Dental Fraud
2012 Update:
It seems I am not the only one who has a beef with our dental profession.......
| 'Dentist the Menace' |
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'I
firmly believe everything I have experienced in my life up until this
point was preparing me for this long and very lonely battle. It has become who I am: A really pissed off grandmother - and I am perfectly OK with that.' ~Debbie Hagan |
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| Debbie's Blog |
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Below is a sampling from several message boards where the topics of crown lengthening, deep root planing and fake cavities are not unpopular topics. Some pretty good information and advice here as well.
Status: Scary scam
An Indiana dentist has been charged with diagnosing patients with cavities that didn't exist. This is the kind of thing that feeds the popular paranoia about dentists:
The attorney general's office said Dunlap diagnosed three patients with cavities, but the patients sought second opinions and were found to be cavity-free. State officials said Dunlap diagnosed a child with 10 cavities in June, but another dentist found that the child did not have any cavities. A similar complaint was filed by a patient in May 2004, said Staci Schneider, a spokeswoman for the attorney general's office.
Personally, I've never had a cavity. But one time a dental assistant cleaning my teeth told me I had three or four cavities. Luckily the dentist who checked her work recognized that the 'cavities' were just grooves in my teeth.
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Heh i can top that, I saw a documentary on bad dentists once, and this dentist told this guy he needed all his teeth out, so the guy had all his teeth removed and then almost bled to death though his gums because the guy didn't sow up the openings. it turned out he needed no teeth removed and the dentist was just, well a freak
And what was the dentists defense? he claimed that the guy had asked to have all his teeth removed....
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I've had this same thing happen; both my wife and I had appointments, and the dentist had all sorts of fancy new equipment. He told us both we had a bunch of cavities, after not having any for a decade, so we went to another dentist who didn't find any. Guess I should have called the VA authorities. Oh well.
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They get paid for removing cavities, so it seems perfectly realistic that this guy is a poor sob who tries abusing his job for the extra money he can scorch
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I found a book at a discount bookstore called MediScame by a guy name Chuck Whitlock. He has a whole chapter on the scams dentist pull.
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A few years ago Erik and I went to a new dentist to get our teeth cleaned. The first appointment we went to, I never even made it in because he spent well over an hour and a half yelling at a patient over insurance, and how theirs is bad etc. (Don't know why they stayed for it either.)
The second time I went, he did get me in to look at my teeth for about 3 minutes, 2 hours after my appt was scheduled.
He told Erik he needed all kinds of stuff done, including gum scraping surgery etc. I was told I needed a ton of work done as well, all very expensive.
Well, we went to another dentist instead - 6 months later because we figured we needed to up our dentist insurance first so we could afford all this work... Erik got his teeth cleaned normally, and I needed a single filling. That's it.
The problem with dentists, is, as I found out, they're not regulated the same way physicians are. I'm just glad we decided to see a different dentist in the end, so the whole thing left me rather skeptical and picky about dentists. I now travel 2 hours each way to go see one I'm happy with.
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Maybe it's just a coincidence, but my wife and I have been going to a very large dental practice for the last 10 years and have been noticing a huge effort to push the so called 'deep cleaning'. Basically, it's an additional teeth cleaning, except they do a little more work on the area below the gumline.
I am especially religious about going for the six month cleanings, brush twice a day, floss reasonably often, and yet every two years, they seem to want to do the deep cleaning. The previous 20 years of my life when I took far less good care of my teeth, no such service was ever requested or even offered. Naturally, this 'extra' is not completely covered by the insurance and seems to make them additional money since they are hitting you up three times a year instead of two. I have consistently gone in to get it when they ask to do it, but today both my wife and I were hit up for it, and they asked us "when was the last time you had a deep cleaning?". This struck me as strange because that shouldn't matter, should it? All that should matter is whether I need it. It felt like they were really asking "when was the last time you had it because the insurance carrier only allows us to hit them up every so often and we want to know if enough time has passed for us to hit the cash register again..."
