filling it had cracked and then finally chipped.
Same dentist suggested zirconium for the crown because it is stronger material and you bite down harder with molars and exactly matching other teeth isn’t as important. It was $50 more but I think it was worth it.

So that’s what I know about the difference in crown materials.
 
In back I always go with gold.
 
Irishgirlyc58 said:
I had the pleasure of having two crowns last Fall.
One on a canine tooth because I tripped, fell, and broke it. My dentist did the ceramic/metal because it was a front tooth and he said that was easier material to match the color of my other teeth. It does match my teeth perfectly.

Then a month later I had a back molar chip due to a large cavity filling it had cracked and then finally chipped.
Same dentist suggested zirconium for the crown because it is stronger material and you bite down harder with molars and exactly matching other teeth isn’t as important. It was $50 more but I think it was worth it.

So that’s what I know about the difference in crown materials.
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I originally had zirconium recommended for a back molar but after further discussion I went with gold even though it was more $$$ since it is kinder to the opposing tooth versus harder materials.
 
SunnyOne said:
... Ok, so differences can be expected I guess, but I'm wondering how much of dentistry is the art of making money vs. the science of keeping teeth in as a good shape as possible, for as long as possible.
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Hard to say, but to be fair to dentists this is just one example of what economists call a "moral hazard" or an "agency problem."

Basically a dentist, a commissioned financial advisor, a car mechanic, a veterinarian, etc. is your agent, charged with performing their task(s) for you in your best interest. There are lots of examples of agents.

The degree of the moral hazard is maybe the $ size and proximity of an action that would be in the agent's best interest, not the client's. For dentists and, probably commissioned brokers, the temptation is large and easy to act on. So that may be why these agents get special attention in threads.
 
SunnyOne said:
Ok, so differences can be expected I guess, but I'm wondering how much of dentistry is the art of making money vs. the science of keeping teeth in as a good shape as possible, for as long as possible.
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I think most dentists are trying to do a good job and both recommendations are probably within reason. My dentist is good about offering options. People vary in how particular. they are especially about aesthetics. Perhaps your first dentist thinks you otherwise look like a movie star. I would have no reservations about trying to repair a crown rather than replace but some people would be very angry if the tightening didn't work and they then needed a replacement. I can understand the temptation to just recommend the more definitive (and profitable) approach.
 
RetMD21 said:
I think most dentists are trying to do a good job and both recommendations are probably within reason. My dentist is good about offering options. People vary in how particular. they are especially about aesthetics. Perhaps your first dentist thinks you otherwise look like a movie star. I would have no reservations about trying to repair a crown rather than replace but some people would be very angry if the tightening didn't work and they then needed a replacement. I can understand the temptation to just recommend the more definitive (and profitable) approach.
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Yep, find a dentist who will work with you on your priorities.

I switched from the one who bought my previous dentist's practice to a more conservative practitioner who understood my preference for durability (amalgam) over cosmetics (composite) when choosing material for restorations.
 
I can see differences of professional opinion and recommendations. I get that. What stood out for me was that the previous dentist added all these treatments to the treatment plan as if they were absolutely mandatory and had appointments lined up - without discussing with me any pros , cons, issues etc.
The second dentist approached it more like a collaborative project - she discussed with me the various options, priorities, etc.
Again, as in life - communication is key - and even more so when thousands of dollars are involved.
 
I have what I think is a funny related story to tell.
In my career, I performed legal reviews along with 3 other attorneys.
A guy we supported complained that he could give all 4 of us the same document - and get back 4 different sets of review comments.
So I had to respond to that this way "this is an art, not a science. If you want to pay us more, we'll work it like a science". That comment drew a lot of laughs. Fun memory.
 
I guess I've been lucky too.

No dentist wanted to remove my amalgam to save me from mercury poisoning.

All preferred amalgam unless front tooth.

I got root canals when I needed them (pain) and crowns after. All which are still in place and working fine.
 
SunnyOne said:
The second dentist approached it more like a collaborative project - she discussed with me the various options, priorities, etc.
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I agree. I don't need certainty- in the case of medical and dental treatments there are situations that are uncertain. Just give me the options and tell me the risks. My current dentist (and the one I had in NJ that I really missed until I found a good one here) will note things that might go bad and tell me we'll "monitor" them. If something starts to get worse, then we discuss treatment. Sometimes that's a few years later.
 
We've lucked out on our current dentist. I just pulled off a crown (he didn't do) & he just put it right back on without the upsell other than an x-ray... They're running through insurance and said it may be free to $50, depending on the insurance response...

He has never been a salesman for 5 years so far & his dentist tech is the only person who has been able to waterpik clean my mouth without pain... I hot 2 unicorns.
 
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