How to avoid getting ripped off by the dentist (2024)

There are plenty of excellent, trustworthy dentists out there who make their patients' interests their top priority.

But there are also some unethical dentists who provide unnecessary treatments and products simply for profit.

I've discovered this after growing up having dental work done by my father, who is now retired. In the years since, while seeing other dentists, my brother has been told he needed six fillings that turned out to be totally unnecessary (based on my dad's look at his X-rays) and I've been pressured to buy prescription toothpaste and other products I didn't need.

Back when he still practiced, my father occasionally saw this kind of thing firsthand. His patients would visit other dentists for an emergency while he was away and be told they needed superfluous crowns or other complex work when a simple filling would have sufficed.

dentistry has far less oversight than any other branch of medicine

To be clear, this sort of frauddoesn't go on in most dental practices. But experts say it still happens all too often. "There are no precise figures about how widespread dental fraud is. The crime is less than a tsunami and more than a trickle," said James Quiggle of the Coalition Against Insurance Fraud. "The vast majority of dentists are honest and ethical. Even so, more fraud likely is flying under the radar than people realize."

One of the main reasons* is that, in the United States, dentistry has far less oversight than any other branch of medicine. "For a dentist who practices alone, there's usually no one looking over your shoulder," my father, Sheldon Stromberg, said. "It's easy to take advantage of people. You're basically given a blank check."

Another reason is that dentistry genuinely involves a degree of subjectivity in each diagnosis. Two honest dentists can disagree about whether a tiny fissure requires a filling or not, and all dentists fall on a continuum of philosophies ranging from conservative to aggressive in their treatments. Some dishonest ones, though, abuse this uncertainty to increase their profits.

With this in mind, I spoke to seven dentists — along with Quiggle and the American Dental Association — to get their advice on how to find an honest practice and avoid unnecessary work. Here are their recommendations.

Beware of practices that advertise and offer deals

How to avoid getting ripped off by the dentist (1)

(Philippe Huguen/AFP/Getty Images)

Every single dentist I spoke with offered the same advice for finding a trustworthy practice — ask a friend. "The best way to get a good referral is to ask friends or coworkers," said Robert Rose, a family dentist who practices in Pasadena.

If you don't have anyone to ask, other options might be getting a recommendation from a local dental society, or even just asking your doctor who he or she sees.

The one thing you shouldn't do, however, is go to a practice based on an advertisem*nt, especially one that offers a free cleaning, tooth whitening, or other deal. "I would be wary of the big advertisers, who have billboards all over the place and advertise on TV," said Mindy Weinman, who practices in Buffalo and is a professor at the SUNY Buffalo dental school.

these offices often use deals as a tool to get patients in the door

Her husband, Dave Weinman — who practices with Mindy and also works as a consultant for an insurance company assessing cases of potential dental fraud — agrees. "I barely see any dental offices, in my area at least, that are heavy advertisers and that I'd feel comfortable recommending," he said.

The reason for this is that advertising-driven offices often use deals as a tool to get patients in the door and then pressure them to accept an expensive treatment plan, whether they need work done or not. Oftentimes, they're corporate-owned chains, like Aspen Dental."These big chains are kind of dental mills," Mindy Weinman said. "They're the ones that give you the free cleaning, and the free exam, then they tell you that you need $3,000 worth of dental work."

Relatedly, manyof the practices you see in ads rely on a quota-based work model, in which each dentists is required to perform a certain number of procedures per month. These sorts of quotas lead dentists to err on the side of extra treatment, rather than less.

Be skeptical of a new dentist that prescribes a ton of treatment

How to avoid getting ripped off by the dentist (2)

(Philippe Huguen/AFP/Getty Images)

The most common pattern of fraud is a patient visiting a new dentist for a checkup and being told he or she needs a heavy amount of work.

"If you go to a new dentist, and you've barely ever needed any work in your mouth,and all of a sudden he tells you that you need 16 fillings, that's a big red flag," said David Silber, a dentist in Dallas.