Maybe I'm just paranoid, and when it comes to my health, I'm obviously going to do what I can to stay as healthy as possible, but something about this procedure struck me as somewhat "made up". What say you on this? I'd particularly like to hear from anyone in the dental field, particularly any former hygenists who might fess up as to whether they have been asked to upsell this...
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A few years ago, as a lowly college student, a local dentist passed out coupons around the neighborhood for a $50 cleaning. Sweet! Don't have to go home for a cleaning, and half price of what the going rate around here is.
2 hours into my cleaning they tell me - via a light/pulse sensor - that I have six cavities. I'd never had a cavity in my damn life! They pressure me to fix them right then an there - at a steal at just under 2k. I tell them I'll make an appointment later in the week and rush out the door to call my mother, my sensible, if very harsh, mother. Who tells me she'll bet it all that I have 0 cavities. So I go to the dental school - the very place that doesn't stand to profit from my mouth. I have a 60 year old professor, retired from 20 years of private practice to teach, tell me I have some of the best enamel she's seen in her career, and that I'll never have a cavity so long as I brush just once (once!) a day. Oh, and I don't have any six or two or four or any cavities then, nor do I now. She had to report him, it was bad. He's still in practice, though.
But the bad part about filling teeth is the evidence is gone once the filling is in, so who's the wiser?
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My previous dentist, working with my HMO, always insisted I needed work done even though everything was fine. I had one cavity, and he said he found a whole bunch of them. I think he was just trying to get my health care moolah.
Soon as I switched dentists to one who my HMO didn't cover (which I had to because of the personal situation which I won't go into here), sure enough, there was less work to do.
Of course, I still wish I could go to an HMO-approved dentist, but not if they're gonna be so greedy with my money and time.
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As a dentist, the #1 cause of scams is...a difference of opinion.
There are a lot of ways to find a cavity. The traditional way is to take an explorer (that sharp, hook-shaped thingy) and poke it into the tooth. If it sticks-cavity. But there are many problems.
The first problem is, a dull explorer rarely sticks! So, a dull explorer will throw off a dentist.
Second, teeth go through cycles of becoming softer and harder, depending on your mineral uptake. So, the outside of a tooth may get harder if you use fluoride or ingest calcium, even if the inside is a big, "jelly donut" of tooth decay.
Third, dentists are people. They are not perfect, and may miss some areas of your tooth.
So is it any wonder that, even using standardized methods in a university study, the traditional method of finding cavities is 46% effective?
To make matters worse, everybody has their preferences. I prefer to treat cavities as soon as I find them, That way, I only have to make a little hole and I save more tooth. My buddy likes to leave little cavities alone, because he feels that as long as a cavity isn't getting bigger, it's OK. (how he measures this I don't know)
So, while second opinions are usually different, that doesn't mean that the first dentist is ripping you off.
I have a device that uses a laser to find cavities. It's called a "Diagnodent" and it's made by Siemens. It is 93% effective in finding cavities. I would recommend finding a dentist that uses this technology-they are keeping up with the times.
Posted ------------------, DDS in Lee's Summit, MO on Fri Nov 11, 2005 at 05:35 PM
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I went to a dentist and he said I needed to spend a bunch of money on this. I put it off, and meticulously brushed and flossed in the meantime. My next checkup was at a different dentist, who said I was fine. I wonder which one is right. Am I supposed to do 2 out of 3 opinions? 3 out of 5?
The first one also asked me if I wanted braces, which pissed me off because I already HAD braces as a teenager. There is a bit of space that opened up between my front teeth since then, but it's symmetrical and I'd never thought anything of it.
My previous dentist was a specialist in wallet extraction. He always had some new scam he was pushing. Deep cleanings, braces, cron replacements, bridges...
It was like have a user car salesman doing my teeth.
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So is it any wonder that, even using standardized methods in a university study, the traditional method of finding cavities is 46% effective?
Even using x-rays???
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The same thing happened to my childhood dentist--he lost his license for insurance fraud and misdiagnosing.
He was replacing fillings that didn't need it.
