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Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly differen

Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teeth, even when they pose no problems. They re-did the experiment recently, and I think one of the guys they sent got his teeth cleaned and tartar removed from 10 dentists in a week or so. No one stopped to see if it was actually needed, they all just do it by default and charge you for it.

donatj 5y ago
I went to a new dentist for a broken filling and they tried to tell me I had 14 cavities and set me down with a finance person to set up a payment plan for how I was going to pay for them over the next 5 years. I went to a second dentist, they fixed the broken filling and said my teeth were otherwise fine. I have the paperwork to back this up. I’d been seeing another dentist for a while and he suddenly wanted to crown 3 of my teeth. Again I got a second opinion, and again they were like “That’s probably not necessary”. I think a lot of dentistry comes down to how much money they need that month. It certainly doesn’t feel very scientific.
- tomxor 5y ago
  Unnecessary medical procedures are extremely immoral, do you mind sharing what country/practice this was in?
  - donatj 5y ago
    United States. Here’s my yelp review of the first place. https://www.yelp.com/biz/shamblott-family-dentistry-hopkins?hrid=3kR-ZmEnxx-skLw0-tt3LQ https://www.yelp.com/biz/shamblott-family-dentistry-hopkins?...
  - ceejayoz 5y ago
    Not OP, but there's been a lot of this in the US. https://www.pbs.org/wgbh/frontline/article/patients-pressure-and-profits-at-aspen-dental/ https://www.pbs.org/wgbh/frontline/article/patients-pressure... > Former employees say Aspen Dental trained them in high-pressure sales. Corporate management scrutinizes the production of dentists and staff daily. And internal documents show that dentists get paid bonuses as key production targets are met. https://www.elpasotimes.com/story/news/health/2018/01/10/kool-smiles-pay-23-9-million-accused-unnecessary-dental-work-children/1023083001/ https://www.elpasotimes.com/story/news/health/2018/01/10/koo... > "Especially when that fraud involves performing unnecessary procedures on kids —here, unnecessary baby root canals and tooth extractions, among other procedures —we will not hesitate to use every tool at our disposal to punish those who break the law," Bash said. > The accusations against Kool Smiles included prohibiting parents from being present during root canals "to keep hidden the child's suffering" and retaliation against "unproductive" dentists, according to a federal complaint filed in San Antonio in 2013.
    - lupire 5y ago
      > 2013. So they never got punished?
      - ceejayoz 5y ago
        "Kool Smiles to pay $23.9 million" sounds like they're being punished? They typically settle and sometimes pay a fine. https://ag.ny.gov/press-release/2015/ag-schneiderman-announces-settlement-aspen-dental-management-bars-company-making https://ag.ny.gov/press-release/2015/ag-schneiderman-announc... I suspect they still make more profit than they lose in fines.
        mindslight 5y ago
        Having an unexpected cost and thereby not making a profit isn't actually a punishment - it makes the risk calculus a tame "I probably won't get caught", while the expected value remains positive. I realize I'm criticizing our entire enforcement philosophy for white collar crime here. But still, unless there are actual routine-disrupting punishments like jail time for violating basic professional responsibilities, we would expect unethical behavior to just continue increasing. And this goes double for setups to make such violations "nobody's fault" like the creation of perverse incentive structures. In the context of blue collar crime, that's called a "conspiracy".
- brightball 5y ago
  This was my experience as well. I went to the same dentist office for years with no issues. He sold the practice so we went to the new guy...every single time we went in there was a cavity that needed to be filled. Went to a new dentist and everything is fine again.
  - brootstrap 5y ago
    One of my good co-workers is daughter of a dentist from the UK. the practices there are much different. We have had him analyze xrays and scans, he says its fine the people here just want/need your money!
  - FollowingTheDao 5y ago
    My dentist was arrested in the 80's. He gave me three unneeded root canals. He was sniffing laughing gas. Good times....
- pc86 5y ago
  I went to the same dentist for years as a child. Brushed my teeth once a day, never had any issues at all. All of sudden, during a regular checkup, he told my parents (I was ~15 at the time) that I had 9 cavities and needed fillings. In the 20 years since, I have never had a single cavity. And what a shock, he sold his practice between that procedure and my next checkup. I fully believe he was just pumping up his revenue to increase the sale price, and my parents weren't health literate enough to get a second opinion, and I was too young to know that just because he has a white coat on doesn't mean he's a good person. Dentists are in the sweet spot where they actually are very important and necessary (as opposed to chiropractors, who are universally charlatans and frauds), but they don't get quite the scrutiny and oversight that physicians are used to. And they make as much as some of the top tier physician specialties. PCPs, OBs, ER, etc. all make less than dentists by and large.
  - bostonsre 5y ago
    > as opposed to chiropractors, who are universally charlatans and frauds I take it you've never thrown your back out and had an adjustment that fixed a lot of pain?
    - arbitrage 5y ago
      I take it you've never done much to strengthen your core and stretch your muscles properly? A physical therapist can help you with that long-term back pain you got.
    - pc86 5y ago
      That a chiropractor can relieve pain doesn't mean that chiropractics in the "medical" sense isn't a fraud. Imaging that shown the entire concept of "subluxations" in the chiropractic sense are a myth. I've gone to chiropractors for manipulations. Some even were able to bill my insurance (yet surprisingly the cash price was the same as my insurance copay, imagine that). But I treat it the same as getting a massage. It feels good, and I might feel better after, but it's absolutely not any sort of medical science.
      - 5y ago
- joshowar 5y ago
  Its complicated. Technically speaking, if there's any decay in your teeth, that's a cavity. The deeper it is, the faster it'll get worse. When you want to get that filling though, is a judgement call that a lot of dentists make for you sadly. Is it best to go ahead and get those fillings now? Probably, as far as your dental health is concerned. Can it be delayed though and done later? Almost certainly. Just a bigger filling later. Or maybe a crown if it gets too far gone. Also, how fast your decay progresses depends on a variety of factors. For some people, it won't be long before those questionable cavities become serious problems. For others, it can be many years if they decay much further at all even. I think it's largely genetic, but also depends on oral care, diet habits, etc. So, no, I don't think most dentists are just seeing dollar signs and putting fillings onto teeth without cavities. Its not outright fraud or malpractice. But some dentists are sympathetic to your financial situation while others think dental health should be a priority above everything, no matter the cost. So it's a mix I think, between dentists' values/philosophies about dental care, and the lack of science about how fast tooth decay can vary from person to person (and an inability to measure that).
  - malfist 5y ago
