If you’ve ever had a dentist inform you that you need a pricey procedure that wasn’t even on your radar screen, you’re in good company.
When you went in for your regular cleaning, maybe you were told you that you needed a more extensive and expensive “deep cleaning” treatment. Or perhaps the dentist insisted on placing a crown on a tooth with a small cavity instead of just filling it.
Or, maybe you were urged to replace your old mercury fillings even though they were intact.
These examples are part of a disturbing upselling trend dubbed “creative diagnosis” in a recent issue of ADANews, a publication of the American Dental Association (ADA).
Upselling in dentistry isn’t a new phenomenon but it appears to be on the rise. For one, dental school tuition has been increasing, and the average dental student now graduates with $241,097 in debt.
Meanwhile, dentists’ incomes have steadily declined over the last decade. Average general practitioner dentists’ earnings decreased from $215,876 in 2005 to $180,950 in 2013. This may be partly due to the fact that people get fewer cavities than they did in
the past, which means they have less need for dental treatment.
As a result, some dentists try to make up for lost income by recommending more expensive procedures and treatments than may be warranted.
While the mantra in dental school is to treat active decay first, notes Gigi Meinecke, DMD, a dentist in Potomac, Maryland, and a spokesperson for the Academy of General Dentistry, “I’ve seen dentists who will prioritize large ticket items (such as crowns, deep cleanings, or laser whitening) over treating active decay. X-rays seem
to be a frequent up-sell procedure.”
Healthy adult patients without observable cavities generally need a full set of dental X-rays every two years, according to the ADA
Besides excessive X-rays, other upselling tactics you should be on the lookout for include:
Filling replacement. “Without the presence of a recent or current change in overall health, it’s really rare that a person who has been receiving regular dental care would suddenly need to have all their fillings changed — that should raise suspicion in a patient,” Meinecke says.
“Deep” cleaning. “If you’ve been getting your teeth cleaned faithfully every 6 months since forever and someone says you need a deep cleaning, I’d get a friend to recommend another dentist and move on,” Dr. Meinecke says. “If the diagnosis is independently corroborated then go with it.”
Crowns instead of fillings. Having a crown put in is more expensive than a filling — and not always warranted — so this recommendation is a red flag.
“Most patients have a sixth sense about shady dealings,” Dr. Meinecke says. “If you’re feeling uneasy, be polite, make your exit, and seek a second opinion.”
The bottom line: “Most dentists are honest and entered this profession because they want to help people, but every profession has its bad apples,” Dr. Meinecke says.
“Patients should be as careful in selecting a dentist as they are in selecting their friends. If you don’t feel a dentist is trustworthy, genuine, a good listener, or respectful, find another one. There are lots of us out there.”