Why are Some (Most?) Dentists Con Artists?

[athena53]

I never would have thought tooth loss would be associated with cognitive decline.

Interesting- I wonder what factors are at work here. I'm guessing that having most of your teeth intact means you have better nutrition (they specifically measured ability to chew carrots)- you can handle fresh fruits and vegetables and meats and aren't living on soft, processed food. I'm also guessing that people who can afford implants ("fixed prostheses") might be wealthier and have better overall health, giving them access to more mentally stimulating activities.

 

[Walt34]

Interesting- I wonder what factors are at work here. I'm guessing that having most of your teeth intact means you have better nutrition (they specifically measured ability to chew carrots)- you can handle fresh fruits and vegetables and meats and aren't living on soft, processed food. I'm also guessing that people who can afford implants ("fixed prostheses") might be wealthier and have better overall health, giving them access to more mentally stimulating activities.

Of course the flip side may be that people with good cognitive abilities take care of themselves, including oral and dental health. Who knows?

 

[Koolau]

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.

I have no problem with dentists making a decent living. Dentistry would be on my short list of least-favorite-occupations but YMMV. Regarding your question: Esthetics are more or less important to each of us. As long as a dentist offers options (leaning toward esthetics or toward "value") I'm okay with it. I think many dentists find it difficult NOT to provide the most esthetic procedure because that is what they look at all day: Failed, broken, ugly teeth and mouths. Providing esthetically pleasing results is probably the zenith of their day. Cost (your cost) is probably secondary for the most part. Even their profit may not be so important as providing the ultimate in esthetics.

Now, having said that, there are greedy dentists just like there are greedy feather merchants.

 

[Koolau]

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.

My original ceramics chipped and eventually broke although the underlying crown structure remained sound. I believe there have been significant improvements in the process over many years.

 

[Koolau]

In back I always go with gold.

I agree. BTD with gold in the back. They last forever. I had to have a gold crown replaced because the underlying tooth was failing. The crown which was 20+ years old looked brand new (and I still have it in my PM stash.) YMMV

 

[OldShooter]

I have no problem with dentists making a decent living. Dentistry would be on my short list of least-favorite-occupations but YMMV. Regarding your question: Esthetics are more or less important to each of us. As long as a dentist offers options (leaning toward esthetics or toward "value") I'm okay with it. I think many dentists find it difficult NOT to provide the most esthetic procedure because that is what they look at all day: Failed, broken, ugly teeth and mouths. Providing esthetically pleasing results is probably the zenith of their day. Cost (your cost) is probably secondary for the most part. Even their profit may not be so important as providing the ultimate in esthetics.

Now, having said that, there are greedy dentists just like there are greedy feather merchants.

The way I describe dentists (and veterinarians) is that you are dealing with a commissioned salesperson who really believes in their product. So maybe the psychology is that they can do well by doing good.

 

[RetMD21]

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.

Good story. I guess you could offer to come to 4 independent conclusions then meet up to devise a consensus recommendation.

 

[Koolau]

The way I describe dentists (and veterinarians) is that you are dealing with a commissioned salesperson who really believes in their product. So maybe the psychology is that they can do well by doing good.

DW operated a retail business. Her motto was "selling is helping." She believed that spending more to get what you REALLY want is better than skimping and being dissatisfied with the result. I wouldn't doubt that many dentists take the same attitude.

Dentist: "This is the product/service I would recommend to my wife."

Me: "Yeah, but I don't sleep with you."

 

[tfudtuckerpucker]

I came across this- have they have been reading this thread?

 

[Surewhitey]

Confirmed, the crown re-glue was $53 after insurance claim. I'm good with that. Now I gotta stop eating all that candy...

 

[Qs Laptop]

I came across this- have they have been reading this thread?

Best line from the video:

"Now that you're stoned and strapped to a chair, allow me to try to convince you to commit to future mouth torture procedures."

 

[Rianne]

I came across this- have they have been reading this thread?

OMG, I love this guy.

 

[hopefullyoneday]

We are having a issue right now where we have our own insurance and also covered on each others so dual ins. the current dentist is submitting claims for the full amount to each insurance and collecting between the 2 more than the contracted price. When called out on it he says it is not his job to let them know there is dual coverage and the money is not coming out of our pocket so why worry.