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Be very wary of the dental cameras that they use now that magnifies your teeth 100x or something like that. The lighting and magnification make it appear as if you have cavities (dark spots) where none exist. The dentist I went to told me that I needed to have all 4 of my previous fillings replaced, because I was starting to get cavities around them, and showed me the pictures to "prove" it. She then handed me an estimate of $2k and told me to see the receptionist to schedule the appointment. I declined to make the appointment. Instead I made an appointment with my husband's cousin, who happens to be a dentist, though not as conveniently located.
I told him that I was getting a second opinion and explained why. He seemed really surprised. He poked at my teeth with his implements of torture and said there was no evidence of cavities anywhere, including around the fillings. Then he took x-rays of my teeth and showed them to me. He said, "Lisa, if you had cavities, they'd show up on these x-rays. A cavity is basically a hole in your enamel. There are no holes in your teeth."
I showed him the pictures, which looked like the surface of the moon. He reddened and said quite angrily, "She isn't practicing dentistry. This is a MARKETING tool to try to convince you that you need something that you don't. And people like this are giving honest dentists a bad name."
The first dentist actually had the audacity to call me and remind me to make my appointment to fill my cavities. I told the person that I wouldn't be returning. She asked why and I told her that I thought they were being dishonest at best and criminal at worst.
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Wife and I just got done with a new dentist. I don't need cleaning I need "deep" cleaning..which of course isn't covered. We both feel like going to dentists these days, with their fancy offices , tools and large business and personal debts, feels a lot like going to a car dealership to have your car fixed.
Can you get your xrays from your dentist?
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As a hygienist, I am very sorry to hear about your impressions of dentists these days. Here are some things to consider. As far as the "deep" cleaning goes-if your probe readings-those are measurements that indicate gum disease (or periodontal disease) are above 4mm with bleeding, you have early indications of gum disease. Bone and enamel have to degenerate over 30% for it to show up on x rays. If you are unhappy with the diagnosis of either gum disease or decay, I urge you to go to another dentist and EXPECT to have someone explain everything to you, ask questions. Probing and xrays are essential, and be wary of any dentist who says "no you don't need this or that, that does not exist." A good dental office will not bash another professional If a dentist wants to change every tooth in your head, then there might be a problem with the dentist. The Diagnodent that Trevor Clemons mentioned is extremely accurate and finds cavities when they are small, not when they have broken through the enamel and are heading dangerously close to the nerve leading to a root canal. I too have been a victim in my pre hygiene days to insurance fraud and misleading diagnosis. Your dentist/hygienist/assistants are there to serve you! If they lack patience and understanding, maybe they should lack you as patients as well. As far as your insurance goes, they own some responsibility as well, did you know that the max you have right now is the same max they allowed 20 years ago. 80% of the population has a form of gum disease, I urge you to check out periodontal disease on the Internet and arm yourself with more knowledge other than what the insurance company will or will not cover--they are out to make money too. You would be surprised at the antics that they will go through not to cover your treatments.
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I have a question on crown lengthening. I believe that a dentist I had in the past did some work I did not need on a perfectly fine tooth. he root canaled a tooth that was not in any pain .He never put a crown on it, just filled it. He then told me I would need to make an appt for a crown. Ii changed dentists. My new dentist said he would not crown that tooth without a crown lengthening and showed me the xray and explained why. I am satisfied with my new dentist and so far trust him. However, crown lengthening is not covered on my insurance. My old dentist apparently drilled away at this tooth way under the gum line. What can i do? Please give me some advice. I am fixing the tooth regardless, because it is very visible. I feel as though i have been taken for a ride by my former dentist. Is there anything I can do to maybe have the dentist that ruined my tooth be responsible for the repair of this tooth? When all is said and done the tooth will have cost me 2000.00 give or take. Am i just screwed or can i do something? Please help.
