Does your dentist try to sell you add'l. services?
 

I loved my dentist in DC and relished going to see her a few times a year. I haven't had a cavity filling since I was 10 (I'm 36 now) and some of my fillings are 30 yrs. old. My old dentist in DC always said they were fine and looked like they'd hold out for many more years.

Now that I've moved to Phoenix, I've had to go to a new dentist. I'd read a lot on some local chat boards about dentists giving the hard sales pitch on teeth whitening and those new white cavity fillings. I went with one that was highly recommended and right by my house. Sure enough, the dentist came in and started immediately on how my fillings were bad, some were peeling back a little and there were minor cracks in this or that tooth and those new white fillings would fix everything. He used that fiber optic thing to take color photos and I think he purposely left them on the computer monitor for me to stare at for about 20 min. while I was waiting for the cleaning to begin.

When I went to leave, the billing lady had the estimates all printed out for me with the discounted insurance price, since they're "a partner" with my insuranc co. and it looks like my total out of pocket would be about $174. The money is irrelevant and probably a pretty good deal for six fillings replaced. But it just irks me that the first appt. with this guy I get the sales pitch on fillings that my other dentist always told me were fine. I also overheard him telling a few other patients that he'd have estimates for them when they went to pay. Is this normal?

Yep, Its the new business model for US dentists. Since preventative dentistry is so advanced in the US, the growth is in cosmetic dentistry.

He just wants you to have a purdy mouth Rick. Next time start cleaning your gun in the chair for those 20 minutes.
;)

There is no reason to disturb any dental work in your mouth if it is not giving you pain and there are a lot of bad things that can happen if you start opening things up that don't need it. I go to an HMO dentist and asked that specific question. Since they weren't going to make money upcharging me, they leveled with me. Fillings are designed to last only a certain number of years, but they can last a lifetime. You don't do anything to them until they tell you they need it, and you don't have to wonder when they do.

If you brush and floss and your teeth are healthy you won't need anything done indefinitely. Anything else the dentist wants to sell you is optional at best. Sounds like this dentist is a good oportunity for a different customer. The insurance angle is interesting too. A modest out of pocket to you for cosmetic work, but your insurer will pay several hundred dollars for "necessary" treatment. I would not return to that guy.

Oh, and they gave me a free Sonicare toothbrush. These things can't be cheap. When I went out to the billing lady, she asked me when I wanted to schedule those fillings. I said not anytime soon and I'll think on it for a while. She didn't push.

DDS like P-cars too ya know.

I have an old school dentist and he doesn't try to sell me anything, I'm sticking with him. I'm 51 and can't remember the last time I had to have a filling done.

If I were you I would look for another dentist.

I'm dumping my eye doctor for this very same reason, he is a great guy but once the exam is over he hands me over to the hard sell receptionist who tries to sell me $300 designer frames (made in China). :rolleyes:

To be honest, my old dentist in DC always had posters on the wall about teeth whitening or white fillings. And she or someone else there mentioned them to me once in a while. But it was never more than, "Hey, if you really want white teeth..." For the fillings she just said I'd have no doubt when it was time to have them replaced and that would be the time to go white if I wanted to pay the difference myself. I have just about perfect teeth and haven't had anything more than cleanings done since I was in grade school. Wisdom teeth came out in college and that was the only time I've ever had stitches. I know my good luck will run out one day, but I'm in no hurry.

Anytime you disturb a tooth it damages it. So if you have the orginal fillings replace you have to grind more of the tooth away to do a new filling. Thus weakening the tooth. Better to keep the old fillings. I have one filling left that is 40 years old. The other teeth that were filled have basically either had root canals, crowns, one refilled as it was loose and one removed as the Silver filling eventually cracked the tooth as it got mushed down into it....however that took 35 years.

My DDS offered to pull all my teeth...and replace them all with nice new implants...

I read one time in the WSj that the #1 Continuing Education class taken by a particular group of dentists one year was titled "Getting The Patient To Say Yes."

I have some 30 year old silver fillings that my new dentists wants to replace. He wants the better aprt of $1,100 per filling to replace with the white ones. This really bothers me - the fillings, on the other hand, don't!

