The Money Mustache Community
Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: travel2020 on May 14, 2024, 12:25:01 AM
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I recently signed up with a new dentist after my dentist of 20+ years retired. I was behind on my regular cleanings and wanted to get those going again so only did limited research on the dental practice before the initial appointment.
However, I’m second guessing my decision based on experience to date.
For starters, unlike the previous dentist, the new dental practice seems to be pushing different treatments and tests at every opportunity (dentist, hygienist, receptionist..). For example, with my previous dentist, aside from regular cleaning twice a year, I had perhaps 3-4 fillings and a crown done over 20 years. I can only recall one instance where the hygienist recommended deep cleaning to control plaque buildup.
The new dental practice is recommending root planing and deep “laser” cleaning every 3 months because of gum pockets, nightguard because apparently I have a habit of teeth grinding, fluoride applications to protect the teeth (not covered so out of pocket), and an OralDNA test costing a couple of hundred bucks to identify bacteria that may specifically be residing in the mouth and causing gum issues. The bacteria will need to be controlled via prescription antibiotics asap because there’s a strong link between the mouth bacteria and a plethora of major diseases like diabetes, heart disease, and more. They also want to schedule an appointment with their practice’s periodontist for bone graft and gum surgery that will probably cost $3-4k.
While I was waiting, I also overheard a conversation the dentist had with the patient in the next cube who was given a very similar diagnosis and also encouraged to bring in their SO for testing and treatment. Apparently, the patient’s OralDNA test results had confirmed they would require a course of antibiotics and the dentist wanted to examine and start treatment for their SO as well since the patient likely transmitted the bacteria to their SO.
Their whole approach came across as very pushy, not to mention very costly. I have no problem spending money on tests and treatments if they are really needed but I just don’t trust what I’m hearing. Going by other internet posts, it seems night guards and flouride applications are mostly about making money for the dentist. The only info I can find about oralDNA test seems to be put out by the company selling the test itself which makes me skeptical of its validity.
Am I being too skeptical or is this new dental practice only interested in maximizing their profits at my expense?
Thanks.
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Get a new dentist. A legit dentist doesn't sell you this nonsense.
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Get a second opinion if you are unsure. The risk is that the old dentist did not spot a lot of important issues. Modern dentistry is different from how it was taught and practiced 30 years ago.
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Dentistry is one area where the person you're seeing makes a tremendous difference in the care you receive. When I was a teenager I was seeing a dentist who constantly recommended procedures, and I was starting to think that my teeth were really bad. A few years later I moved and started going to a different dentist, who was of the opinion that any alteration in the mouth should be a last resort. Aside from having to repair three fillings that the first guy put in that had problems, I've had no dental issues since.
If something doesn't feel right, it probably isn't right.
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I ran into this a couple times after moving and having to find a new dentist. In the US, the label "comprehensive dentistry" is used by dentists who are trying to make your mouth 100% perfect - for a price. I personally am fine with the old school approach of don't fix it if it ain't broken. If that describes you as well, I would start researching new dentists.
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Based on the OralDNA's website, one of the key advantages of their test is that it helps increase the number of suckers who buy the crap being pushed by the dentist.
Incorporating OralDNA® Labs into your practice protocol has shown to increase patient acceptance of therapy and showcase cutting edge science to better personalize patient care.
https://www.oraldna.com/for-providers/
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Get a new dentist.
Some of the stuff you are being pushed can be 100% legit.
-- I have a night guard, because I literally cracked a couple of teeth grinding them at night. Made a huge difference.
-- Deep cleaning/scaling is sometimes necessary, particularly when you've been lax with the 6-month appointments for a while. I gave in and had this done, and my gum health measures improved pretty significantly (they weren't bad, but bordering on the level of "something needs to be done soon so it doesn't get bad").
Some of the stuff you are being pushed sounds like total quackery (DNA testing? GMAFB).
And some of the stuff you are being pushed can be in a complete grey area between the two, valuable to some who want "perfect" bright white teeth, not at all valuable to others who want to come in for an hour twice a year and be done with it. Dentristry has changed significantly since we were kids, which means there are more options available for treatment/improvement, and it's up to each person to decide how much of those new things they want.
But the thing is, it doesn't matter what is and is not legit. You are not comfortable with their approach. That means you don't trust when you need to follow their advice and when you don't. So find someone else who you can trust, whose approach more closely mirrors your own.
Why pay money for specialty medical care if you can't trust the advice you're paying for?
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This sounds like a dental chiropractor hybrid.
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I am also in the PNW and it sounds like we go to the same dentist or, at a minimum, they are in the same "how to make the most money off your patients" group. It's really frustrating. How do you get legitimate dental care without it being like a spa or plastic surgery office? Dental care for health and to keep your teeth?
@Metalcat Any suggestions you can offer?
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I have seen dentists like this. They are not my current dentists. Laura33 is right - you're not comfortable. Find a new dentist.
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I am also in the PNW and it sounds like we go to the same dentist or, at a minimum, they are in the same "how to make the most money off your patients" group. It's really frustrating. How do you get legitimate dental care without it being like a spa or plastic surgery office? Dental care for health and to keep your teeth?
@Metalcat Any suggestions you can offer?
Lol @ oral DNA testing.
Up to that point I was giving this clinic the benefit of the doubt, but fuck that noise.
The reason I was giving the benefit of the doubt is because "supervised neglect" is actually really common among older dentists, so it's extremely common that a new dentist will take over someone's care and legit find 5 figures worth of urgent work to do.
