"Revenue enhancement" at the dentist's office?

[zigzagzerr]

I was in for my regular six month checkup last night, and first of all, they decided to do this really extensive set of x-rays (15-20 different views, lots of biting down in weird uncomfortable positions, kwim?). Then the hygienist did her normal cleaning -- we're chatting away, she says everything looks good. Same as always. I'm a big flosser, so she rarely has any issues. She said the xrays show the bones beneath the surface look really solid, nothing eating away at the roots (eww!), etc.

While I'm waiting for the dentist to come check things out, I'm listening to the patient next door being told all the stuff she needed to have done -- replacing silver fillings with gold, nerve gas, valium, four separate appointments (frankly, it sounded awful).

My regular dentist wasn't in, so a different dentist from the practice came to check my teeth at the end of the appointment. She starts shooting out notes to the hygienist (complete "dentist-speak", I have no idea what she was talking about) and the next thing I know they say I have 4 cavities in between my teeth, and about 4-5 teeth they need to watch. Wham bam out the door, be sure to schedule the appointment for this. Bye.

First of all, although I'm sure cavities can occur in between teeth, I have never heard of anybody having this before. How do you do a filling in between teeth?

Secondly, if I had such extensive problems, wouldn't the regular dentists have noticed something or made a note of potential issues during my regular visits all these years?

Third, I am irritated that this doctor did not speak directly to me and did not bother to explain anything. The few times I have had a cavity in the past, the dentist showed me where it was -- I could see it and feel it, so it made sense to me to take care of it.

Anyway, I guess this is partially a vent more than anything else -- I called the dental office this morning and asked them to fax over a copy of their recommendations so I could get a second opinion. Which seems kind of silly for cavities, but I figure if I'm uncomfortable with the situation, I'd rather get more information than blindly go wherever the medical profession tells me I should.

I almost feel like they needed to find something wrong in order to justify all those very expensive x-rays.

Do you ever feel like the dentist's office sees you as a walking dollar sign rather than as a patient?

 

[AlexWyattMommy]

Cavities between your teeth are no fun to have filled. Hopefully it is just one tooth on one side and not both teeth. Ouch!

I would definitely make a follow up with your normal dentist before doing any work.

It IS possible that they missed the start of a cavity between your teeth or that you are just starting them now. The sooner you fix those, the better. Maybe all those new fancy x-rays showed what the normal ones missed?

I had a dentist who was like that, didn't explain things well. I don't have that dentist anymore.

 

[jen0610]

I was in for my regular six month checkup last night, and first of all, they decided to do this really extensive set of x-rays (15-20 different views, lots of biting down in weird uncomfortable positions, kwim?). Then the hygienist did her normal cleaning -- we're chatting away, she says everything looks good. Same as always. I'm a big flosser, so she rarely has any issues. She said the xrays show the bones beneath the surface look really solid, nothing eating away at the roots (eww!), etc.

While I'm waiting for the dentist to come check things out, I'm listening to the patient next door being told all the stuff she needed to have done -- replacing silver fillings with gold, nerve gas, valium, four separate appointments (frankly, it sounded awful).

My regular dentist wasn't in, so a different dentist from the practice came to check my teeth at the end of the appointment. She starts shooting out notes to the hygienist (complete "dentist-speak", I have no idea what she was talking about) and the next thing I know they say I have 4 cavities in between my teeth, and about 4-5 teeth they need to watch. Wham bam out the door, be sure to schedule the appointment for this. Bye.

First of all, although I'm sure cavities can occur in between teeth, I have never heard of anybody having this before. How do you do a filling in between teeth?

Secondly, if I had such extensive problems, wouldn't the regular dentists have noticed something or made a note of potential issues during my regular visits all these years?

Third, I am irritated that this doctor did not speak directly to me and did not bother to explain anything. The few times I have had a cavity in the past, the dentist showed me where it was -- I could see it and feel it, so it made sense to me to take care of it.

Anyway, I guess this is partially a vent more than anything else -- I called the dental office this morning and asked them to fax over a copy of their recommendations so I could get a second opinion. Which seems kind of silly for cavities, but I figure if I'm uncomfortable with the situation, I'd rather get more information than blindly go wherever the medical profession tells me I should.

I almost feel like they needed to find something wrong in order to justify all those very expensive x-rays.

Do you ever feel like the dentist's office sees you as a walking dollar sign rather than as a patient?

Yep and that is why we no longer go to that dentist.