As a Dentist, I would venture to guess that many that move out of the older, conservative growing cites into areas like Florida, Arizona, and Calif come under the same experience. Ask how long the Dentist has been out there? Many Dr's go in search of the "promise land" and expect to find someone that is willing to dump $5000 into their mouth because they have the disposable income to do so. There a lot of similarities between Cosmetic Surgeon and Dentist in that both can dramatically change your appearance and it seems that is important in areas mentioned above. From talks I have from patients that left my office in Pittsburgh and moved out West, they same over aggressive treatment happens to them. Chalk if up to the high cost of living I suppose. After determining that everything if fine with a patient after a check up, I ask them if they are happy with their appearance and if they want any changes. If not, that is fine with me. In fact, it's the ones that want too much change I worry about.

Either pics are needed, or you are weird . . .

It's not like I hung out with my dentists socially. I don't have any photos and I don't think she has any on her office site.

Is there any reason to have a panoramic x-ray every year and if there is why doesn't my insurance pay for it?

I've only ever had that done once and it was for my wisdom teeth removal.

play hard to get

Old school dentist? :eek:

http://images.scrippsweb.com/HGTV/20...mf303_2c_e.jpg

No thanks! I'll take "new & improved"...

I like my DDS. We always talk about P-cars. He is very reasonable. A friend of mine had a tooth that need pulled and he had beend told it risked a dry socket and all this crap and that it would cost 1500 to pull and he couldnt afford it. I told him to go to my guy and they pulled it for 75$ and there were no issues at all. My dad had a crown go bad once and this DDS fixed it for free. Said it was his error. Ahh the joys of small town Ok.

I used to be a rep in this industry selling to general dentists...the whole thing is a push-down where the manufacture reps train the dentists in weekend seminars for "CE credits" as well as "lunch and learns" with the and staff and also "study clubs" related to clinical issues and of course marketing to patients. The dental market is a huge money maker on all ends, and the good reps work hand in hand with the general dentist on clinical and marketing issues.

In addition to this, there are many, many practice-management groups across the country that hold their own seminars and sell their expertise on 'marketing to the patients' ' growing your practice' etc.

There are about 10,000 general dentists in Los Angeles alone...it is a very competitive situation for these guys and they do what they can to 'grow their practice'.

This doesnt make it "a scam" but it is what it is and is not unlike other industries....the dentists really do have a lot of overhead, employees to pay, expenses, insurance etc.

in addition....the whole economic world really is one big scam filled with marketing, price manipulations etc. all designed to get the money...if you really think about it. Medical and dental are able to thrive however on patients not really knowing any better...and this is where the onus is on the patient to become educated or get another opinion before spending the money on possibly unnecessary services.

btw $174 out of pocket for new fillings is an insane STEAL jump on that one Rick

Bingo. It just seems many of the Dentist in the growing area's are strong followers of them. I truely think in their own minds they are doing what's best for the patient. One of the reasons I never go to them, (I'm busy enough with a 3 month wait for appointments.) I don't mind informing new patients there is nothing wrong and move on. It's the "hungry" seller you have to beware. Interesting enough, one of the biggest consultants in Dentistry is Sterling Management, owned by Scientologist. http://www.Scientology-lies.com/press/atlanta-journal-constitution-1989-03-18/consulting-firm-aims-dentists.html

What an insurer pays should never be the absolute guideline for what needs to be done. Implants are a good example that not covered by insurers (generally) but, in my opinion, superior to other alternatives. As for Panoramic films, one every year is unnecessary. They are only to view wisdom teeth and other problems usually not viewed with routine bitewing radiographs. Insurances only pay for these every 3-5 years, which in this case is correct.

Almost 20 yrs ago a dentist told me I had a 6mm "pocket" that had to be fixe with some type of gum surgery. I went to see the surgeon, new MB outside, diamond bezel president on his wrist. He tells me $1200 or $1500, I can't remember which (with ins). Neither one seemed to be able to persuade me that it was really necessary. I declined. They warned that it would increase in size and consequences would be dire. Almost 20 yrs later it's still 6mm & I'm still waiting for the "dire consequences."