My job was to help dentists frame this as high quality service, not fraud.
It's a very, very tough sell since dental neglect is generally painless and doesn't cause problems until it's way too late and no one realizes how much prevention was missed along the way.
Anyhoo, point being, going to a new dentist and suddenly requiring a ton of work on your gums is common. My DH was a diligent flosser and got cleanings every 6 months for a decade. His dad was a dentist, he cared greatly about oral hygiene. Only, his lovely hygienist whom he adored because she caused no pain was never cleaning below his gums, which means she was never actually cleaning his teeth.
He had the gum health of a homeless drug addict. It took 9 hours and 4 surgeries to remediate the problem and 8 years later he just had to have one of those teeth pulled 2 weeks ago because it was too late for that one, even though it took 8 years for it to fail, it was doomed 8 years ago.
His dentist would have looked at his x-rays every year and had he bothered looking for it would have detected the shelves of calcified bacteria colonizing his tooth roots and destroying the jaw bone.
Fucking supervised neglect.
And yet, it's the neglectful dentists that people like and trust most.
So yeah, I was willing to give your new dentist the benefit of the doubt but DNA testing?? Fuck the fuck off with that bullshit.
I would definitely seek a second opinion at least.
My rule of thumb with dentists is to give them the benefit of the doubt when it comes to treatment, dentists under recommend treatment way more than they over recommend treatment because they're so conflict averse and it actually stresses them out to even have to recommend expensive treatment.
Also, fun fact, basic fillings are among the most profitable things dentists can do, so they would much rather tell everyone all day that they only need a few fillings than have to broach more expensive treatment.
Beware of diagnostics though. Not a lot of tech in dentistry actually adds that much in terms of diagnostic value. Most diagnostic tests in dentistry are just really good sales tools to demonstrate to patients why they need treatment, because again, dentists aren't terribly comfortable recommending treatment, so a test that shows that something should be done is a huge sales benefit.
The scammy/chiro model dentists I've seen (and refused to work with) tend to lean heavily on their diagnostic bells and whistles.
In any field of medicine, if you see an abnormally high emphasis on "advanced" testing that isn't industry standard, it's good to question what's more probable, that this practitioner is ahead of the curve and others are just failing to adopt truly important tech? Or that they are either scammy themselves or naive and fell for a scammy sales pitch?
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I had something similar happen when I moved. Because my old dentist was still practicing, just 7 miles away, I asked him for recommendations and found a better fit.
The person you saw... they aren't even very good at scamming people because they came on too strong. Ya gotta ease people in.
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I left a dental practice that was ‘preferred’ by my insurance company (and thus much cheaper) because they were always trying to upsell me on teeth whitening type treatments in a way I found uncomfortable.
Your situation is a little bit trickier as the procedures they are recommending aren’t just cosmetic but it definitely sounds off.
You have nothing to lose by trying a different dentist for your next cleaning - if they make the same recommendations you will be more confident going ahead with them.
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My dentist wants to do fluoride at pretty much every visit (I push back on this and won’t do it at a cleaning if I did/will do for crown/filings/other work near it. So about 2 out of 3 times. After multiple dentists pushing it, I finally agreed to the night guard due to grinding teeth. I think this can help prevent issues. I just did my first deep cleaning after a few years of deep pockets and infected gums. They also did antibiotic shots (which alone didn’t work last year). It’s pretty common for dentists to suggest 3-4 cleanings a year if you have issues too. My dental work is expensive, but not doing it in the long run is more expensive.
lol re DNA test. I’d be skeptical.
In any event, get a second opinion if you’re not comfortable. And consider switching dentists. Quality really does vary by dentists so I have some bad work in my mouth by prior dentists that failed.
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Thanks all for the replies!
@Metalcat @Laura33 appreciate the detailed responses. I agree some recommendations may be legit and point taken re older dentist missing stuff. Sounds like the OralDNA test is mostly to help the dentistry business and not a common industry tool to help patients.
At this point, I just don't have much trust in the new dentist's recommendations, so I'll spend some time researching other dentists in the area and schedule my next cleaning to see what they have to say. Will also reach out to the dentistry school in the area when they are back after the summer and get another opinion from them.
Thanks
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Relevant article: https://arstechnica.com/science/2024/05/do-you-need-a-dentist-visit-every-6-months-that-filling-the-data-is-weak/
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This same thing happened to me.
My trusty old dentist retired in 2016, and a new guy took over his practice. When I came in for my regular cleaning, he took 3-D X-rays of my head with a fancy-shmancy, expensive-looking new machine. He did the cleaning, then told me I had severe gum disease and was recommending a procedure where slow-dissolving antibiotic capsules would be surgically implanted in my gums.
This sounded fishy to me, because I've always had good teeth. I never even have cavities. I did some research on the procedure he recommended, and a common thread which came up is that it's a moneymaker for unscrupulous dentists.
I called the practice back and told them that the dentist recommended an inappropriate treatment and I wouldn't be returning. I found a new dentist I've been seeing ever since. She never said a word about this supposed severe gum disease the other guy claimed I had, and I continue to not get cavities.
There's a good article here on shady dentists:
https://www.vox.com/2014/8/12/5951321/dentistry-fraud-treatments-products
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Thanks @Bartlebooth and @FireLane for the article links. Interesting reading and an eye opener. Guess I’ve been fortunate to avoid running into this in the past dentists I’ve had.
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Thanks. Already switched to another dentist and happy with the move. Results are noticeably much better and they have not pushed a single additional service.