For one reason or another, DH didn't go to the dentist for 5 years. But he is a 2-3 x's a day brusher, flosses daily, and uses mouth rinse daily. When he went in for the first cleaning, everything looked good, they were impressed at how good it looked for how long it had been since he had seen a dentist. He goes back 6 months later, didn't change anything in his routine, and now he needs to get 6 cavities filled, talking about correcting the yellowing of his teeth, need to replace his old fillings with the new white stuff they use. They just go on and on about what he NEEDS to have updated.

He set up an appointment with a different dentist and took the list of NEEDED items with him. The 2nd dentist found nothing wrong - one spot to watch for a cavity. When DH showed him what the other dentist was pushing to do, the new dentist asked DH if he had any issues with the color of his teeth or the silver fillings. DH told him no. The dentist handed the list back and said then you DON'T NEED any of this. According to the new office, they were getting quite a few new paitiants due to the 1st dentist new procedures for pushing unneeded or unwanted procedures.

We switched all four of us over to the 2nd dentist and left the old one behind.

 

[apirateslifeforme]

I started to feel this way some years back, when my "partnership" dentists sold the practice to a new, young dentist in preparation for their eventual retirement. I've been going to the same office for 30 years. One dentist did retire a few years ago; the other is still there, albeit on a limited basis.

Actually, I shouldn't blame the new guy for what I'm about to relate; this was recommended by a hygienist. As she was doing the cleaning, she asked me if I'd ever thought about bleaching and getting some veneers. Honestly, yes I had. So she goes into a long spiel about what would be involved...bleaching, doing veneers on my top four front teeth, and doing some composite bonding on the bottom two front teeth. She put it all into the computer, then said I could get pricing at the front desk. She also added that due to one particularly large gap, the veneers wouldn't fill in completely.

Once there, the girl handed me a breakdown, plus a credit application...the grand total came to $8000 and change To which she cheerfully added, "Oh, but you have a year to pay it off..."

Between that and the fact that they can't really fill in the existing gaps, I said no way. Still, they called me once a month after that to ask me when I wanted to schedule step 1...they badgered me when I came in for my appointment...continued to call...they finally stopped calling about a year ago, but they still ask at every appointment.

 

[Imzadi]

Are you flossing? I'm guessing that your cavities between teeth might be from not flossing well. I've had a cavity between teeth. They have to drill from the side to get to it. If you really do have cavities, they would show up as dark spots in your x-rays. You don't need them to send you an itemized list. Just find a new dentist and have your x-rays forwarded to that dentist. You paid for them. they are yours. It's also dangerous to have new x-rays done again. So, I think they have to send the x-rays if you request them.



As for your enhancement question,. Yes, I strongly think that happened to me too. I've known forever that my wisdom teeth are impacted, (grown in totally sideways, at a 90 degree angle under my gums.) I was always told I would probably need to have them taken out. I'd be lucky if I made it to my 30's and they didn't cause a problem. (My mom didn't have hers taken out till then.)

A couple years ago, my teeth shifted and started crowding a lot. I used to have braces and perfectly straightened teeth. I read that people who have had braces might later have a problem with teeth shifting, so it might actually be an orthodontic problem instead. But I also thought it could be my wisdom teeth finally moving, so I saw an oral surgeon about it.

He was surprised that my wisdom teeth have lasted this long. While he didn't see any immediate, emergency situation, especially as I'm in no pain & they don't bother me at all other than the thought of the crowding, the x-rays indicated there may be a cyst in front of one tooth and possible abscessing in the other. He said I may have a potential problem in my 50's. He wants to take the bottom ones out NOW as a preventative action.

The top ones, which was my bigger concern in regards to my teeth crowding, he wasn't even touching. So, the extractions won't fix the crowding at all.

I felt his preventative diagnosis was all well & good - if I had the money. While insurance will pay quite a bit, a hefty sum would come out of my pocket.

I was quite a bit cynical, especially in this economy. He was highly, highly recommended to me by my regular dentist. But, his waiting room was empty and they were practically able to fit me in for an appointment at any time, for the consultation and the extractions.

Of course, the extractions would be beneficial to me. But I wondered if this expensive, preventative operation - when there's no real immediate problem, may be more about helping to pay the dentist's rent.

I finally decided NOT to get my wisdom teeth out. After talking to both my mom & DSis, who also hadn't had hers taken out and is older than me, none of us has had problems. My mom said in the country where she's originally from, no one has them unnecessarily taken out.

Instead, I went to a cosmetic/aesthetic orthodontist. He put on laminates over my front crowded teeth, so they are perfectly in alignment again. Plus the extra thickness would help stop the shifting. AND he gave me an Invisalign retainer, just in case they do start shifting.

I don't regret my decision. I'll deal with my wisdom teeth IF & when I finally have problems.

 

[luvmy3jewels]

Do you ever feel like the dentist's office sees you as a walking dollar sign rather than as a patient?