Of course, if you're visiting the dentist because ofa specific pain, this advice doesn't necessarily apply. But in some cases, an unethical dentist will seek to maximize treatment on a new patient. "If you go in to a new dentist for a cleaning, and things are feeling good in your mouth, and all of a sudden they say you need a ton of work — that's probably not a good thing," Mindy Weinman said.

Related is what James Quiggle calls the pressure trap: "The dentist tries to pressure you to get expensive procedures done right away, citing urgent medical need," he said. "The dentist is evasive about details involving your medical need but is specific about the urgency for that procedure."

Watch out for the following products and procedures

How to avoid getting ripped off by the dentist (3)

(William Warby)

Apart from the general problems outlined above, the dentists I interviewed mentioned several specific products and procedures that are often abused:

1) Replacing old fillings: Although old fillings can sometimes crack or become surrounded by decay, necessitating a replacement, some dentists will try to replace all your fillings simply due to age — a practice that isn't actually necessary if they're not causing problems.

"The big red flag is if you go to the dentist and they say, 'oh, you've got old silver fillings, we need to take them out because there's mercury leeching out," Mindy Weinman said. "There's been no evidence to prove that actually happens."

2) Veneers.Sometimes, a dentist will tell a patient that pricey veneers are necessary to improve the color of a tooth, but if its shape is acceptable to begin with, bleaching — a much cheaper process — is perfectly fine. "A lot of cosmetic dentists tend to push this kind of treatment,"said Sean Tomalty, a family dentist in South Florida.If you're certain you do want veneers, Dave Weinman recommends going to a prosthodontist rather than a general dentist.

3) Fluoride toothpaste and treatment. I was recently told I needed a $30fluoridetreatment and $25 prescription high-fluoride toothpaste — neither of which was covered by my insurance — even though I've only had a couple of cavities in my life.

"Most people get enough fluoride in their drinking water and from regular toothpaste, and by the time you're an adult, and your teeth have fully formed, the fluoride treatment doesn't do much," my dad said. "For someone who doesn't get lots of cavities, it's a waste."

4) Night guards. I was also offered a $700 night guard during my recent visit, due to some signs of wear on my teeth, presumably caused by nighttime grinding.

In truth, some people do need night guards — mainly if theyhave TMJ pain, or show especially high rates of wear. But all people gradually wear down their teeth over the course of their lifetimes, and not everyone needs a night guard. Some dental practices simply prescribe them to most patients as a matter of course.

5) Sealants.Dental sealants are preventative coatings applied to the surface of your molars to prevent plaque from accumulating in the pits on their surfaces. They can be useful in some cases — especially for cavity-prone kids — but are also overprescribed by some dentists.

"The problem is, a lot of the time,those teeth weren't going to decay anyway, you've weakened the tooth by etching into it to adhere the sealant," my dad said. "An office that does a lot of sealant for adults is something to watch out for."

Ask to see X-rays and get a second opinion

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(BSIP/UIG Via Getty Images)

Virtually all honest dentists will gladly show you X-rays of your teeth that contain evidence of the work you need."X-rays, legally, are your property. A dentist can charge for them, but they have to share them with you," Mindy Weinman said.

You won't necessarily be able to see evidence of every single type of problem in an X-ray, but many of them should be apparent. A dark spot or blemish, in general, corresponds to a cavity. And in general, the dentist should be willing and able to explain why you need certain procedures, both by using X-rays and other means.

if the first dentist seems reluctant to let you get it, that's a bad sign

But regardless of what the X-rays show, ifyou're skeptical of the treatment a dentist is prescribing — especially if it's your first visit to the practice, and they're recommending far more work than you're ever needed before — the best response is to get a second opinion. This was mentioned to me by every dentist I spoke with, along with the American Dental Association.