 

[Koolau]

We are having a issue right now where we have our own insurance and also covered on each others so dual ins. the current dentist is submitting claims for the full amount to each insurance and collecting between the 2 more than the contracted price. When called out on it he says it is not his job to let them know there is dual coverage and the money is not coming out of our pocket so why worry.

Heh, heh, why worry? One little word. FRAUD. Thats why you should worry. When the insurance finds out, they won't care who they come after - you, the dentist or both. I'd say now that you know, you should protect yourself and let the insurance companies know. Ask them not to narc on you for narcing on your dentist. You don't want an angry dentist poking around in your mouth with sharp objects. Better yet, find a dentist who follows the rules. If s/he is dishonest with the insurance companies, why would YOU expect honesty from the dentist. YMMV as always.

 

[athena53]

Heh, heh, why worry? One little word. FRAUD. That's why you should worry. When the insurance finds out, they won't care who they come after - you, the dentist or both.

There can be a legitimate reason for this. There should be "co-ordination of benefits" so no one profits unfairly. The claim should be submitted to the primary insurer first (I'd say that's the one the patient has through his/her own employer) and then to the secondary insurer. The secondary insurer may pay additional depending on limits, deductibles, etc. AND taking into account what the primary insurer paid. When my Ex and I were both employed we had DS on both our health plans. We got slightly higher payments but certainly not more than the service cost.

A better approach might be to call the secondary insurer, let them know primary insurance applies, and ask how that will work. If they didn't know about the primary insurance, they will then.

 

[hopefullyoneday]

There can be a legitimate reason for this. There should be "co-ordination of benefits" so no one profits unfairly. The claim should be submitted to the primary insurer first (I'd say that's the one the patient has through his/her own employer) and then to the secondary insurer. The secondary insurer may pay additional depending on limits, deductibles, etc. AND taking into account what the primary insurer paid. When my Ex and I were both employed we had DS on both our health plans. We got slightly higher payments but certainly not more than the service cost.

A better approach might be to call the secondary insurer, let them know primary insurance applies, and ask how that will work. If they didn't know about the primary insurance, they will then.

The secondary insurance knew about the primary insurance because they stated they needed the copy of the primary insurance exp of ben in order to process the claim.

 

[OldShooter]

... so why worry.

Worry because if he'll lie to the insurance companies he'll lie to you. Dishonesty is a one-strike-and-you're-out criterion for me. Good bye dentist.


Reporting the situation to the insurance companies is certainly the civic-minded thing to do. I would try it and see what happened.

 

[Koolau]

There can be a legitimate reason for this. There should be "co-ordination of benefits" so no one profits unfairly. The claim should be submitted to the primary insurer first (I'd say that's the one the patient has through his/her own employer) and then to the secondary insurer. The secondary insurer may pay additional depending on limits, deductibles, etc. AND taking into account what the primary insurer paid. When my Ex and I were both employed we had DS on both our health plans. We got slightly higher payments but certainly not more than the service cost.

A better approach might be to call the secondary insurer, let them know primary insurance applies, and ask how that will work. If they didn't know about the primary insurance, they will then.

Yep, the key is to patch both insurance companies into the loop. That way, there's no chance of fraud (and possible unpleasant repercussions.)

 

[Koolau]

Worry because if he'll lie to the insurance companies he'll lie to you. Dishonesty is a one-strike-and-you're-out criterion for me. Good bye dentist.


Reporting the situation to the insurance companies is certainly the civic-minded thing to do. I would try it and see what happened.

Plus we all pay for fraud in the end. I agree that it would be good to report it but YMMV.

 

[athena53]

The secondary insurance knew about the primary insurance because they stated they needed the copy of the primary insurance exp of ben in order to process the claim.

Perfect. That's the way it should work. I don't blame the dentist's office for not wanting to figure out which insurer owes what. Many larger practices have one person dedicated to dealing with insurers because it's so complex. As long as the secondary insurer knows about the primary coverage, all is well and no one is getting more than they should.

 

[MRG]

+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.

+25,000

I was told yesterday that I needed 20-30k worth of work done. I'm a heavy grinder and spent a couple of nights without my splint. Knocked a corner off a tooth that does need crowned and some product bonded to my front teeth.

My new dentist, who recently bought the practice, decided that I should have crowns to build up my front teeth and veneers done. I explained I didn't want to have the prettiest teeth in the mortuary, but he insists this will help my grinding.