Here is my opinion from a dentist's standpoint...

Every patient is different and it is unfair to generalize or make an opinion based on an internet description. Everything that has been said here is absolutely 100% correct in "some" cases. Yes, there are money hungry dentists out there just like any other profession. They make me sick. I see the patients come into my office with all their silver fillings replaced with white ones just because their old DDS said they would get MS or some other unproven ailment. Arrrgh, now the white fillings are leaking and I need to explain to them why they need to be replaced all while they are still making payments on the old ones...yes, it does happen!!!

Now, that being said...there are lots of cases where fillings need to be replaced and sometimes they need to be replaced with crowns. If you could sit in my seat for a day you would see that old fillings can cause teeth to fracture leading to potentially more work, i.e root canals or extractions. There are different types of fillings, different techniques to placing them and of course the skills of dentists varies widely. I have seen both silver and white fillings fail and patients report that they were done only a couple years ago by a previous DDS. On the other hand, I have seen just the opposite with 30+ year old silver and gold fillings that look amazing. I am certainly not afraid to tell patients if their 30 yr old fillings look good. As a rule of thumb though, silver fillings usually last an average of about 25 years. They almost always need to be replaced eventually. White fillings usually have a somewhat shorter lifespan.

I hate to give people big expensive treatment plans and I do patients and friends favors ALL the time...but if it needs to be done, it needs to be done. I am hoping to not scare my patients away with this sort of stuff so they will return often and refer all their frients and family. In your case, I am sure your old dentist got used to seeing you every six months and has not noticed how things have worsened slowly over time. Now the new dentist is noticing a defective margin or a small fracture and wants to treat it...that is good. If in doubt, go get a second opinion. I am confident in my work and encourage a second opinion if the patient seems doubtful. Often times they return with a much, much larger treatment plan and estimate!

BTW, $174 for six fillings is dirt cheap!!! Get one or two done and see what you think of the work and experience and go from there.

Good luck and don't be an "anti-dentite!"

My perio guy is a good friend and we socialize with him a lot. He recently came back from some conference and said, with a huge energetic smile, that he'd found out about a 'new' bacteria that needed to be tested for and, if found, one needed a $500 root planing and course of antibiotics. Perhaps it's all true but the energetic smile made me ultra suspicious. Of course my wife and I both have that bug.

As a Veterinarian, I have been to numerous conferences where the practice mgmt. guys have classes so I know exactly what goes on. Add to this, this dentist friend has recently hired a very expensive practice consultant. Prices for routing prophy went up 40% !!

Hey can one of you dentist hook me up with a deal on a grill?

Something tasteful, maybe gold with platinum Porsche badges on each tooth.

My best friend from college is a dentist in Mountain View, CA. Hopefully, I'll see her in the next few mos. so she can take a look. I trust her more than anyone else. If she says it needs to be done, then I'll have it done.

Again, the $174 isn't the issue. I know it's cheap. But I didn't know that white fillings had a shorter service life. My old dentist often showed me close-up photos of my old fillings and always said they still look great. I have no reason to doubt her and she probably knows I'd do whatever she suggested without getting a second opinion.

Today my wife went for her first cleaning since moving to Phoenix and, of course, was subjected to the new patient sales pitch on getting all fillings replaced. They said it would be $850 out of pocket after insurance and they could do it today. Then they tried to make her feel bad for not doing it. What is with this BS? I'm getting my x-rays or photos on a CD to take to my dentists friend in CA next week for a second opinion. This whole pushy sales pitch from dentists is a totally new phenomenon to me.

Additional services?? Does this topic have a happy ending? Oops, wrong profession.