Yep, I have had that feeling. That's why dh and I decided to switch to a different dentist for our next dental visit. Our old dentist retired and sold his practice to a new dentist. Well, we started noticing that it seemed like there was a revolving door with all of their employees (which to me indicated that something wasn't right). But even worse were the sales pitches every time we went to get our teeth cleaned (from whitening products to electric tooth brushes). Dh and I both suddenly developed early stages of gingivitis, which of course required us to buy an expensive solution to swish around in our mouths. It felt like the dentist was trying to squeeze every dime she could out of us. I thought it was very unprofessional of them to try to hard sell their patients on things that they don't need.

We finally made up our minds after our last appointment that we were done with our former dentist. We are now scheduled in with a different dentist who just opened a practice here.

 

[Toad_Passenger]

My old Dentist (note that he's my OLD dentist) tried to sell me on all sorts of whitening products when I was graduating college. He told me that in today's world you need to have bright teeth for job interviews.

I didn't get the treatments, and left him in the dust as quick as possible. 11 years later, and I've been gainfully employed for the entire time, even without bright, white teeth.

I may have to drop my current practice, though. The guy I've been seeing is retiring and they just hired a bunch of kids fresh out of Dental school, and they are all on the "Widsom Tooth" train. Even though the guy I've been saying raves about how perfectly my wisdom teeth have come in, and how lucky I am that I only have 2 of them.

But, I guess everyone has to make a dime somehow, right?

 

[zigzagzerr]

Are you flossing? I'm guessing that your cavities between teeth might be from not flossing well. I've had a cavity between teeth. They have to drill from the side to get to it. If you really do have cavities, they would show up as dark spots in your x-rays. You don't need them to send you an itemized list. Just find a new dentist and have your x-rays forwarded to that dentist. You paid for them. they are yours. It's also dangerous to have new x-rays done again. So, I think they have to send the x-rays if you request them.

I think that's part of why I'm uncomfortable. It didn't seem like she had anything to point out on the x-rays -- she made a comments or two about how she couldn't really see clearly on the x-ray but I had some redness in the gums from the cleaning. It seemed like a bit of a leap.

My friend and I were talking about this today. I'm all for preventative maintenance, but I'm not sure I want to go through some painful procedure without any evidence that something is wrong.

But even worse were the sales pitches every time we went to get our teeth cleaned (from whitening products to electric tooth brushes). Dh and I both suddenly developed early stages of gingivitis, which of course required us to buy an expensive solution to swish around in our mouths. It felt like the dentist was trying to squeeze every dime she could out of us. I thought it was very unprofessional of them to try to hard sell their patients on things that they don't need.

They do seem to be pushing the cosmetic stuff pretty hard - I get the spiel about the professional whitening products everytime too.

 

[tasha99]

Get a second opinion. Without doing that, you have no way of knowing if this is a real problem or fraud.

 

[fhtpdw20]

About 30 yrs ago, I worked in dental office during high school and until the dentist died. To answer how, we had a little clamp device that was used with a band of flexible metal that formed a loop. The dentist would drill out the cavity and undercut the tooth to give the silver something to hold onto. The band was placed on the tooth and tighted to form what becomes the back of the tooth. The filling material was compacted into the tooth and the band removed. You would then gently bite down on a piece of carbon paper. Any heavy blue marks would be scrapped off while the filling was soft until there was a faint blue mark which meant that the bite contact was aligned so you would not break the filling. Of course you could not eat on that side for a few days until the filling had harded. I have no clue what they do these days.

 

[missypie]

I totally think it's revenue enhancement. About 15 years ago everyone was hearing "all your silver fillings need to be replaced." I think they all went to a seminar where they were told that when it's time to send their kids to college, start on the replacement kick.

I am so distrustful of my dentist. They always call my insurance and see how much they'll pay for then hound me to have that much done.

 

[bicker]

I suppose when dentists become charities (or slaves), instead of medical professionals who are looking toward their revenue to pay for the financial needs and financial security of themselves and their staff, then perhaps things will be different.

 

[X and G's mom]

Yep! I've always been right on time at 6 months for my kids and my cleaning. We had moved about 3 years ago and I took both my kids to see a pediatric dentist in town. Between the 2 of them they had 7 cavities and 1 baby tooth needed to be crowned It was only going to be $2,500 and they could set me up with easy monthly paments of $500

I was like, wait a minute! There is NO WAY a mouth could get that bad in 6 months! (Both my kids have always brushed 2 times a day and flossed). So, I figured either I was being scammed, or my old dentist was wack. I contacted my old dentist for a consultation and when we went in there was NOTHING wrong with the teeth! He said there was a very small cavity in one of the teeth, but the tooth was loose and going to fall out!