"Ifeverything is fine, and all of a sudden I go to a dentist that's telling me I have a bunch of cavities, I would definitely get a second opinion," Tomalty said.

Even before you actually get the second opinion, doing this can provide useful information. If the first dentist seems reluctant to allow you to get it, that's a bad sign. "If they're legitimate in their diagnosis, they should have no concerns about it at all," Dave Weinman said. "It's a red flag if they fight you on that."

It's important to remember that no dentist can force you to have work done — and if you're uncomfortable with how things are proceeding while you're in the chair, it's entirely within your rights to get up and leave. In general, they should be willing to listen to you, hear out your concerns, and patiently explain the work they're prescribing.

Dental insurance can actually cost you more

How to avoid getting ripped off by the dentist (5)

(Thomas Trutschel/Photothek via Getty Images)

To many people, dental insurance sounds a lot like medical insurance — a prudent way of ensuring you can pay for potentially catastrophic treatment costs.

But for a few different reasons, dental insurance is far less important to have than medical insurance (whichis now mandatory in the US) — and might even be a bad deal on the whole.

"Insurance is supposed to be for rare, catastrophic losses that can't be predicted — like your house burning down, or a heart attack. But dental care isn't rare, or unexpected, or catastrophic," my father said. "For the most part, it's relatively small charges, on the order of hundreds of dollars, and you know you'll need to visit a dentist every year."

All types of insurance companies aim to make money, so they make sure thatthe total money everyone pays in premiums is larger than the amount they pay out in treatment costs. For unpredictable, potentially catastrophic things (like heart attacks), this extra cost borne by the policy holders is worthwhile, because virtually no one has a few hundred thousand dollars lying around to pay for a coronary bypass surgery. But for dentistry, that isn't the case.

insurance plans put perverse incentives in place for in-network dentists

As a result, people can opt out of dental insurance, then build up treatment needs over the course of several years, then opt in. Dental companies know this, and so to turn a profit, they're forced to cover relatively little, in terms of treatment. Most dental plans come with a hard cap on the total amount of treatment they'll pay for in a given year — the exact opposite of theout-of-pocket maximums in medical insurance plans.

Even more problematically, insurance plans put perverse incentives in place for in-network dentists. When dentists become part of these networks, they agree to extremely low reimbursem*nts for cleanings and exams, in exchange for a steady stream of patients. "To make up for it, some dentists will find work to do," Silber said. "There's always going to be treatment, because they mathematically need to do something so they don't lose money on the cleaning."

Most often, the treatments they recommend are the very ones that insurance doesn't cover — such as quadrant scaling, an intensive cleaning procedure that requires extra office visits. This is what happened to me when I recently saw a new dentist I found through my insurance network.

Ultimately, your dental plan might give you a free cleaning and exam every six months, but it could also make the dentist more likely to find necessary work that it doesn't cover. Most of the dentists I spoke with strongly recommended against going to a new dentist solely because he or she is accepted by your insurance plan, and a few warned against dental insurance entirely.

One option: dental school clinics

How to avoid getting ripped off by the dentist (6)

(Wired Photostream)

If you're stuck and having trouble finding a dentist you trust, my father recommended one unorthodox option: going for a consultation at the clinics operated by most dental school.

"The work can take a long time, and the hours can be pretty restricted, but they're inexpensive and the work is generally very good," he said.

That's because having work done at a dental school clinic inherently involves a huge amount of oversight: every diagnosis and filling is checked over by several students and professors. Like massage and salon schools, they provide essentially the same product as professionals for a fraction of the cost. And in general — and contrary to many people's idea of dentists-in-training — dental school students do quality work by the time they're treating actual patients, after learning on models. In any event, these clinics are a great place to go for a second opinion.

*Why does all this unnecessary work happen?