    It's not that cut and dry. Just because you have a small carie doesn't mean it's only going to get worse. That's the reason for fluoride in our water, in our toothpaste and in the wax the dentists applies at the end of your cleaning (that for some reason, insurance never wants to pay for). Fluoride treatments and good dental hygiene can reverse carries. Carries should only be treated if they're large, or if they're still growing after discovery and alerting the patient.
    - FollowingTheDao 5y ago
      And did you know dental plaque and tartar are actually protecting your teeth? And just because vanity we want to get it removed? https://pubmed.ncbi.nlm.nih.gov/17016887/ https://pubmed.ncbi.nlm.nih.gov/17016887/
      - andreareina 5y ago
- andi999 5y ago
  The thing seems to be more interesting, here I talked to the university dentist, and it seems there a like 4 stages of cavity, and you only start treatment at stage 4. But it seems not 100% clearcut when stage 4 is reached.
- Aeolun 5y ago
  It is unbelievable how much my faith in the necessity of dental procedures has risen after I started going to see a dentist that was my friend first, and my dentist only later (after I got tired of constantly wondering if the others actually had my best interests at heart). I never doubted the dentist I had during my youth, and as far as I know he’s actually just really good at his job, so it was kind of a shock to find that so many of them are just winging it.
- saiya-jin 5y ago
  In our eastern european backwater and largely primitive country (Slovakia), greed has its prime. New dentist offices sprang up recently all over the place from where I come from. They took relatively big loans, and as greed is bottomless, want to pay them as quickly as possible to move to other investments. I had similar experience as others - one guy wanted to set series of visits (4 hours each) to remove all older fillings. He was doing a fine work otherwise (replacing urgently one that started breaking apart). The detail being, he didn't do an X-ray to check if older fillings actually needed replacement (the idea is, your teeth can handle only few filling replacements depending on situation, so definitely don't fix things that aren't broken). After that (and few months), went to another dentist who first did full x-ray, found that one filling needed replacement and the rest were fine and I ended up paying 5% of the price of first one. Good dentists are worth gold (same as many other professions for that matter) - if you find a skilled professional who is not ripping you off, you stay there till you die. This quality mix is unfortunately not easy to find.
- OJFord 5y ago
  > I think a lot of dentistry comes down to how much money they need that month. I notice that even with my NHS dentist and just in how long he recommends leaving it until next time. When I went back after 18 months (on a recommendation of 12-18) I got a cursory checkup, probably the most glowing 'all fine' I've ever had, a routine X-ray (i.e. that wouldn't be due again for a while) and then he asked to see me in six. I double-took and confirmed, so booked in for six months. (Then we had a pandemic and it was more than two years before I could get a non-emergent appointment. That went fine too.)
- ccwilson10 5y ago
  Wife is a dentist. There certainly are practices where treatments are recommended as a function of money and cashflow (laser treatment and other "optional" treatments are a great example of this). However, crown / cavity recommendations are largely dependent on how aggressive that particular dentist's philosophy is. E.g. my wife only goes to her father for treatment because he focuses on saving teeth whenever possible. Unlikely that a dentist would ever recommend filling cavities if they didn't believe it was necessary – they're not very profitable for practices. Crowns are sometimes recommended when a filling will suffice, but that's usually because crowns last ~10 years and fillings only delay the inevitable crown for a few years.
  - asdff 5y ago
    This is why I like going to dental schools faculty or student practices. They are all about saving the teeth if it can be saved and will need to see sufficient evidence in the imaging before moving forward with just about anything. Things seem to take longer and involve more appointments (e.g. i have to schedule a separate appointment with dept of radiology vs the private practice dentist walking me to the next room with the xray), but it seems like every decision involves multiple dental professors looking at my imagery or feeling up my teeth or gums before anything is done, which definitely boosts my confidence. I like having a committee and hearing them discuss the evidence in this war room setting when I'm laying there on the chair mouth open
    - argonaut 5y ago
      I've looked into this myself and one negative is that students still have some pressure to overtreat because students have graduation requirements (e.g. must do a certain number of fillings, crowns, etc.). Granted, having to run everything by a supervisor will eliminate the egregious cases.
      - asdff 5y ago
        They can't overtreat due to the nature of it with literally all work needing a professor looking at the mouth or the work in progress and validating. If anything they need too much evidence to go forward and will want to see things like a CT to validate something in a traditional xray. When they want to do a certain amount of required things, they screen the local community for cavities and turn up plenty, including mine when I went and they were sure to point out the cavity to me on the imagery and go over my options and relative risks. Most of the times they are overburdened with demand of patients since this is about the only place where low income people can afford dental care so I expect they see plenty of examples to study. Oddly though my student told me he hoards extracted teeth to study and practice with.
- LouisSayers 5y ago
  I had a similar experience with a dentist. All my previous experiences I had minimal issues, and then suddenly at a different dentist I needed several fillings and needed to drill a good tooth to "fix a cavity" in-between my teeth. I didn't get any of that done. My next visit at a different dentist a couple years later and I had a single tooth that needed a filling. When something feels off, it's always good to get a second opinion.
- asdff 5y ago
  If you are in need of cavities repaired I suggest getting in touch with your local dental school. Once a year there will be a practical where students have to repair caveties on a patient, so they will often offer free cavity screening + repair to the public for these exams. When I went to one, they discovered a few very small ones that looked like they could get bad in the future and opted to just do them right then. Dental schools outside of this are probably the cheapest way to have competent dental work done especially if you are uninsured (payment plans will be very permissive too)
- Ma8ee 5y ago
  My dentist is very busy. That often means that I have to wait a couple of months before I can get an appointment, if I'm not in active pain. That is of course sometimes annoying. The flip side of that is I'm quite confident that she won't suggest anything that isn't necessary since she already have a full schedule.
gehwartzen 5y ago
At least in the US its because dental insurance isn't part of normal health insurance. Dental insurance mostly just covers the bare bones (teeth?) treatments like regular cleanings and an xray every couple of years. SO in order for the Dentist to make money they ahve to upsell every other treatment not covered by insurance. With regulars health insurance the doc is payed for pretty much any specific treatment they deem necessary so they know they will be payed. I think if we had the 'pay out of pocket' kind of thing for other health care we would see the same thing.
- pc86 5y ago
