Why are Some (Most?) Dentists Con Artists?

[harllee]

I get a lot of plaque on my teeth between dental appointments and my dentist suggested I floss first, rinse my mouth with water and then brush with an electric toothbrush. Seems to be helping.

 

[Music Lover]

Name me any profession that doesn’t have good, bad and average practioners? They’re all still people after all, some are skilled and conscientious, some are definitely not and everything in between. That’s life. We used to be able to trust some professions, not any more sadly.

I think the difference between doctors and dentists is that many people who become doctors think of it as a noble calling whereas a higher percentage of people that choose dentistry are more motivated by the money.

 

[OldShooter]

I think the difference between doctors and dentists is that many people who become doctors think of it as a noble calling whereas a higher percentage of people that choose dentistry are more motivated by the money.

I don't know about that, but dentists, chiropractors, and veterinarians have business arrangements that cause them to immediately benefit financially from their treatment recommendations. At best, they are commissioned salespeople who really believe in their products. Medical doctors are less connected to the financial impact of their recommendations.

That said, I did know a cardiologist who told me he was moving from a large system to a much smaller group. The reason was that the group owned some kind of machine that he frequently used for patients and that in the group he would benefit from the money that the machine earned. In the large system, nothing like that could happen.

 

[Happyras]

And yea, you need to be careful with vets too. Get the service you need from them and move on.

Hey, easy on the Vets. We owned a nice large practice which we sold to a major corp a few years back. The problem with "the service you need" is that it is an emotional decision. Now dentists do take advantage, but so do auto shops (we owned one when I was a kid). Vets try to manage the patient and the client, they really love the animals and know what is best, but the client has to decide if life is worth the costs. Sad situation typically, but we had some awesome Vets and caring staff.

Back to dentists, recently my wife fell and broke her #8 front tooth below the gum line. Dentist said we can root canal, oh boy, and bond the tooth to the next until it heals then put on a crown. Came back, and they said no, you need an extraction and implant and they would then do the crown.

The surgical extraction included a lot of prep costs for the implant (of course it did). Bone graft etc, but no one said it was not going to work out fine.

Went back for evaluation to proceed with the implant and the bone graft was no bueno, but we get to pay $500 for assessment of the surgery and were sent away with a lot of wasted time and expense.

Went back to the original dentist. He sold his practice 3 years ago to a major corp, and his franchise was now taken over by a new intern dentist. Of course there was no offer to do anything other than a full bridge. No credit for prior work that failed or bad advice on the implant work, nor lack of warning it could fail. Two crown preps and order a 3 tooth bridge. Charged for 3 crowns, after all it was 3 teeth bridge.

In our Vet practice we took responsibility for recommended course of treatments, usually compensating with discount for un-necessary procedures recommended in error. Dentists are money grabbers for the most part recommending useless panoramic xrays in addition to bite wings, topical flouride when mouthwash is all you really need, DEEP cleanings when you really do not even need more than an annual cleaning etc.....

 

[OldShooter]

Hey, easy on the Vets. ...

Nassim Taleb has an interesting concept he calls "silent evidence." Basically this is evidence that we never hear, leaving an unbalanced discussion. I think that is happening here to some extent. We're hearing mostly about the bad dentists. Unfortunately since the evidence is silent, we really never know how much there is.

My guess is that the silent evidence would show that many if not most of the dentists, vets, etc. are well meaning. But many are still commissioned salespeople who really believe in the product. In Olden Times, I don't remember dentists with crown-making machines, I don't remember that dogs ever needed full anesthesia for a tooth-brushing, etc. But now stuff like that seems to be the norm pushed by practitioners who really believe that a product or service is needed -- without their own financial well-being being the main consideration.

Basically this whole discussion is about examples of what the economists call an "agency problem." https://en.wikipedia.org/wiki/Principal–agent_problem

 

[travelover]

Hey, easy on the Vets. We owned a nice large practice .......... Dentists are money grabbers for the most part .....

Kind of all a matter of perspective ain't it?

 

[Happyras]

Kind of all a matter of perspective ain't it?

it certainly is but the mega corp that bought us out is churning it for everything they can. It is America after all.......

 

[JoeWras]

You can say no

You can say no.

Part of the problem here with dentists, vets and auto shops is one of blind trust. You have the right to say no. Use it when you feel it is necessary. You don't have to blindly trust all they say.