This article is mainly a guide to avoiding unnecessary work. But it also raises an interesting and important question: why is dentistry more prone to fraud than other branches of medicine? Here are some of the reasons most commonly brought up by the dentists I spoke to:

1) Lack of oversight. "If you go to a doctor, and you have a procedure done in a hospital, the staff and lots of other people know what's going on," my father said. "With dental work, no one's looking at you. You can do and say anything."

In rare cases, oversight can come in the form of audits by insurance companies suspicious of fishy-looking billing patterns (and in extreme cases, in patient complaints to local dental societies or malpractice suits), but on the whole, few dentists have anybody evaluating their work on a consistent basis. Moreover, for most types of finished work — say, a new set of fillings — it's pretty much impossible for any other dentist to tell after the fact whether they were necessary or not.

2) Inherent subjectivity. An individual dentist's treatment philosophies and personal judgement are an inescapable part of dentistry. "You can have five dentists look at your mouth, and sometimes you'll get five different answers on what treatment you need," Tomalty said. "Every dentist has their own philosophy."

Conservative dentists might be content to wait years for a tiny cavity to become bigger before drilling, for instance, while more aggressive ones might want to work on it immediately. Neither is wrong, but in some cases, unethical dentists can take advantage of this grey area to push more treatment.

3) The changing business of dentistry. Several dentists I spoke with singled out a few additional business factors: the increasing amount of debt taken on to pay for dental school and the rising technological costs needed to outfit a new practice.

"The new dentist today is up to their eyeballs with debt and needs to make money, so in some cases, they may be doing too much treatment," Dave Weinman said. This could mean erring on the side of unnecessary work to sustain a fledgling practice, or it could mean joining a large existing practice that has quotas in place for new dentists.

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How to avoid getting ripped off by the dentist (7)

How to avoid getting ripped off by the dentist (2024)

FAQs

How to avoid getting ripped off by the dentist? ›

Prevent Dental Fraud

The dental consumer can protect themselves in the following ways: Always get an estimate before treatment. Ask questions about the estimate & have it explained. Ask to see the x-rays and or photos. Ask questions about the procedure.

How to not get ripped off at the dentist? ›

Here are their recommendations.
  1. Beware of practices that advertise and offer deals.
  2. Be skeptical of a new dentist that prescribes a ton of treatment.
  3. Watch out for the following products and procedures.
  4. Ask to see X-rays and get a second opinion.
  5. Dental insurance can actually cost you more.
  6. One option: dental school clinics.
Aug 12, 2014

How to not get scammed by dentist? ›

Prevent Dental Fraud

The dental consumer can protect themselves in the following ways: Always get an estimate before treatment. Ask questions about the estimate & have it explained. Ask to see the x-rays and or photos. Ask questions about the procedure.

What should you not say at the dentist? ›

Common Things People Say to Their Dentist – That are Absolutely NOT True
  • NOT True # 1: “But it doesn't hurt so why do you say I need a….” ...
  • NOT True #2: “My insurance only covers cleanings every 6 months so that's all I need” ...
  • NOT True #3: “Mouthwash is way cheaper than what you are telling me to do to treat.
Mar 22, 2021

Do dentists give fillings unnecessarily? ›

But did you know that many dental fillings are actually overprescribed? In many cases, small cavities don't need to be filled immediately since they may not worsen or even cause discomfort. This means some people end up paying for a procedure they don't really need! So yes, fillings can be a money trap.

Is 10 cavities a lot? ›

How Many Cavities is Too Many? A few cavities may be normal due to sugary diets and oral hygiene, but more than 3 or 4 may indicate a need for better dental care and diet changes. Actively having a high number of cavities (more than 4 or 5) at one time might indicate issues with oral hygiene or diet.

What are the signs of a bad dentist? ›

Warning Signs of a Bad Dentist
  • Ignoring Dental Symptoms. ...
  • Missing or Incomplete Dental Records. ...
  • Lack of Proper Sterilization Procedures. ...
  • Lack of Informed Consent. ...
  • Conducting Procedures Not Covered by Insurance. ...
  • Unnecessary or Excessive Treatments. ...
  • Unprofessional Behaviour. ...
  • Surprise, Inaccurate, or Multiple Bills.