  Just because it's covered by insurance doesn't mean they don't get paid for the work.
- lupire 5y ago
  I'm curious if you'll reread your comment and can see how you disproved your own point.
  - gehwartzen 5y ago
    I'm not sure I see the contradiction? I'm just saying that if regular health care only covered something like wellness visits and a cast every other year they would probably be more likely to try and sell you additional services to drive their revenue. And by upsell I just mean convincing you the financial burden is worth the proposed extra treatment. Right now as long as I have health insurance I don't care abut the extra cost of extra treatments beyond a health check because I don't directly bear the cost. I mean pretty much every other health related thing that's not covered by insurance has the same dynamics; eye care, cosmetic surgery.
- hnburnsy 5y ago
  In the US, many consider dental insurance a pre-paid, discount dental plan, not really insurance in the traditional sense.
karencarits 5y ago
Article: https://www.nrk.no/trondelag/hvor-ofte-ma-du-ga-til-tannlege_-1.15849774 https://www.nrk.no/trondelag/hvor-ofte-ma-du-ga-til-tannlege... "Gjessing visited eight dentists. * Five found no holes. * One found a hole. * One found two holes. * One found three holes. * Three removed tartar. * One recommended brace for 2500 kroner and a new appointment. ... Memo visited six dentists. * Three thought everything looked good. * Two recommended replacing fillings. * One found two holes and said they had to be fixed quickly. * One took a panoramic x-ray."
- matsemann 5y ago
  The last one also got tartar removed at all dentists according to the article. Probably him I was thinking of. Wonder if this is the original I was thinking about, from 10 years ago. Crazy difference in what they get recommended based on the dentist. https://www.aftenposten.no/norge/i/kJqKj/samme-tenner-helt-forskjellig-behandling https://www.aftenposten.no/norge/i/kJqKj/samme-tenner-helt-f...
- gs17 5y ago
  Reminds me of an experience I describe as "two out of three doctors agree: you're not on fire". (It was just a bit of body hair hit by an electrocauterizer that was smouldering, but two doctors in the room told me I was imaginging the heat and smell, while the third rushed to grab a cup of water).
mrits 5y ago
While I have heard of plenty of scammy dentists myself, I don't see a reason to complain about them cleaning your teeth. If you actually told them you just got your teeth cleaned that is a different issue though.
- lupire 5y ago
  The 10th dentist didn't notice there was no tartar? Or the first 9 didn't remove the tartar? Which is the good option?
  - bombcar 5y ago
    Dentists aren’t really setup to assume the patient is being weird. It’s like going to a full service car wash right after getting your car washed - they’ll wash it again for you.
  - mrits 5y ago
    You don't just get your teeth cleaned to remove tarter though. It is part of preventive holistic dental plan. If you want a better chance of finding early decay and get to the bottom of any sensitivity you need a hygienist to poke around a lot more than the dentist usually does. In my case they found a tumor in my jaw during a cleaning that even was overlooked in a full set of X-Rays.
a2tech 5y ago
Dentists are trying VERY hard to get included under standard medical insurance in the US. If you think they're scammy now, wait until they can start billing your insurance. People with insurance are often divorced from the cost of services rendered so they'll really be able to reap profit then.
- jnsie 5y ago
  The naive part of me wonders if this will improve services. I have good health and dental insurance and while my health insurance becomes really beneficial once I've hit a threshold and met my deductibles, there is a hard upper limit on how will be paid for dental work annually, to the point I've had to spread (non-emergency) care over multiple years to cover the costs.
- Ma8ee 5y ago
  Ah yes! I had to repair a broken tooth when I was in the US, which was covered by our insurance. The dentist took 19(!) x-ray plates of my teeth, which she then charged the insurance company for.
seanmcdirmid 5y ago
Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon. The problem with wisdom teeth is that they increase maintenance requirements, it’s hard to clean back there and they can affect adjacent teeth if they do go bad. So I get why many dentists default suggest to remove them (I still have mine but recently started running into problems at 47).
- delecti 5y ago
  > Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon Bit of a meaningless distinction if they're in the same office.
  - coryrc 5y ago
    In the US, that would be rare.
    - lupire 5y ago
      Pointless nitpick, especially because providers pay referral fees.
      - cma 5y ago
        "Payment by or to a physician or health care institution solely for referral of a patient is fee splitting and is unethical. Physicians may not accept: Any payment of any kind, from any source for referring a patient other than distributions of a health care organization's revenues as permitted by law." https://www.ama-assn.org/delivering-care/ethics/fee-splitting https://www.ama-assn.org/delivering-care/ethics/fee-splittin...
- matsemann 5y ago
  > they just refer you to an oral surgeon Perhaps in the US where they drug you down? Here the dentist just gives you a local anesthetic and pry them out, unless there is something extraordinary. Or perhaps it's a different person? But still the same company getting the money.
Unklejoe 5y ago
I had a dentist appointment before COVID. They found a cavity and scheduled me to have a filling. Then, COVID hit and I cancelled the appointment. I went back two years later for another checkup/cleaning. They didn't find any cavities. Maybe it healed itself? Apparently that's possible via re-mineralization. Either way, if that was possible, then perhaps they shouldn't have been so eager to drill and fill?
- tomxor 5y ago
  To add to the confusion of the very real risk of immoral and unnecessary dental work mentioned elsewhere in this thread - xrays can be legitimately difficult to interpret when looking for small cavities. Ideally you do want to get even small ones filled as a preventative measure. However IME trustworthy dentists will acknowledge the potential for false positives on less obvious xrays upfront and offer a choice of either probing the area with a very fine drill first or simply defer work altogether and monitor it on each check-up. Point is, in your case it could be an untrustworthy dental practice (suggesting unnecessary procedures), or the original xray was ambiguous and there was never anything there, or the dentist was poor at interpreting it. Either way if it was that minor they should have made it clear - i'd recommend scepticism next time, feel free to interrogate them, they are doctors and usually welcome it... if they are unconvincing and defensive, go elsewhere.
  - argonaut 5y ago
    > Ideally you do want to get even small ones filled as a preventative measure. To add even more confusion, this is mostly untrue. Fillings don't last forever, so prematurely filling "starts the clock" because the filling will eventually fail and every time a filling is made, more healthy tooth must be removed. (I say mostly untrue because mercury amalgam fillings really can last multiple decades, but these have fallen out of favor).
AndrewThrowaway 5y ago
My experience: Teeth looks fine and healthy, not much tartar to clean. When was the last time you visited? Two years ago. Oh no you should visit at least twice a year (?). Even if all looks fine x-ray is recommended which can reveal some things. I do the x-ray. All is fine. You don't even have upper wisdom teeth. Lower wisdom teeth are at 90deg so they can pose a risk if they started growing. Yeah, but I am 40 years old already? My mother is 70 and has the same 90deg wisdom teeth, never started growing? TBH it really starts to feel "scammy" when they start suggesting procedures for things that might never happen.