We're going to crown the one broken tooth, and he'll put together a treatment plan for me to review. OK, fine.

What he doesn't know about us is that DW'S brother is a recently retired dentist and thinks this is a really, really, really, bad idea for a heavy grinder. We had a great discussion yesterday, and he pointed out all the negative things that will likely happen that totally agree with my experience. I will be replacing the new guy with a different practice.

 

[5Miler]

My dentist of 25 years recently retired and sold her practice to another dentist with 10 years experience. Tragic case as my dentist lost her daughter in a car accident where another daughter was the driver. The accident was the fault of the other party. This happened last fall and she made the decision to stay home more with her kids and thus I have a new dentist.

I am due to get my new crown on my implant in July/August so this will be the first interaction with the new dentist. Crossing my fingers as I was with my previous dentist from when she first opened her practice and she has been the best. She provides her advice on what she thinks is the best course of action for any issues and usually they make sense without being the most expensive option.

When I had problems resulting in my current implant situation, she laid out my options including a bridge, implant or leaving it be. She suggested I would be money ahead with the implant even though it would cost a bit more and she wouldn't be doing the work as she refers out to an oral surgeon. From all I have learned about implants since our conversation, she didn't lead me wrong. I will miss her terribly. I hope her replacement proves to be as trustworthy.

 

[Koolau]

My dentist of 25 years recently retired and sold her practice to another dentist with 10 years experience. Tragic case as my dentist lost her daughter in a car accident where another daughter was the driver. The accident was the fault of the other party. This happened last fall and she made the decision to stay home more with her kids and thus I have a new dentist.

I am due to get my new crown on my implant in July/August so this will be the first interaction with the new dentist. Crossing my fingers as I was with my previous dentist from when she first opened her practice and she has been the best. She provides her advice on what she thinks is the best course of action for any issues and usually they make sense without being the most expensive option.

When I had problems resulting in my current implant situation, she laid out my options including a bridge, implant or leaving it be. She suggested I would be money ahead with the implant even though it would cost a bit more and she wouldn't be doing the work as she refers out to an oral surgeon. From all I have learned about implants since our conversation, she didn't lead me wrong. I will miss her terribly. I hope her replacement proves to be as trustworthy.

Yep, my dentist is only a year younger than I am and I keep pumping him to see if he is planning to retire any time soon. I don't look forward to that day as I have no idea where to turn for a new dentist.

 

[Rianne]

This article is a long read. There are many specific paragraphs that apply to this thread. I gifted the whole article but am highlighting a bit. "The Truth about Dentistry"

"Among other problems, dentistry’s struggle to embrace scientific inquiry has left dentists with considerable latitude to advise unnecessary procedures—whether intentionally or not. The standard euphemism for this proclivity is overtreatment. Favored procedures, many of which are elaborate and steeply priced, include root canals, the application of crowns and veneers, teeth whitening and filing, deep cleaning, gum grafts, fillings for “microcavities”—incipient lesions that do not require immediate treatment—and superfluous restorations and replacements, such as swapping old metal fillings for modern resin ones. Whereas medicine has made progress in reckoning with at least some of its own tendencies toward excessive and misguided treatment, dentistry is lagging behind. It remains “largely focused upon surgical procedures to treat the symptoms of disease,” Mary Otto writes. “America’s dental care system continues to reward those surgical procedures far more than it does prevention.”

“Excessive diagnosis and treatment are endemic,” says Jeffrey H. Camm, a dentist of more than 35 years who wryly described his peers’ penchant for “creative diagnosis” in a 2013 commentary published by the American Dental Association. “I don’t want to be damning. I think the majority of dentists are pretty good.” But many have “this attitude of ‘Oh, here’s a spot, I’ve got to do something.’ I’ve been contacted by all kinds of practitioners who are upset because patients come in and they already have three crowns, or 12 fillings, or another dentist told them that their 2-year-old child has several cavities and needs to be sedated for the procedure.”

https://www.theatlantic.com/magazin...opy-link&utm_medium=social&utm_campaign=share

 

[Walt34]

Yep, my dentist is only a year younger than I am and I keep pumping him to see if he is planning to retire any time soon. I don't look forward to that day as I have no idea where to turn for a new dentist.

When I retired and we moved I first found a new primary doctor. I then asked the dr. who his dentist was. He referred me to the practice across the street from his office, which turned out great! Turns out they'd known each other since about high school.