Dental Fraud 101: Unnecessary Procedures & Predatory Dentists

While most dentists are ethical, too many across the US and Canada are unhappy with the private insurance or Medicaid payouts they receive. They creatively and deviously convince unsuspecting patients to undergo treatments or buy products they don’t need. In some cases more expensive treatments are urged by the dentist when a lower-costing treatment is just as effective. The American Dental Association reports that $13 billion of the $136 billion Americans spend annually on dental care is lost to dental fraud. Below are a few of the more common unnecessary procedures, bad dentists and sound advice. (Three sources at end of text)

Do those old fillings really need replacing?

“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 (Clinical Professor, Restorative Dentistry, Buffalo, NY) said. ‘There's been no evidence to prove that actually happens.’"

Quadrant scaling is a common, often unnecessary procedure pushed for by some dentists:

“One treatment patients are commonly pressured to undergo in corporate dental chains is quadrant scaling: an invasive teeth-cleaning procedure along the gum line, usually done over three or four visits. While the procedure can be helpful if a patient suffers from severe gum disease, it can erode gum tissue that cannot grow back. Dentists can charge between $800 and $1,200 for each procedure, while a standard cleaning nets them only about $100.”

Nickel-chromium steel means more money in dentist’s bank account:

“Dr. Michael Davis, a dentist practicing in Santa Fe, New Mexico, said some dentists look for procedures for which Medicaid pays more. He explained that Medicaid pays three to six times more for nickel-chromium steel crowns than for standard fillings, so some dentists recommend those more profitable and invasive treatments to unsuspecting patients. ‘The fit of pre-manufactured steel crowns is unfavorable and can show gaps,’ Davis said, ‘so unethical dentists target little children who won’t notice the misshapen fit until their permanent teeth come in.’”

Pulpotomies

“Children who still have their baby teeth are prime targets for pulpotomies — the removal of the pulp of a tooth — whether they need them or not.”

A bolt is sturdier than a thumbtack:

“A standard dental implant is an artificial tooth root that dentists install to anchor a dental crown or bridge. A mini-implant, by contrast, is like ‘a thumbtack compared to a bolt,’ said Dr. David Weinman, a dentist practicing in Buffalo, New York. In the past, mini-implants were used only to hold dentures in place, but because they are so much quicker to install and cost the dentist as much as 60% less than a regular implant, more dentists have been recommending them as a long-term solution. ‘We in the dental community see a high failure rate when mini-implants are used where a regular implant is needed,’ Weinman said, ‘but that hasn’t stopped some dentists from pushing them on patients who don’t know better.’”

Researchers compared the cost and effectiveness of dental procedures with related products sold at the drugstore:

------Nine teeth whitening products were tested -- whitening strips, on-line bleaching tray, dental office bleaching, dental office take home tray, baking soda toothpaste, lemon juice, whitening toothpaste, whitening mouthwash and charcoal toothpaste. Whitening strips, specifically hydrogen peroxide gel strips, provided the most value in whitening teeth.

------Three teeth straightening products were tested - Smile Direct Club, Invisalign and orthodontic braces. Smile Direct Club provided the most value to straighten teeth.

Dentists Gone Bad - While obviously a minority, there are numerous dentists who break the law and endanger their patients. Just two examples:

------“The Texas Dental Board revoked the license of Bethaniel Jefferson, a dentist who was practicing in Houston, after she was found to be endangering her patients by needlessly administering general anesthesia to take advantage of the same insurance payments. She left one patient in an oxygen-deprived state for so long the child suffered severe brain damage.”

------ “Dr. Scott Charmoli, a Wisconsin dentist, was charged with fraud after he was found to be using his drill to intentionally break patients’ teeth so he could bill the insurance company for crowns instead of fillings. The indictment alleges that he performed more than $2 million worth of crown procedures between Jan. 1, 2018, and Aug. 7, 2019 — amounting to more than 80 fraudulent crown procedures a month.”

Advice from Buffalo, New York’s Dr. David Weinman:

“Weinman said patients can always seek a second opinion — especially for expensive treatments — and that a dentist who seems hesitant when you say you want a second opinion is worrisome. ‘A dentist who is confident in his or her abilities won’t have a problem with you checking a diagnosis or treatment plan elsewhere,’ he said.

“Other red flags: Weinman said to be wary of any dentist who seems to be reading from a script, or who pushes a treatment plan too hard or refuses to explain treatment options. ‘There may be several scientifically sound, evidence-based treatment plans available to a patient,’ Weinman said, ‘and a good dentist is willing to explain your options — even the ones that may not be as profitable.’”

Sources

How to avoid getting ripped off by the dentist https://www.vox.com/2014/8/12/5951321/dentistry-fraud-treatments-products

Why Your Dentist Might Seem Pushy https://khn.org/news/article/why-your-dentist-might-seem-pushy/

A Comparative Expected Cost Analysis Study on Dental Services and Products Used in the United States https://www.researchgate.net/publication/339339405_A_Comparative_Expected_Cost_Analysis_Study_on_Dental_Services_and_Products_Used_in_the_United_States

Further Reading

12 Red Flags To Watch For At The Dentist's Office https://www.prevention.com/health/a20484715/red-flags-at-the-dentists-office/

The Truth About Dentistry https://www.theatlantic.com/magazine/archive/2019/05/the-trouble-with-dentistry/586039/

The Challenge of Health Care Fraud https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/

Wisconsin Tops 2020 List of the States With the Best Oral Health https://www.dentistrytoday.com/news/industrynews/item/5961-wisconsin-tops-2020-list-of-the-states-with-the-best-oral-health

Photo: https://www.microsoft.com/en-us/p/mad-dentist-bieber-3d/9nbnzhgwgklp?&activetab=pivot:overviewtab

Jerry De Luca is a Christian freelance writer who loves perusing dozens of interesting and informative publications. When he finds any useful info he summarizes it, taking the main points, and creates a (hopefully) helpful blog post.