- egberts1 5y ago
  90-degree? Yeah, you should get those wisdom teeth out because general anesthesia at your advanced age would not be good for your longevity. That is, if your wisdom teeth were ever then to surface and rot.
  - malfist 5y ago
    Impacted, unerupted wisdom teeth are not always a problem. If you're over 25 [1] it's highly unlikely they'll ever attempt to erupt, never causing a problem. Impacted wisdom teeth don't always stay impacted when they start moving too. They can straighten up when they start coming in. [1] Hupp J, et al. Contemporary Oral and Maxillofacial Surgery. Chapter: Principles of Management of Impacted Teeth. From https://www.animated-teeth.com/wisdom_teeth/t6-wisdom-tooth-not-extract.htm#page-ref https://www.animated-teeth.com/wisdom_teeth/t6-wisdom-tooth-...
    - lotsofpulp 5y ago
      I have 4 impacted wisdom teeth completely sideways, and dentists on the east and west coast of the US have told me not to bother taking them out since I was 25 or older unless they start causing me problems.
  - askonomm 5y ago
    General anesthesia? Here in Europe we don't do that. I had one wisdom tooth that got rotten and the injections did not help with the pain because of the infection, so the nurse held me down while the doctor pulled the tooth, me screaming in agony. Then they gave me a shot for the trauma so I would calm down. This is Northern Europe.
throwaway0a5e 5y ago
> Why are dentists so scammy? Because everyone is and you can generally afford it when cheaper professionals do it and don't know when expensive ones (doctor, lawyer, etc) do it.
ThinkingGuy 5y ago
One explanation I've heard (don't remember which news source) is that dentists just don't have as much demand as in previous decades. Due to improvements in hygiene, and public health measures such as water fluoridation, children get fewer cavities and adults lose fewer teeth ("having an insufficient number of teeth" was once a major cause of men being rejected from the military draft). So dentists have had to pivot from providing necessary care, such as fillings and extractions, to more discretionary services such as whitening and other cosmetic procedures (oh how my last dentist used to try to push Invisalign® on me at every visit!)
- fallinghawks 5y ago
  And some dentists are straight up charlatans wanting to line their pockets. When I moved across the bay I left my dentist of 10+ years and went in search of someone closer. I admit to delaying a couple years, but found a place, got cleaned and x-rayed. The dentist told me I had 13 cavities that needed to be tended to. I was pretty shocked; I don't have great teeth, but to have developed that many cavities in such a short time seemed wrong. I went back to my old dentist for a second opinion and he told me that I had 2 genuine cavities at the edges of old fillings, but the rest of it was pretty much nonsense: amalgam fillings that could be replaced with porcelain for appearance but were still perfectly good, and some slight discolorations that were not actually cavities.
wpietri 5y ago
I think you'll see the same thing wherever people have complex problems and they consult people with an individual profit motive. Car repair, for example. Or alternative "medicine" things like chiropractors. Some of the people will be legit. Some will be frauds. And in the middle you have a bunch of people who don't intend to be frauds but that just hill-climb their way to good businesses but aren't skilled and disciplined enough to measure the value of their interventions. I suspect the same is true of people getting contract development done. Given the number of horror stories I've heard and the number of terrible code bases I've had to clean up, I'd guess the custom-software industry is no better than dentistry or car repair.
cute_boi 5y ago
My dentist also told me to remove wisdom teeth. Its been more than 10 years and it hasn't caused any troubles.... And, the crucial part is the hospital is considered as no 1 hospital in my country.
FollowingTheDao 5y ago
> Why are dentists so scammy? Why? Capitalism. And I am serious. It is just the need to make a profit that drives them to these places.
- jll29 5y ago
  Certainly capitalism when applied to medics causes a form of conflict of interest between patients' well-being and growing the personal bank account.
floren 5y ago
We recently moved and my wife & I both scheduled checkups at the same new dentist. She recommended a crown replacement and Invisalign to both of us, in my case while wearing an Invisalign-branded face shield. We both got weird vibes from that place and don't intend to go back. Didn't help that the hygienist said something like "oh, the crown replacement is easy, we just got a brand new machine to make them in-house!" which sounds to me like "wow we really need to pay off this machine"
- elliekelly 5y ago
  I had a very similar experience with a new dentist this week and the front desk was very pushy with getting me to schedule an appointment for a routine cleaning. I'm still mad at myself for acquiescing but they were determined to steamroll right over all of my attempts to politely demur. I don't intend to return to the practice but I am absolutely dreading the phone call to cancel the appointment because I know I'm in for even more of their aggressive "encouragement" to change my mind.
kobalsky 5y ago
my dad is a dentist (oral surgeon by usa definition) and he took out all my wisdom teeth (that didn't bother me at all) one time I visited him at his practice. from my single data point I can conclude that: 1) dentists will remove wisdom teeth that don't bother you even for no financial gain. 2) never visit your parents practice unless you have a excuse to bail out immediately if they try to get you on the chair.
johncessna 5y ago
Pediatric dentistry is especially scummy. If you don't do insanely expensive treatment that almost no one did 20 years ago you could maybe potentially sometimes damage your kid's oral hygiene permanently.
asdff 5y ago
I think its because they don't keep up with the field. You have some dentists who learn how things are done when they are in dental school in the 1970s and that's how they continue to operate in their private practice until they retire. They might also be good friends with other specialists and will send their patients there because of that relationship (and they do at least trust their work). There are also different philosophies. Some dentists might prefer you keep original tooth if possible and have you get some advanced imaging done before they decide a treatment plan; others might lean on the side of avoiding additional imaging and just pulling the tooth assuming it is compromised. To get around that, I prefer to get dental work done at dental schools. The faculty at the schools have their own practices within the schools, and you can be sure that they are doing all the up to date stuff that is currently being taught and following sensible practices in terms of treatment plans. Prices are also fair. If you opt for a student dentist its even cheaper and many low income people use this service (although appointments are much longer since everything they do has to be signed off by a faculty member responsible for a floor of students).
nitwit005 5y ago
If you want a laugh, walk into a chiropractor's office, and learn about the many issues your spine has. People tend to be unfortunately incentivized to find something wrong with you, as they get paid based on treatments performed. In the US, this produced the idea of Health maintenance organizations (HMOs), where there is a large member count paying a fixed fee. The hope was they'd want to spend on preventative care, and minimize other costs.