Why do dentists push crowns? ›

Dentists use crowns if the original tooth is cracked, chipped, or broken; if it requires a filling that's too large for the tooth to support; if it has too much decay or is too worn; or if it's extremely discolored or misshapen.

How to tell if a dentist is good? ›

If you're wondering whether or not yours is top of the line, we believe these are ten qualities that make a good dentist:
  1. Actively Listens to You. ...
  2. Educates You. ...
  3. Respects Your Time and Resources. ...
  4. Keeps a Clean Office. ...
  5. Only Promotes What Is Necessary. ...
  6. Gets to Know You. ...
  7. Values a Long-Term Relationship. ...
  8. Cares About Their Staff.
Jan 9, 2023

What dental specialty is most sued? ›

Oral and maxillofacial surgery Prosthodontics results are in accordance with the majority of studies conducted by other authors 1,2,3,14,15,16,17,18 , indicating that prosthdontics, oral and maxillofacial surgery and orthodontics are the specialties mostly involved in civil liability lawsuits.

Should I close my eyes at the dentist? ›

The more compliant you can be about lying back, actually turning your whole head (not just shifting your eyes), and staying open wide, the better we can treat you and remain in our career.

Will dentist be disgusted by my teeth? ›

Even if you're coming into our office for treatment for a dental problem, there's no need to feel like your mouth is “gross” or beyond repair.

What are the most common dentist mistakes? ›

Common mistakes include misdiagnosis of tooth decay, failure to take x-rays before treatment begins, performing unnecessary procedures, and incorrect filling placement or extraction techniques.

How to know if a dentist is scamming? ›

4 Warning Signs of a Fraudulent Dentist
  • Urgency Without Details. If your dentist tells you that you need to have a procedure done immediately, ask why. ...
  • Heavy Work That Comes Out of the Blue. ...
  • Deals That Are Too Good to Be True. ...
  • Diagnosing a Lot of Procedures Not Covered By Insurance. ...
  • Not Showing You X-Rays.
Jan 12, 2015

Why are dentists pushing Invisalign? ›

The reasons why many dentists are promoting Invisalign are multifaceted. Patient demand for discreet orthodontic solutions, high satisfaction rates, technological advancements, and the expanding scope of treatable cases are some of the key drivers.

Can you fix cavities without fillings? ›

If you see white spots on your teeth, you are probably looking at the earliest stages of tooth decay. At this point, the cavity can be reversed by building up the minerals in the enamel with fluoride toothpaste and/or fluoride treatments from your dentist. The strengthened enamel can stop the decay in its tracks.

How can I avoid going to the dentist? ›

Top Excuses to Not Visit a Dentist
  1. My teeth don't hurt, so I don't need to visit. An analogy could be applied to a car maintenance. ...
  2. I have more important things to do... (like clean my toilet). ...
  3. My insurance doesn't cover my treatment in full. ...
  4. It's going to hurt, so why visit. ...
  5. I've had a bad experience in the past.
Apr 1, 2019

How can I fix my teeth if I don't have money? ›

State and Local Resources. Check with your state or local health department to learn about programs in your area that offer free or reduced-cost dental care. The State Health Insurance Programs provide free counseling and assistance with Medicare. They have locations in every state.

Is a dental deep cleaning ever really necessary? ›

In some cases, a dentist may determine that regular cleaning is sufficient for maintaining oral health, even if signs of mild gum disease are present. However, if gum disease has progressed to a more advanced stage, deep cleaning becomes necessary to address the underlying issues effectively.

Why do dentists no longer pull teeth? ›

Another reason why dentists refuse to extract your tooth and convince you of the more expensive option is that when they pull your tooth out, the other teeth will shift. It would eventually harm your everyday functions, such as eating and smiling.

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