So, we've been continuing with our old dentist and been commuting 2 hours each way for the last 3 years. We have a great relationship with everyone in the office.

I always tell people to get a second opinion!

 

[merryweather20]

A long time ago I was watching one of those sting 60 minutes/20/20 / Dateline type shows and they sent a guy in to a bunch of dentists.

Every dentist said something different. 5 cavities, no cavities. Basically the gist of the show was that finding a cavity was not an exact science. The best thing to do was to go see a dentist regularly, that you were comfortable with. He/she would be able to tell watch your teeth from visit to visit and would know for sure whether a cavity was developping.

 

[lovesmurfs]

I've never questioned cavities (except that DS16 apparently didn't have any when I know he doesn't do anything but brush in the morning....), but we had a problem with a pediatric dentist when he was 4.

DS had hit a front tooth on his high chair and we took him to the dentist as a precaution. Dentist told him that it's "likely" the tooth would grey and die, and the best action for us would be to CAP it. I was certainly not about to cap a baby tooth that may or may not need it in the future. We told him we'd wait and see.

Never greyed, no problem.

 

[RitaZ.]

Do you ever feel like the dentist's office sees you as a walking dollar sign rather than as a patient?

Our former dentist is like that.

 

[mandylo]

I used to work for a dentist. The office had to meet "production" every week or we got a thorough chewing out. The dentist and office manager (a married couple) were NOT good people and I regret that I ever worked for them.

 

[JerseyJanice]

I suppose when dentists become charities (or slaves), instead of medical professionals who are looking toward their revenue to pay for the financial needs and financial security of themselves and their staff, then perhaps things will be different.

This is easily one of the most ridiculous posts I have ever seen on here.

Unfortunately, there are mercenary and unscrupulous people in every walk of life. That is why it is important to ask around and get references whenever you seek the services of a professional. Whether it's your teeth, your body, your car, your plumbing, whatever--true professionals do not recommend procedures only for their own financial gain.

Health care PROFESSIONALS do not recommend unnecessary procedures to their patients. Ever. Period. And guess what? That does not make them slaves or charities. It makes them decent dentists (or surgeons or mechanics or plumbers or whatever).

It is absurd to suggest that performing unnecessary procedures on patients is the only way a dentist's practice could be profitable.

OP, I would see my regular dentist if I were you.

 

[bicker]

This is easily one of the most ridiculous posts I have ever seen on here.

Your reply is "easily one of the most ridiculous [replies] I have ever seen on here." The idea that everyone has to see the world precisely as you see it is going to lead you to no end of disappointment and disaffection. I suggest you purge yourself of such illusions.

Unfortunately, there are mercenary and unscrupulous people in every walk of life.

There are, but that works both ways, and I've never seen any set of service providers, whether they be doctors, lawyers, repair people, what-have-you, that were anywhere close to as mercenary and unscrupulous as some of the customers they provided service to.

That is why it is important to ask around and get references whenever you seek the services of a professional.

This is, at least, good advice.

The rest of your message had nothing to do with the comments you were replying to.

 

[bumbershoot]

Dentistry seems to be a tricky thing, and yes sometimes it's hard to tell the difference between a truly needed procedure vs the dentist having a balloon payment on a boat coming due.

DH doesn't really agree with what our dentist is telling him, but the same dentist is VERY conservative with me and my friend who has seen him since he was a newbie dentist, doing almost nothing with our teeth...so he's decided to trust him.

But the second dentist DS saw was just a scammer extraordinaire, and we left his office laughing. Remove two teeth that obviously needed to be removed (they grew in yellow, turned brown, and started disintegrating...considering that some of DH's babyteeth and ALL of FIL's babyteeth crumbled, we figured that "only" two was good for DS!), remove two others because of a cavity (which would have left a 4 tooth gap in the front top of DS's mouth at only one year old, which the dentist said wouldn't have an effect on DS's speech ha ha ha), fill ALL the tiny spots he saw...all of this would need to be done in ONE BIG appointment, in his office, with an anesthesiologist and nurse from the local hospital, because DS would be under *general*.

NO NO NO.

Found someone sane instead. DS had the two teeth pulled (to this day I have no idea how he even got a grip on those teeth, let alone pulled them...I wasn't in the room b/c DS did better with DH, but DH says he did it gently and quickly), a cavity behind the middle two filled (didn't take those teeth out b/c of a cavity), and has been watching the "spots". For nearly 4 years now. No anesthetic needed for the filling. A blip of lidocaine for the pulling. That's it.


Dentists definitely vary, and it's very possible that a tried and true person has recently been to some continuing education seminar and got sucked into something new....