donatj 5y ago

I went to a new dentist for a broken filling and they tried to tell me I had 14 cavities and set me down with a finance person to set up a payment plan for how I was going to pay for them over the next 5 years. I went to a second dentist, they fixed the broken filling and said my teeth were otherwise fine. I have the paperwork to back this up. I’d been seeing another dentist for a while and he suddenly wanted to crown 3 of my teeth. Again I got a second opinion, and again they were like “That’s probably not necessary”. I think a lot of dentistry comes down to how much money they need that month. It certainly doesn’t feel very scientific.

tomxor 5y ago
Unnecessary medical procedures are extremely immoral, do you mind sharing what country/practice this was in?
- donatj 5y ago
  United States. Here’s my yelp review of the first place. https://www.yelp.com/biz/shamblott-family-dentistry-hopkins?hrid=3kR-ZmEnxx-skLw0-tt3LQ https://www.yelp.com/biz/shamblott-family-dentistry-hopkins?...
- ceejayoz 5y ago
  Not OP, but there's been a lot of this in the US. https://www.pbs.org/wgbh/frontline/article/patients-pressure-and-profits-at-aspen-dental/ https://www.pbs.org/wgbh/frontline/article/patients-pressure... > Former employees say Aspen Dental trained them in high-pressure sales. Corporate management scrutinizes the production of dentists and staff daily. And internal documents show that dentists get paid bonuses as key production targets are met. https://www.elpasotimes.com/story/news/health/2018/01/10/kool-smiles-pay-23-9-million-accused-unnecessary-dental-work-children/1023083001/ https://www.elpasotimes.com/story/news/health/2018/01/10/koo... > "Especially when that fraud involves performing unnecessary procedures on kids —here, unnecessary baby root canals and tooth extractions, among other procedures —we will not hesitate to use every tool at our disposal to punish those who break the law," Bash said. > The accusations against Kool Smiles included prohibiting parents from being present during root canals "to keep hidden the child's suffering" and retaliation against "unproductive" dentists, according to a federal complaint filed in San Antonio in 2013.
  - lupire 5y ago
    > 2013. So they never got punished?
    - ceejayoz 5y ago
      "Kool Smiles to pay $23.9 million" sounds like they're being punished? They typically settle and sometimes pay a fine. https://ag.ny.gov/press-release/2015/ag-schneiderman-announces-settlement-aspen-dental-management-bars-company-making https://ag.ny.gov/press-release/2015/ag-schneiderman-announc... I suspect they still make more profit than they lose in fines.
      - mindslight 5y ago
        Having an unexpected cost and thereby not making a profit isn't actually a punishment - it makes the risk calculus a tame "I probably won't get caught", while the expected value remains positive. I realize I'm criticizing our entire enforcement philosophy for white collar crime here. But still, unless there are actual routine-disrupting punishments like jail time for violating basic professional responsibilities, we would expect unethical behavior to just continue increasing. And this goes double for setups to make such violations "nobody's fault" like the creation of perverse incentive structures. In the context of blue collar crime, that's called a "conspiracy".
brightball 5y ago
This was my experience as well. I went to the same dentist office for years with no issues. He sold the practice so we went to the new guy...every single time we went in there was a cavity that needed to be filled. Went to a new dentist and everything is fine again.
- brootstrap 5y ago
  One of my good co-workers is daughter of a dentist from the UK. the practices there are much different. We have had him analyze xrays and scans, he says its fine the people here just want/need your money!
- FollowingTheDao 5y ago
  My dentist was arrested in the 80's. He gave me three unneeded root canals. He was sniffing laughing gas. Good times....
pc86 5y ago
I went to the same dentist for years as a child. Brushed my teeth once a day, never had any issues at all. All of sudden, during a regular checkup, he told my parents (I was ~15 at the time) that I had 9 cavities and needed fillings. In the 20 years since, I have never had a single cavity. And what a shock, he sold his practice between that procedure and my next checkup. I fully believe he was just pumping up his revenue to increase the sale price, and my parents weren't health literate enough to get a second opinion, and I was too young to know that just because he has a white coat on doesn't mean he's a good person. Dentists are in the sweet spot where they actually are very important and necessary (as opposed to chiropractors, who are universally charlatans and frauds), but they don't get quite the scrutiny and oversight that physicians are used to. And they make as much as some of the top tier physician specialties. PCPs, OBs, ER, etc. all make less than dentists by and large.
- bostonsre 5y ago
  > as opposed to chiropractors, who are universally charlatans and frauds I take it you've never thrown your back out and had an adjustment that fixed a lot of pain?
  - arbitrage 5y ago
    I take it you've never done much to strengthen your core and stretch your muscles properly? A physical therapist can help you with that long-term back pain you got.
  - pc86 5y ago
    That a chiropractor can relieve pain doesn't mean that chiropractics in the "medical" sense isn't a fraud. Imaging that shown the entire concept of "subluxations" in the chiropractic sense are a myth. I've gone to chiropractors for manipulations. Some even were able to bill my insurance (yet surprisingly the cash price was the same as my insurance copay, imagine that). But I treat it the same as getting a massage. It feels good, and I might feel better after, but it's absolutely not any sort of medical science.
    - 5y ago
joshowar 5y ago
Its complicated. Technically speaking, if there's any decay in your teeth, that's a cavity. The deeper it is, the faster it'll get worse. When you want to get that filling though, is a judgement call that a lot of dentists make for you sadly. Is it best to go ahead and get those fillings now? Probably, as far as your dental health is concerned. Can it be delayed though and done later? Almost certainly. Just a bigger filling later. Or maybe a crown if it gets too far gone. Also, how fast your decay progresses depends on a variety of factors. For some people, it won't be long before those questionable cavities become serious problems. For others, it can be many years if they decay much further at all even. I think it's largely genetic, but also depends on oral care, diet habits, etc. So, no, I don't think most dentists are just seeing dollar signs and putting fillings onto teeth without cavities. Its not outright fraud or malpractice. But some dentists are sympathetic to your financial situation while others think dental health should be a priority above everything, no matter the cost. So it's a mix I think, between dentists' values/philosophies about dental care, and the lack of science about how fast tooth decay can vary from person to person (and an inability to measure that).
- malfist 5y ago