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I just hate dentists - I go in to have a couple gum line cavities filled - (2 appointments) they are all nice - fixed em up perfectly. Then I get a cracked tooth from some corn nuts (ha) - I go back they drill and fill - I am told to bite down - she makes a face then says I broke the tooth - we gotta do it all over - she re-drills and fills it with some white stuff - I come home the novacaine wears off and I'm in ice pick splitting pain - I give it a few days w ibuprofen - still pain - I go back they file it down a little but still pain - they tell me if it still hurts in a week I will need a root canal and a crown- I go in tomorrow - I'm getting it pulled - I'll be damned if I'm giving those crooks any more money for sabotaging my tooth - I'm so pissed - it hurts so damn much.. They act like I'm a drug addict for asking for pain meds when I have to pay for their screw up - I hate Dentists - all of them have a scam - One I went to I had to pay more because he called it a hook - he had to twist his wrist funny so it cost me another 150 bucks - I hope they all die in pain.
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Jackie, unfortunately you had come across a dentist that was not so good. I am afraid your only recourse might be legally. But it would probably cost you more than paying for the tooth.
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Long "Deep Throat" style post.
Hello everyone. As a Dental Hygienist I have seen and felt terrible about all of what you patients have been and will go through. You are truly up the creek when dealing with Dentistry.
If you want it to change here is your chance.
Copy and Paste this post as well as the others and write, not e-mail your state and federal representatives and ask them to introduce a bill.
A bill to oversee and to regulate dentists and free hygienists to offer cleanings in their own offices. The rep is going to ask you whom should oversee them. What do we know about it they will say. Answer below.
The Dental School they graduated from should be responsible for their behavior. Have the state or fed fund a program for spot checks and interviews of patients. Will this work? Oh yes. Dental students are scared of instructors in school. They dreamed of the day they would get their license and never be told what to do again.
Everything had to be PERFECT working on patients in school. If today, they (Dentists) knew that someone from their school could "drop-by" and evaluate their work, patient environment, billing, at a moments notice, gone would be the "god complex"
We are all fighting when dealing with our Dentist.
You can make it stop with a letter. Keep sending. Once a month would make a real effect in this.
What causes all this?
Money is the problem.
An ethical dentist is the one in the regular house and regular car. Making honest money on teeth is HARD these days. If you see signs of extreme wealth, your insurance is getting emptied every year for CERTAIN. These Dentists believe your coverage is money owed to them. They just need to find a way to bill for it on procedures you will agree to. They call it making the patient compliant.
Non-compliant patients are something whole seminars are held for to teach wealthy Dentist about. Patients are the Dentist's adversary they are taught. Seminars to keep you from suing for negligence, seminars for getting you to sign over insurance check directly to them by giving them copies of your signature. The list is endless.
Does the office have lots of associates? One owner? These associates are usually foreigners or recent graduates who have very little experience. The host or owner Dentist is supposed to be around constantly watching or improving these person's technique. Most of the time you will find the owner Dentist not on premises or even out of state (vacation again?)
Dental Groups and HMO/DMO identify these practices most frequently.
Now to my group. Poor souls, really.
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Part II
An ethical Hygienist gets paid per hour to clean your teeth. The better job they do, the less work next visit. The better educated you are about your teeth and how to keep them healthy, the easier their job will be year after year. An unethical Hygienist is in "bed" with the Dentist to sell you on cavities and expensive root canals before the Dentist even comes in the room to give you an exam. "Soften them up, they trust you." They tell us. Dentist want to go in that room after a cleaning and just get verbal approval without any explanation on their part. Lawyers have taught them explanation educates the patient of what to expect. Let the Hygienist do it for you.
It lessens their exposure to successful lawsuits.
Hygienists with the highest incomes get paid for production in these office. The more drilling that is diagnosed the more they get paid in bonuses, including powered toothbrushes and prescription fluoride rinses and such. If your hygienist tells you that you have a cavity, they committed a crime in 98% of the counties in the U.S.
Why? A little know law and the iron ball that enslaves and prostitutes Hygienists to Dentists.
The law that keeps Hygienists from practicing in their own offices and giving reasonable cost cleanings to the public is the law prohibiting anyone but a Dentist telling you you have cavities.