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i dumped a guy for doing stuff like that

what reallt pissed me off is he tried pushing a bunch of cosmetic stuff on my 81 yr old mom - he knew she was in ill health too

i mentioned it to a friend who used the same guy - he is chief of staff at the largest hosp. in town, so it may get around

there are plenty of fine dentists who are not greedy

when this happens - stop them right there, explain the problem and tell them you are going to find somebody else

I changed dentists when the one I had gone to for several years started giving me those kinds of pitches. Seems he'd recently gone to some kind of training for cosmetic dentistry. He also commented about how I had gum disease everytime I went in, when I couldn't perceive anything wrong over a long period of time. I changed to a great little Japanese lady dentist who's doing a great job and couldn't be happier.
I became suspicious of dentists from the time I was in grammar school. My parents took me to the dentist in our small town. He told my parents I needed all of my molars filled in the centers because of cavities. I told them I couldn't see any cavities, but they made me to do it because "the dentist knew about those things and we didn't". So I had to take time off from school for quite a while for my appointments while he ground and filled. That was in the days when they had those low speed, cable driven drills. Anyway, years later, my molars started cracking and breaking apart from all those large fillings and had to be capped. I know he scammed me (us - my parents), and have been suspicious since of dentists that push a bunch of procedures.

How did your wife find out about this Dentist? The problem with many areas that have been growing quickly is that there aren't many people with "roots" in the area that can give you a recommendation based on years of experience. And yes, it is upsetting to find out those that have unnecessary work proposed. Find coworkers or neighbors that live in the area and ask them. Don't use the phone book or any stupid 1 800 Dentist (these are just payed for by Dentist for referrals). If you ever step into an office and they diagnose and then want to do the work the same day, run. Unless for some kind of strange anomaly, most office are booked for months.

I actually read a long thread on this topic on City Data Forum and someone listed a few dentists within walking distance of my house that they claimed didn't pull this sh.....stuff. I think my wife found hers on her insurance co. website. We're both going elsewhere next time. I think Joeaksa told me he had someone, so I'll check with him. My mom told me the other day that she has some fillings older than 50 yrs. I mean, I'd rather be proactive and fix things before they require more work. But this used car sales pitch BS is very off-putting. Do they teach this nonsense in dental school nowadays?

I went to the same dentist for several years. Cool guy, we always talked about flying and aviation. Then he bought a new Mooney. Perhaps a coincidence, but suddenly my teeth got very bad. All of a sudden I had two cracked teeth that needed capped, one worse than the other. I got the "bad" one done with plans to get the other done at a later date. Then my wife went in, and she had two teeth that needed capped as well. This was after going to the guy for several years, all of a sudden we both needed a lot of work. They also started getting much more pushy with the whitening and adult braces, and raised their rates.

We bailed and went to a dentist recommended by a dental hygenist friend. No mention of my remaining cracked tooth, no mention of my wife's supposed two cracked teeth. Suddenly, both of us are fine. He asked me once, "has anyone ever talked to you about braces?" I answered yes, and that was the end of the conversation.

Personally, I think some are more "aggressive" than others and push work that doesn't really NEED to get done. Keep my teeth from falling out, don't waste my time, and I'm a happy camper.

Doesn't seem to be a problem with my dentist. Hell I even had an old filling fall out. He filled that one and said don't worry about the others unless they came loose.

My dentist completely changed the view that I had acquired of them as a child. My childhood dentist used a belt driven drill that did about 50 rpm. He would literally push me up the back of the chair and then stop so I could slide back down to start over. The dentist that I've had for the past 15 years or so is incredibly gentle and painless. As far as selling stuff, he said that I showed signs of excessive night grinding. He said that I could buy one of the mouth guards that they sell for a couple of hundred or go to Rite-Aid and get a football mouth piece for a couple of bucks that would do the same thing.:)

No Rick, I don't think they teach it in dental schools but all of them go to continuing education seminars all the time. Just after I came back into the US from Nam and started to practice (Vet Med) the seminars began to include 'practice management' classes. Many of these were directed at improving your income and it went from there. Their pitch was for you to just sell more products and services mostly by 'client education'. Not all these were bad ideas, in fact most are good, but some practicioners take it to extremes and don't have much in the way of honest sounding presentations.

My wife and I have both had the 'filling replacement' speach/scam run on us several times. Fries my bacon when that happens too but I expect that some old fillings do need to be replaced if they are deteriorating.

my dentist is always hounding me about x-rays. i have no cavities, no problems and im 42. whats he gonna see now that has not already shown itself.

My first of 4 will be starting college in less then 2 years. Maybe you should stay away from my office for a while.:(