  It's not that cut and dry. Just because you have a small carie doesn't mean it's only going to get worse. That's the reason for fluoride in our water, in our toothpaste and in the wax the dentists applies at the end of your cleaning (that for some reason, insurance never wants to pay for). Fluoride treatments and good dental hygiene can reverse carries. Carries should only be treated if they're large, or if they're still growing after discovery and alerting the patient.
  - FollowingTheDao 5y ago
    And did you know dental plaque and tartar are actually protecting your teeth? And just because vanity we want to get it removed? https://pubmed.ncbi.nlm.nih.gov/17016887/ https://pubmed.ncbi.nlm.nih.gov/17016887/
    - andreareina 5y ago
andi999 5y ago
The thing seems to be more interesting, here I talked to the university dentist, and it seems there a like 4 stages of cavity, and you only start treatment at stage 4. But it seems not 100% clearcut when stage 4 is reached.
Aeolun 5y ago
It is unbelievable how much my faith in the necessity of dental procedures has risen after I started going to see a dentist that was my friend first, and my dentist only later (after I got tired of constantly wondering if the others actually had my best interests at heart). I never doubted the dentist I had during my youth, and as far as I know he’s actually just really good at his job, so it was kind of a shock to find that so many of them are just winging it.
saiya-jin 5y ago
In our eastern european backwater and largely primitive country (Slovakia), greed has its prime. New dentist offices sprang up recently all over the place from where I come from. They took relatively big loans, and as greed is bottomless, want to pay them as quickly as possible to move to other investments. I had similar experience as others - one guy wanted to set series of visits (4 hours each) to remove all older fillings. He was doing a fine work otherwise (replacing urgently one that started breaking apart). The detail being, he didn't do an X-ray to check if older fillings actually needed replacement (the idea is, your teeth can handle only few filling replacements depending on situation, so definitely don't fix things that aren't broken). After that (and few months), went to another dentist who first did full x-ray, found that one filling needed replacement and the rest were fine and I ended up paying 5% of the price of first one. Good dentists are worth gold (same as many other professions for that matter) - if you find a skilled professional who is not ripping you off, you stay there till you die. This quality mix is unfortunately not easy to find.
OJFord 5y ago
> I think a lot of dentistry comes down to how much money they need that month. I notice that even with my NHS dentist and just in how long he recommends leaving it until next time. When I went back after 18 months (on a recommendation of 12-18) I got a cursory checkup, probably the most glowing 'all fine' I've ever had, a routine X-ray (i.e. that wouldn't be due again for a while) and then he asked to see me in six. I double-took and confirmed, so booked in for six months. (Then we had a pandemic and it was more than two years before I could get a non-emergent appointment. That went fine too.)
ccwilson10 5y ago
Wife is a dentist. There certainly are practices where treatments are recommended as a function of money and cashflow (laser treatment and other "optional" treatments are a great example of this). However, crown / cavity recommendations are largely dependent on how aggressive that particular dentist's philosophy is. E.g. my wife only goes to her father for treatment because he focuses on saving teeth whenever possible. Unlikely that a dentist would ever recommend filling cavities if they didn't believe it was necessary – they're not very profitable for practices. Crowns are sometimes recommended when a filling will suffice, but that's usually because crowns last ~10 years and fillings only delay the inevitable crown for a few years.
- asdff 5y ago
  This is why I like going to dental schools faculty or student practices. They are all about saving the teeth if it can be saved and will need to see sufficient evidence in the imaging before moving forward with just about anything. Things seem to take longer and involve more appointments (e.g. i have to schedule a separate appointment with dept of radiology vs the private practice dentist walking me to the next room with the xray), but it seems like every decision involves multiple dental professors looking at my imagery or feeling up my teeth or gums before anything is done, which definitely boosts my confidence. I like having a committee and hearing them discuss the evidence in this war room setting when I'm laying there on the chair mouth open
  - argonaut 5y ago
    I've looked into this myself and one negative is that students still have some pressure to overtreat because students have graduation requirements (e.g. must do a certain number of fillings, crowns, etc.). Granted, having to run everything by a supervisor will eliminate the egregious cases.
    - asdff 5y ago
      They can't overtreat due to the nature of it with literally all work needing a professor looking at the mouth or the work in progress and validating. If anything they need too much evidence to go forward and will want to see things like a CT to validate something in a traditional xray. When they want to do a certain amount of required things, they screen the local community for cavities and turn up plenty, including mine when I went and they were sure to point out the cavity to me on the imagery and go over my options and relative risks. Most of the times they are overburdened with demand of patients since this is about the only place where low income people can afford dental care so I expect they see plenty of examples to study. Oddly though my student told me he hoards extracted teeth to study and practice with.
LouisSayers 5y ago
I had a similar experience with a dentist. All my previous experiences I had minimal issues, and then suddenly at a different dentist I needed several fillings and needed to drill a good tooth to "fix a cavity" in-between my teeth. I didn't get any of that done. My next visit at a different dentist a couple years later and I had a single tooth that needed a filling. When something feels off, it's always good to get a second opinion.
asdff 5y ago
If you are in need of cavities repaired I suggest getting in touch with your local dental school. Once a year there will be a practical where students have to repair caveties on a patient, so they will often offer free cavity screening + repair to the public for these exams. When I went to one, they discovered a few very small ones that looked like they could get bad in the future and opted to just do them right then. Dental schools outside of this are probably the cheapest way to have competent dental work done especially if you are uninsured (payment plans will be very permissive too)
Ma8ee 5y ago
My dentist is very busy. That often means that I have to wait a couple of months before I can get an appointment, if I'm not in active pain. That is of course sometimes annoying. The flip side of that is I'm quite confident that she won't suggest anything that isn't necessary since she already have a full schedule.