Unfortunately, these things tend to be emotional and people get pressured into saying yes.

As for chiropractors: I say No, Never will I visit one again. Problem solved. It is just my opinion. You may find relief from their treatment. That's fine.

As for dentists doing crowns in the office: I love it. No temporary. I watched mine being made. It is not 3d printing, it is 3d removal. Just FYI. Same price to me. My dentist offered me the option to get it lab made. I opted for in-office. So my dentist gets a cut. Big deal. Did we all work for free?

 

[Koolau]

it certainly is but the mega corp that bought us out is churning it for everything they can. It is America after all.......

I can see why dentists (and doctors) are going the mega corp route. Running either type of office creates mounds of paperwork and research of various insurance plans. My dentist used to get by with one office person but now requires two. It's basically the dentist, a hygienist, an assistant and two office staff. That seems lop-sided, but it's the way things are done now. With a megacorp there are economies of scale. YMMV

 

[mcbraemer]

Over the course of the past 20 years our children, DW and I have all used a local dental practice that has continued to grow and expand to four locations based on what originally began as very personalized friendly dental office. We were all generally impressed and satisfied with the group. Recently however, the business seems to have changed, with more frequent pushing of expensive options of questionable value including topical fluoride treatments, frequent xrays and other screenings well beyond what would be expected during regular 6-month cleanings.
My recent experience here was probably my last visit, and I am hoping to find a less ambitious family dental practice to meet my needs over the balance of our time here on earth (we turn 68 and 71 respectively this calendar year. My last straw began last year when a 3-tooth bridge put in maybe 10-h years ago would not stay in, due to the gradual loss of the underlying teeth to which to bridge was affixed. I was presented with two expensive options (partial denture option or two implants and a 4-tooth bridge) roughly $7k or $11k). I have a couple of previous implants so opted for the higher priced option, despite the fact that we are both on std Medicare and have essentially no dental insurance. After 6-7 visits spanning over 12- months, I was finally done very late last year 2021, and presented with the bill of $14k!!! That is a little more than $3k over my written treatment plan of which I still have a copy. I spoke with 3 different people at the office including the head of billing, and was casually told that oh, the treatment plan changed well into the treatment timespan, due to the fact that the original plan mistakenly missed several initial details, and that the correct price is $14k+ which unfortunately I owe. This is after I produced the documentation I received and had made my case quite clear! No relief was offered whatsoever. 9 months later, I am still whittling down the bill ( have roughly $6k balance left) and hoping to have it all paid off before the 18mos same as cash deal expires in May 2023. Meanwhile, I did return last December for a regular cleaning, but have cancelled my June 2022 visit, despite frequent automated texts, emails and one personal phone call urging me to reschedule.
I haven't told them why I am not returning (should I?) rather just said I have several vacations this summer and not ready to reschedule.
I hope to find a suitable local practice to switch to in the meantime. Based on what I read in this thread, I probably need to choose carefully.

 

[Time2]

I don't know about that, but dentists, chiropractors, and veterinarians have business arrangements that cause them to immediately benefit financially from their treatment recommendations. At best, they are commissioned salespeople who really believe in their products. Medical doctors are less connected to the financial impact of their recommendations.

That said, I did know a cardiologist who told me he was moving from a large system to a much smaller group. The reason was that the group owned some kind of machine that he frequently used for patients and that in the group he would benefit from the money that the machine earned. In the large system, nothing like that could happen.

My Orthopedic Surgeon is at least part owner of the MRI machine in the building next door to his office. Guess where his Office makes the appointments? The Office said we will make an appointment for you and they will call to let you know when. I'm not really complaining, I once made an appointment for a back MRI paying cash and they charged $300. I was at the office at 1PM setting up the appointment, they said, can you come back at 9PM. I'll see you then!

 

[Time2]

I just calculated what it would cost to payback a loan for tuition and housing for a recent dental graduate. The school cost plus housing was very close to $300,000. If the loan is at 6% for 10 years, the yearly payment is $40,000.
No need to ask me how I know.
Not that that justifies any purposeful misdiagnosis.

 

[UpQuark]

I got scammed by one dentist who found a tooth needing a crown at every checkup. After two crowns (with two more identified as needing crowns the next year) I was feeling so suspicious that I changed dentists and I went to the new dentist for years and never needed any work. After I moved I was very suspicious but got lucky with the dentist. Then my current dentist is awesome, over a decade and no crowns needed and the 'watch' on one tooth has remained a watch only.