If a Hygienist or Assistant tells you there is a problem with your teeth; cavity, abscess, gum disease, run from that practice. Go. Now. Tell everyone that that is what they are doing. They broke the law. Hygienist: "I told them they 'might' have a cavity, so the Dentist would not be mad at me." Ask a judge or a member of the Board of Dentistry if "might" or "area of concern" means you were not the first person to bring up the idea of a disease infecting the patient? Thought so. You just diagnosed a disease and committed a crime under the Dental Practice Act.
Why was it written?
Simple problem, Dentists need sales. No time to butter every patient up themselves. Tell Hygienist or assistants to talk to patients while cleanings and x-rays are being done. Problem solved.
Wait?
What if Hygienists and Assistants offer their services to the public?
Damn, problem two.
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Part III
Make what we ask them to do illegal. Conflict? No. Dentistry is regulated by Dentists. The states gave us that right. No one oversees what we do to patients after we graduate. Unless a patient complains to the state. Ha Ha! They can't see in their own mouth! Second opinion? Dentist do not tell on each other. It is part of the ethical code we agreed to in getting our license. We can pull a complaining Hygienist's license based on accusation. A Dentist gets a hearing and can still keep drilling teeth. We will fine him and the public will be happy. Hell it is just money to us. We have plenty!
There are check and balances in every other profession EXCEPT Dentistry. Why not Dentistry?
The morality of the men going into the field was unquestioned during most of the twentieth century.
Remember what has changed in our society in the 21st century. How do people feel about morality?
How many people lie about things every day now? Kids think lying is a skill set, not a liability for living life.
People lie a lot today. People who can get extra money from you for lying have motivation to lie more than those that do not.
Dentists have : Motive and opportunity to steal.
Little ache from cold water sir? No. That is the beginning of an abscess. With all my years of experience I have seen it before. (Bad Hygienist or assistant looks at floor so patient cannot read if we agree or not. Good Hygienist or assistant raises eyebrows and shakes head no, just barely to let patient know something is not kosher and should seek another Dentist.)
Nice older patient who has always listened to their Dentist even though the practice was bought by a recent new graduate who has lots of certificates on the wall from "Advanced Dentistry Weekend" courses, say "you know best doc, I just thought Ice cream was giving me the problem that's all."
Ethical Hygienist and assistant know sensitivity to heat is the test for an abscess. They know that the x-ray showed no abscess. They are powerless if they want to feed their family, since if the Dentist loses his license for doing things like this, they have no job. They keep quiet and hope things will someday change.
Whew. That is 1,000th of the problem that needs to be addressed. Don't get me started about how a room that needs 10 minutes to properly disinfect, sees a new patient before the chair is even cold from the last... Ask to look at the patient schedule. They will tell you no. It violates the privacy of the other patients. It will also show you that there is no time between patients for proper disinfection. It is done in under 60 seconds for most rooms and is not CDC or WHO compliant to kill disease from the previous patient. Want to be safe? Be seen first in the morning. Most virus and bacteria could not survive the whole night at room temperature and no water supply.
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Part IV
Ask for an internal affairs type program for dentistry like the police have. Ask to see your Hygienist freed from being "Pimped" by their Dentist. Patients want a cleaning every six months to look good. Dentists designed that exam at the end to convince that drilling needs to be done. Ask for an exam every year, not every six months and see how fewer fillings you will have. A real test of the problem is the following. If the Dentist still wants to come "check on things" after you told him you did not want to have an exam billed, and says there will be "no charge." They cannot find a filling to fill up their schedule with profitable procedures if you will not agree to letting them in your mouth every six months to convince you they are needed.
Tell the Dentist your insurance is maxed. They will probably tell you to wait until it renews to get your work done. Another insurance crime, but a way to keep you happy not paying out of pocket and feeling like the Dentist is "helping" you get the most out of your coverage. The Dentist really just made you party to insurance fraud. You did not know that, but that is not what the Judge is going to tell you. Watch out!