gehwartzen 5y ago

At least in the US its because dental insurance isn't part of normal health insurance. Dental insurance mostly just covers the bare bones (teeth?) treatments like regular cleanings and an xray every couple of years. SO in order for the Dentist to make money they ahve to upsell every other treatment not covered by insurance. With regulars health insurance the doc is payed for pretty much any specific treatment they deem necessary so they know they will be payed. I think if we had the 'pay out of pocket' kind of thing for other health care we would see the same thing.

pc86 5y ago
Just because it's covered by insurance doesn't mean they don't get paid for the work.
lupire 5y ago
I'm curious if you'll reread your comment and can see how you disproved your own point.
- gehwartzen 5y ago
  I'm not sure I see the contradiction? I'm just saying that if regular health care only covered something like wellness visits and a cast every other year they would probably be more likely to try and sell you additional services to drive their revenue. And by upsell I just mean convincing you the financial burden is worth the proposed extra treatment. Right now as long as I have health insurance I don't care abut the extra cost of extra treatments beyond a health check because I don't directly bear the cost. I mean pretty much every other health related thing that's not covered by insurance has the same dynamics; eye care, cosmetic surgery.
hnburnsy 5y ago
In the US, many consider dental insurance a pre-paid, discount dental plan, not really insurance in the traditional sense.

karencarits 5y ago

Article: https://www.nrk.no/trondelag/hvor-ofte-ma-du-ga-til-tannlege_-1.15849774 https://www.nrk.no/trondelag/hvor-ofte-ma-du-ga-til-tannlege... "Gjessing visited eight dentists. * Five found no holes. * One found a hole. * One found two holes. * One found three holes. * Three removed tartar. * One recommended brace for 2500 kroner and a new appointment. ... Memo visited six dentists. * Three thought everything looked good. * Two recommended replacing fillings. * One found two holes and said they had to be fixed quickly. * One took a panoramic x-ray."

matsemann 5y ago
The last one also got tartar removed at all dentists according to the article. Probably him I was thinking of. Wonder if this is the original I was thinking about, from 10 years ago. Crazy difference in what they get recommended based on the dentist. https://www.aftenposten.no/norge/i/kJqKj/samme-tenner-helt-forskjellig-behandling https://www.aftenposten.no/norge/i/kJqKj/samme-tenner-helt-f...
gs17 5y ago
Reminds me of an experience I describe as "two out of three doctors agree: you're not on fire". (It was just a bit of body hair hit by an electrocauterizer that was smouldering, but two doctors in the room told me I was imaginging the heat and smell, while the third rushed to grab a cup of water).

mrits 5y ago

While I have heard of plenty of scammy dentists myself, I don't see a reason to complain about them cleaning your teeth. If you actually told them you just got your teeth cleaned that is a different issue though.

lupire 5y ago
The 10th dentist didn't notice there was no tartar? Or the first 9 didn't remove the tartar? Which is the good option?
- bombcar 5y ago
  Dentists aren’t really setup to assume the patient is being weird. It’s like going to a full service car wash right after getting your car washed - they’ll wash it again for you.
- mrits 5y ago
  You don't just get your teeth cleaned to remove tarter though. It is part of preventive holistic dental plan. If you want a better chance of finding early decay and get to the bottom of any sensitivity you need a hygienist to poke around a lot more than the dentist usually does. In my case they found a tumor in my jaw during a cleaning that even was overlooked in a full set of X-Rays.

a2tech 5y ago

Dentists are trying VERY hard to get included under standard medical insurance in the US. If you think they're scammy now, wait until they can start billing your insurance. People with insurance are often divorced from the cost of services rendered so they'll really be able to reap profit then.

jnsie 5y ago
The naive part of me wonders if this will improve services. I have good health and dental insurance and while my health insurance becomes really beneficial once I've hit a threshold and met my deductibles, there is a hard upper limit on how will be paid for dental work annually, to the point I've had to spread (non-emergency) care over multiple years to cover the costs.
Ma8ee 5y ago
Ah yes! I had to repair a broken tooth when I was in the US, which was covered by our insurance. The dentist took 19(!) x-ray plates of my teeth, which she then charged the insurance company for.

seanmcdirmid 5y ago

Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon. The problem with wisdom teeth is that they increase maintenance requirements, it’s hard to clean back there and they can affect adjacent teeth if they do go bad. So I get why many dentists default suggest to remove them (I still have mine but recently started running into problems at 47).

delecti 5y ago
> Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon Bit of a meaningless distinction if they're in the same office.
- coryrc 5y ago
  In the US, that would be rare.
  - lupire 5y ago
    Pointless nitpick, especially because providers pay referral fees.
    - cma 5y ago
      "Payment by or to a physician or health care institution solely for referral of a patient is fee splitting and is unethical. Physicians may not accept: Any payment of any kind, from any source for referring a patient other than distributions of a health care organization's revenues as permitted by law." https://www.ama-assn.org/delivering-care/ethics/fee-splitting https://www.ama-assn.org/delivering-care/ethics/fee-splittin...
matsemann 5y ago
> they just refer you to an oral surgeon Perhaps in the US where they drug you down? Here the dentist just gives you a local anesthetic and pry them out, unless there is something extraordinary. Or perhaps it's a different person? But still the same company getting the money.

Unklejoe 5y ago

I had a dentist appointment before COVID. They found a cavity and scheduled me to have a filling. Then, COVID hit and I cancelled the appointment. I went back two years later for another checkup/cleaning. They didn't find any cavities. Maybe it healed itself? Apparently that's possible via re-mineralization. Either way, if that was possible, then perhaps they shouldn't have been so eager to drill and fill?

tomxor 5y ago
To add to the confusion of the very real risk of immoral and unnecessary dental work mentioned elsewhere in this thread - xrays can be legitimately difficult to interpret when looking for small cavities. Ideally you do want to get even small ones filled as a preventative measure. However IME trustworthy dentists will acknowledge the potential for false positives on less obvious xrays upfront and offer a choice of either probing the area with a very fine drill first or simply defer work altogether and monitor it on each check-up. Point is, in your case it could be an untrustworthy dental practice (suggesting unnecessary procedures), or the original xray was ambiguous and there was never anything there, or the dentist was poor at interpreting it. Either way if it was that minor they should have made it clear - i'd recommend scepticism next time, feel free to interrogate them, they are doctors and usually welcome it... if they are unconvincing and defensive, go elsewhere.
- argonaut 5y ago
  > Ideally you do want to get even small ones filled as a preventative measure. To add even more confusion, this is mostly untrue. Fillings don't last forever, so prematurely filling "starts the clock" because the filling will eventually fail and every time a filling is made, more healthy tooth must be removed. (I say mostly untrue because mercury amalgam fillings really can last multiple decades, but these have fallen out of favor).