I did unfortunately get overcharging eye doctors, I've always had a suspiciously angled nerve that needed to be watched, but it had always been fine to just get checked once a year, but the new city I moved to they said I needed to come in twice a year, then after a few years they wanted me to come in 4 times a year, and then they wanted me to use prescription drops as a preventative. It was scary because I don't have any expertise to judge their recommendations, but it also seemed suspicious so I switched to another eye doctor at the same practice and explained that I felt like I was getting unnecessary appointments. He checked my eyes and said my condition could cause a less experienced doctor concern but that it was okay and I only needed to come in once a year. Then the next year he told me I needed to come in every 6 months and I asked why and he said some result had been getting worse for the past three visits. But he hadn't said that the previous year when I'd complained of unnecessary appointments, so I felt like he was just making it up.
I changed to another doctor at the practice (there just wasn't a lot of choice in practices where I was living), and that guy said there had been no changes in the scans over the years and that once a year checkups were enough.

 

[FindingForward]

Back to dentists, recently my wife fell and broke her #8 front tooth below the gum line. Dentist said we can root canal, oh boy, and bond the tooth to the next until it heals then put on a crown. Came back, and they said no, you need an extraction and implant and they would then do the crown.

The surgical extraction included a lot of prep costs for the implant (of course it did). Bone graft etc, but no one said it was not going to work out fine.

Went back for evaluation to proceed with the implant and the bone graft was no bueno, but we get to pay $500 for assessment of the surgery and were sent away with a lot of wasted time and expense.

Went back to the original dentist. He sold his practice 3 years ago to a major corp, and his franchise was now taken over by a new intern dentist. Of course there was no offer to do anything other than a full bridge. No credit for prior work that failed or bad advice on the implant work, nor lack of warning it could fail. Two crown preps and order a 3 tooth bridge. Charged for 3 crowns, after all it was 3 teeth bridge.
.

Similar thing here. Implant failed (months later, after crowns were on). They tried again. No go. At this point, no longer a candidate for grafts. Wasted cost didn't bother me as much as finding out later that 1 of the teeth extracted didn't need to be & will now cause me shifting/addtl tooth loss that didn't have to happen.

Practice sold. New group tried pushing implants on me again at full cost with all the workup fees (panoramics, eval, etc).

I blame myself for not getting 2nd opinion on addtl extraction. (Three dentists did weigh in on initial extraction - that one did have to go.) But I vetted this surgeon closely: experienced & good rep; even taught at dental univ.

I considered suing, but was told by an attorney (and read the same thing from others online) that it's difficult to win a dental lawsuit compared to medical, unless there's significant disfigurement (like major jaw issues) or big drop in daily quality of life (e.g. no longer able to eat solid food).

Even if you sue & win, judgements are usually smaller. No big attorney paydays, so many patients have to foot all legal costs vs "on contingency" arrangements.

Be careful out there: learn from my stupidity!

 

[jollystomper]

$1350 for a root canal is a bargain.

Really? I had to have one done last year (first one in a long while), it was $550. We do have dental insurance so maybe that made a difference.

 

[Chuckanut]

There is a huge number of dentists in my area who are into 'Smiles'. Everything is about your smile. I get the feeling that a few years ago there was a giant "How to market smiles' conference in my area and at least 1/2 the dentists went to it.

That said, my current dentist seems OK. They do have me come in for an extra cleaning every year, but that is because I had extensive orthodontic work in my teens that make me more prone to deeper pockets. But, so far nobody has found much of anything to worry about other than a surface crack in one tooth. That crack has been there for maybe a decade.

 

[athena53]

That said, my current dentist seems OK. They do have me come in for an extra cleaning every year, but that is because I had extensive orthodontic work in my teens that make me more prone to deeper pockets. But, so far nobody has found much of anything to worry about other than a surface crack in one tooth. That crack has been there for maybe a decade.

I get 4 cleanings a year due to my implants and I'm OK with that. Cheap prevention.

I had a surface crack in a molar that I could feel, so I knew no one was making anything up. Eventually I needed a crown but it took years to get to that point.