Hygienists are Prostitutes? Looks like it. Feels like it every day. If a Hygienist feels otherwise, she just likes the arrangement she has and looks forward to keeping things as they have always been. Abused wife syndrome comes to mind.
It is illegal for her to do her job unless she does it on his "corner"(office) and he gets his "cut"(70-80% of the procedures she performs.)
Think she got what she asked for becoming a Hygienist?
If not, tip her some cash, she works hard all day so his wife does not have to!
After ten years of being there, you think of all the patients and staff who have suffered...for inflated fees and Dentists down the street that knew, but never reported what was happening.
Failure to report is complicit in crime remember Doctor?
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P.S. For all you Hygienists and Dentist will halos and white angel wings, no it was not just one office. Not it was not one area. It was a county that is the third most wealthy in the United States.
I have fought with Dentists to do the right thing and watched them laugh and do it anyway. I have watched new graduates come in wanting to do good in the world and seen the slow and steady transition into what I described above. They want the wealth, the opportunity is there and they succumb.
Please ignore any spelling mistakes since I type close to 80 wpm. Dentists use Hygienists as Secretaries when things are slow. Typing is one of the requirements in a lot of offices.
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I found this website today after I came home absolutely pissed after going to the dentist. I have good insurance that pays for twice yearly routine exam and cleaning. I go to a new dentist today and they take a bunch of xrays and look at my teeth. then he says I need to come back another day for a "deep cleaning" which the insurance doesn't cover. I tell them I just want a routine cleaning covered by the insurance and he says he wont do it. then I later find out that my insurance wont cover the unnecessary "full mouth" xrays he took. so basically I'm stuck with a $100 bill for some useless xrays, and my teeth are still not cleaned. these guys are just a bunch of crooks. I'm going back to the cheap o dentist in the mall who just does the basic stuff without all this extra fluff to steal my money and the insurance's money. as for the dentists and hygienists reading this, I'm a physician in an academic hospital and I don't treat my patients this way or make clinical decisions based on how much money I can get from them. I do what's in their best interest.
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Corporate Dentistry
I am a practicing dentist for over 14 years and I can say I am not a fan of corporation dentistry. However, what people need to understand is that my overhead is 70%. Could you imagine starting a business that has that kind of overhead? I admit that I should have been aware prior to dental school(160K in debt in 1996) that this is the case but I was not. Also keep in mind dental insurance has not changed their benefits of $1000-1500 since the late 1960's. So as a dentist it is very tempting to just sell off the practice that needs 24 hours of constant attention and instead work for a big corporate owned place that lets me go home at 6pm and not think about business...so I understand why these are around. This program made it seem as all dentist are greedy. I know most dentist give back more than all my physician friends who make a lot more money and have zero overhead. Every time I see a patient it costs $40 just to set up(sterilization etc.) and then I have to pay staff. How am I going to do an extraction for $75 when it could possibly be life threatening. It's just not worth it . The system is broke.
It’s all designed to fool the taxpayer. Politian's get into trouble for overspending. They cut services, in this case Medicaid reimbursement fees for dental treatment. To keep the special interest happy, they agree to cover another procedure, everyone’s happy.
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Sealants
I work in an office (corporate mill) that takes Medicaid- MassHealth-in my state. which covers sealants on primary molars. In my opinion, I think sealants on second primary molars (first primary, very rare) are beneficial in only a small percentage of cases; high risk, deep grooves, ability to obtain good isolation, etc.
Here's what I find troublesome and wasteful from a taxpayers point of view.
- We routinely seal all primary molars up to the age of 8, even on low risk patients with shallow grooves
- 90% of the time dental assistants place them alone with poor isolation.
I only do sealants when I have good isolation. 95% of the time I use my Isolite.
With my criteria, I rarely seal primary molars.
The dentists who do treatment plan sealants on a 3 year old, that will not even remain still for an exam or cleaning are wasting tax dollars in my opinion. I do see pressure for assistants to do them from the corporate headquarters. Corporate heads want a “sealant” report daily. That irks the hell out of me. It irks me even more when the dentist is not busy at all and still let's the assistant do them alone!