AndrewThrowaway 5y ago

My experience: Teeth looks fine and healthy, not much tartar to clean. When was the last time you visited? Two years ago. Oh no you should visit at least twice a year (?). Even if all looks fine x-ray is recommended which can reveal some things. I do the x-ray. All is fine. You don't even have upper wisdom teeth. Lower wisdom teeth are at 90deg so they can pose a risk if they started growing. Yeah, but I am 40 years old already? My mother is 70 and has the same 90deg wisdom teeth, never started growing? TBH it really starts to feel "scammy" when they start suggesting procedures for things that might never happen.

egberts1 5y ago
90-degree? Yeah, you should get those wisdom teeth out because general anesthesia at your advanced age would not be good for your longevity. That is, if your wisdom teeth were ever then to surface and rot.
- malfist 5y ago
  Impacted, unerupted wisdom teeth are not always a problem. If you're over 25 [1] it's highly unlikely they'll ever attempt to erupt, never causing a problem. Impacted wisdom teeth don't always stay impacted when they start moving too. They can straighten up when they start coming in. [1] Hupp J, et al. Contemporary Oral and Maxillofacial Surgery. Chapter: Principles of Management of Impacted Teeth. From https://www.animated-teeth.com/wisdom_teeth/t6-wisdom-tooth-not-extract.htm#page-ref https://www.animated-teeth.com/wisdom_teeth/t6-wisdom-tooth-...
  - lotsofpulp 5y ago
    I have 4 impacted wisdom teeth completely sideways, and dentists on the east and west coast of the US have told me not to bother taking them out since I was 25 or older unless they start causing me problems.
- askonomm 5y ago
  General anesthesia? Here in Europe we don't do that. I had one wisdom tooth that got rotten and the injections did not help with the pain because of the infection, so the nurse held me down while the doctor pulled the tooth, me screaming in agony. Then they gave me a shot for the trauma so I would calm down. This is Northern Europe.

throwaway0a5e 5y ago

> Why are dentists so scammy? Because everyone is and you can generally afford it when cheaper professionals do it and don't know when expensive ones (doctor, lawyer, etc) do it.

ThinkingGuy 5y ago

One explanation I've heard (don't remember which news source) is that dentists just don't have as much demand as in previous decades. Due to improvements in hygiene, and public health measures such as water fluoridation, children get fewer cavities and adults lose fewer teeth ("having an insufficient number of teeth" was once a major cause of men being rejected from the military draft). So dentists have had to pivot from providing necessary care, such as fillings and extractions, to more discretionary services such as whitening and other cosmetic procedures (oh how my last dentist used to try to push Invisalign® on me at every visit!)

fallinghawks 5y ago
And some dentists are straight up charlatans wanting to line their pockets. When I moved across the bay I left my dentist of 10+ years and went in search of someone closer. I admit to delaying a couple years, but found a place, got cleaned and x-rayed. The dentist told me I had 13 cavities that needed to be tended to. I was pretty shocked; I don't have great teeth, but to have developed that many cavities in such a short time seemed wrong. I went back to my old dentist for a second opinion and he told me that I had 2 genuine cavities at the edges of old fillings, but the rest of it was pretty much nonsense: amalgam fillings that could be replaced with porcelain for appearance but were still perfectly good, and some slight discolorations that were not actually cavities.

wpietri 5y ago

I think you'll see the same thing wherever people have complex problems and they consult people with an individual profit motive. Car repair, for example. Or alternative "medicine" things like chiropractors. Some of the people will be legit. Some will be frauds. And in the middle you have a bunch of people who don't intend to be frauds but that just hill-climb their way to good businesses but aren't skilled and disciplined enough to measure the value of their interventions. I suspect the same is true of people getting contract development done. Given the number of horror stories I've heard and the number of terrible code bases I've had to clean up, I'd guess the custom-software industry is no better than dentistry or car repair.

cute_boi 5y ago

My dentist also told me to remove wisdom teeth. Its been more than 10 years and it hasn't caused any troubles.... And, the crucial part is the hospital is considered as no 1 hospital in my country.

FollowingTheDao 5y ago

> Why are dentists so scammy? Why? Capitalism. And I am serious. It is just the need to make a profit that drives them to these places.

jll29 5y ago
Certainly capitalism when applied to medics causes a form of conflict of interest between patients' well-being and growing the personal bank account.

floren 5y ago

We recently moved and my wife & I both scheduled checkups at the same new dentist. She recommended a crown replacement and Invisalign to both of us, in my case while wearing an Invisalign-branded face shield. We both got weird vibes from that place and don't intend to go back. Didn't help that the hygienist said something like "oh, the crown replacement is easy, we just got a brand new machine to make them in-house!" which sounds to me like "wow we really need to pay off this machine"

elliekelly 5y ago
I had a very similar experience with a new dentist this week and the front desk was very pushy with getting me to schedule an appointment for a routine cleaning. I'm still mad at myself for acquiescing but they were determined to steamroll right over all of my attempts to politely demur. I don't intend to return to the practice but I am absolutely dreading the phone call to cancel the appointment because I know I'm in for even more of their aggressive "encouragement" to change my mind.

kobalsky 5y ago

my dad is a dentist (oral surgeon by usa definition) and he took out all my wisdom teeth (that didn't bother me at all) one time I visited him at his practice. from my single data point I can conclude that: 1) dentists will remove wisdom teeth that don't bother you even for no financial gain. 2) never visit your parents practice unless you have a excuse to bail out immediately if they try to get you on the chair.

johncessna 5y ago

Pediatric dentistry is especially scummy. If you don't do insanely expensive treatment that almost no one did 20 years ago you could maybe potentially sometimes damage your kid's oral hygiene permanently.

asdff 5y ago

I think its because they don't keep up with the field. You have some dentists who learn how things are done when they are in dental school in the 1970s and that's how they continue to operate in their private practice until they retire. They might also be good friends with other specialists and will send their patients there because of that relationship (and they do at least trust their work). There are also different philosophies. Some dentists might prefer you keep original tooth if possible and have you get some advanced imaging done before they decide a treatment plan; others might lean on the side of avoiding additional imaging and just pulling the tooth assuming it is compromised. To get around that, I prefer to get dental work done at dental schools. The faculty at the schools have their own practices within the schools, and you can be sure that they are doing all the up to date stuff that is currently being taught and following sensible practices in terms of treatment plans. Prices are also fair. If you opt for a student dentist its even cheaper and many low income people use this service (although appointments are much longer since everything they do has to be signed off by a faculty member responsible for a floor of students).

nitwit005 5y ago

If you want a laugh, walk into a chiropractor's office, and learn about the many issues your spine has. People tend to be unfortunately incentivized to find something wrong with you, as they get paid based on treatments performed. In the US, this produced the idea of Health maintenance organizations (HMOs), where there is a large member count paying a fixed fee. The hope was they'd want to spend on preventative care, and minimize other costs.