 

[ncbill]

So we went to the dentist office today for our six month cleaning. After the cleaning a dentist who now works for the practice did a check up of our teeth. We have never met this dentist before and our regular dentist was not in the office today due to an emergency. The dentist did not find any cavities but state that she was concerned about the age of my amalgam fillings. She recommended removing them with composite fillings. She proposed replacing 8 fillings at a cost of $385 each. I politely told her to "pound sand".

I've had little luck with composite fillings (all my previous dentist did) lasting more than 4-5 years (supposed to last 8-10)

So after switching to a more conservative dentist I now request amalgam if at all possible.

 

[PatrickA5]

I've had the same dentist for over 30 years. She has had the same group of four dental assistants for at least 25 years. Rarely does she think I need anything done. She's been checking in on the same "spots" for many years and continues the "wait and see" approach. My only concern is they will all retire at once - probably in the next 5 years.

My daughter, who went to the same dentist the first 25 years of her life, recently had to change dentists due to insurance problems. She went to the closest "chain" dentist to her house. Yup, first visit was told she had 8 cavities and more than $3K worth of work. She declined. She went to a different dentist a year later and was told she didn't have any cavities. A miracle must have happened!

 

[Koolau]

I've had the same dentist for over 30 years. She has had the same group of four dental assistants for at least 25 years. Rarely does she think I need anything done. She's been checking in on the same "spots" for many years and continues the "wait and see" approach. My only concern is they will all retire at once - probably in the next 5 years.

My daughter, who went to the same dentist the first 25 years of her life, recently had to change dentists due to insurance problems. She went to the closest "chain" dentist to her house. Yup, first visit was told she had 8 cavities and more than $3K worth of work. She declined. She went to a different dentist a year later and was told she didn't have any cavities. A miracle must have happened!

Guess I'll find out today if my 42 year experience with my dentist is still a good one. (Today is my cleaning appt.) I keep asking him when he plans to retire (he's 74) and he keeps saying "never." For my sake, I hope he lives to 90! YMMV

 

[travelover]

...... I keep asking him when he plans to retire (he's 74) and he keeps saying "never." For my sake, I hope he lives to 90! YMMV

I had a barber like that. He liked to clean up the sides with a straight razor. One his hands started shaking, I found a new barber.

 

[Texas Proud]

I have had many dentists over the years but only one that I would say was 'money hungry'.... but even with him I said all I was interested in is healthy teeth, no caps or crowns to make me look better and he was good after that... but only had him 2 years..


My pockets were getting deep and the dentist recommended a Sonicare brush.... it did the trick and my gums have been good since then...


My current dentist gets a LOT of money from my wife's teeth as she has many implants and crowns... but for me I do not have much...


On one tooth I was having problems... he was going to put in a cap... the temp cap did not seem to work as I was still could feel cold... he said wait awhile and see if the nerve settles down... we then went to steroids... I had the temp in over a year before he finally said he would look at it... well, drilling down he was able to see the tooth was cracked in two... got a root canal and a crown and am happy.... if he was money hungry he would have gone for the root canal right away...




One of the big problems could be your latest dentist.... he might be telling you what you want to hear as the pocket depth you stated is not good...and it seems you are having problems but just ignore them...

 

[ychuck46]

My daughter, who went to the same dentist the first 25 years of her life, recently had to change dentists due to insurance problems. She went to the closest "chain" dentist to her house. Yup, first visit was told she had 8 cavities and more than $3K worth of work. She declined. She went to a different dentist a year later and was told she didn't have any cavities. A miracle must have happened!

I'm going to venture a guess that the chain your daughter went to had a name that rhymed with "aspen". No one should ever use that group. They are notorious for doing work that is unnecessary. Not sure why there aren't class action suits against them left and right. Maybe there are but being in the "medical" field it makes it difficult to prove.

 

[Koolau]

Guess I'll find out today if my 42 year experience with my dentist is still a good one. (Today is my cleaning appt.) I keep asking him when he plans to retire (he's 74) and he keeps saying "never." For my sake, I hope he lives to 90! YMMV

Just got back. Same charges as last year (to the penny.) YMMV

 

[razztazz]

I'm going to venture a guess that the chain your daughter went to had a name that rhymed with "aspen". No one should ever use that group. They are notorious for doing work that is unnecessary. Not sure why there aren't class action suits against them left and right. Maybe there are but being in the "medical" field it makes it difficult to prove.

Seconded. I didn't mention the name of the office in my post but that's the one