is dentistry a shady business?

[toothache]

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you know the more i do research on dentistry and the more i know, it seems to me that dentistry is really a shady business. it's just a money game.... and the thing is you can make lots of$$$$... the reason i bring this up is that i have some friends who are practicing and i hear lots of crazy things. i guess the people who really have a passion and desire to be a great dentist are ideal, and the other people are the shady ones. let me know what you guys think.

 

[Bickle]

Every profession is going to have many ethical people and also some shady ones. It just matters how you want to run your bizness. Do you want to be the next Dr. Julius Hibbert or the next Dr. Nick?

 

[dientesfuertes]

Just because a profession has the potential to be lucrative doesn't mean that it is automatically "shady."
Everybody expects their dentist to be highly-trained, very skillful, extremely friendly and compassionate, have a state-of-the-art office, well-dressed, active in the community, etc., etc.
But when it comes to income, dentists are considered greedy or "shady" if they desire to be compensated more than about $25,000 a year. It is pretty ridiculous!
Why doesn't anybody pick on the plumbing industry? Do you know what a good plumber charges just to come out to your house these days?!

 

[DcS]

Originally posted by dientesfuertes

But when it comes to income, dentists are considered greedy or "shady" if they desire to be compensated more than about $25,000 a year.

For a debt that will total over 150 grand after dental school, lord knows i expect to make more than 25 grand a year. You honestly consider that greedy? I sure hope u meant 250,000 and not 25.

 

[dientesfuertes]

DcS,
I think you zeroed-in on the the wrong part of my post. We're on the same side here.
My point was that it IS ridiculous for dentists to be classified as "shady" just because they earn a good living.
-Andy

 

[DcS]

My bad andy, hard to pick up on sarcasm sometimes on the net 😀

 

[Kalel]

I agree that a lot of dentistry in private practice is definitely shady. I recall watching a 20/20 special where they sent the same patient with a healthy set of teeth to some 6-7 random dentists in the community, and each one wanted to do work on different teeths. There isn't a lot in the way of standard of care, and a lot of their reccomendations are not evidence based. I boycotted going to the dentist for some 7 yrs, before I decided to go to my dental school for my dental care because I assume that because they are academic, they are more honest there. It's not advisable to postpone your dental care too, I had a lot of teeth that needed fillings because I postponed my care. I think that I am going to stick with the dental school residents (one year post-graduate training fellows) from now on. They are cheap and they seem pretty competent.

 

[groundhog]

In the USA, dental practices that are located on the north side of medical/dental centers can be somewhat shady. Then there are the real schizos who set up practices at or above the arctic circle. They are totally shady in winter but submit to the full light of day during the summer.

 

[swisschez2000]

Originally posted by toothache
you know the more i do research on dentistry and the more i know, it seems to me that dentistry is really a shady business. it's just a money game.... and the thing is you can make lots of$$$$... the reason i bring this up is that i have some friends who are practicing and i hear lots of crazy things. i guess the people who really have a passion and desire to be a great dentist are ideal, and the other people are the shady ones. let me know what you guys think.

You are right. It is shady. More for me. Which business doesn't have shady people? No offense to Catholics, but look at the recent headlines. They dished out 100s of millions in monetary damages last year alone. That's probably just a penny of their coffers though. So, even venerable, "sacred", "holy", institutions can have shady people.

 

[swisschez2000]

Originally posted by groundhog
In the USA, dental practices that are located on the north side of medical/dental centers can be somewhat shady. Then there are the real schizos who set up practices at or above the arctic circle. They are totally shady in winter but open up their practices to the full light of day during the summer.

 

[swisschez2000]

Originally posted by Kalel
I agree that a lot of dentistry in private practice is definitely shady. I recall watching a 20/20 special where they sent the same patient with a healthy set of teeth to some 6-7 random dentists in the community, and each one wanted to do work on different teeths. There isn't a lot in the way of standard of care, and a lot of their reccomendations are not evidence based. I boycotted going to the dentist for some 7 yrs, before I decided to go to my dental school for my dental care because I assume that because they are academic, they are more honest there. It's not advisable to postpone your dental care too, I had a lot of teeth that needed fillings because I postponed my care. I think that I am going to stick with the dental school residents (one year post-graduate training fellows) from now on. They are cheap and they seem pretty competent.

When I used to be an EKG tech in a hospital, we had a doctor who gave practically everyone a pacemaker and a cath. He was doing over 10 pacemakers a month when other people do 2 in a population less than a million people. Why? Because that's how you pay for a $1,000,000 house in cash. So which is worse, taking a tooth out, inserting filling, perhaps, or tubing your vessels, or sticking a pacemaker in you and have you all jumpy near metal detectors and cell phones?

 

[Supernumerary]

Originally posted by Kalel
I agree that a lot of dentistry in private practice is definitely shady. I recall watching a 20/20 special where they sent the same patient with a healthy set of teeth to some 6-7 random dentists in the community, and each one wanted to do work on different teeths. There isn't a lot in the way of standard of care, and a lot of their reccomendations are not evidence based. I boycotted going to the dentist for some 7 yrs, before I decided to go to my dental school for my dental care because I assume that because they are academic, they are more honest there. It's not advisable to postpone your dental care too, I had a lot of teeth that needed fillings because I postponed my care. I think that I am going to stick with the dental school residents (one year post-graduate training fellows) from now on. They are cheap and they seem pretty competent.

These shows love to take cheap shots at whomever they can get their hands on. The purpose is not to inform but to scare the crap out of people so they stay glued to their sets throughout the commercials. That is not journalism - that is the legacy of P.T. Barnum at its finest.

What so many of these shows fail to take into consideration is that there are many and varied ways of restoring teeth. 99% of them are valid. Some dentists will fill a tooth with enough metal to build a Yugo while some will only offer a crown if there aren't at least two solid cusps remaining. It doesn't mean that the second dentist is trying to rip anybody off; that is what he has found works for him and his patients. If you don't want that level of dentistry you go to the guy who does the kind of dentistry you want. You don't go to 7 different car dealerships in a town and get prices ranging from $3,000 to $50,000 and conclude that the guy selling the '92 Chevy Colt is honest cause his product is cheap and the dealer selling the loaded Hummer is ripping you off. People, you have to think things through. 🙂

Ideally, all dentists would offer several levels of treatment: ideal, pretty good, and patch-em up. Many dentists, however, are scared to offer ideal dentistry fearing that the cost will scare patients off. So they only offer pretty-good to fair treatment. Or they only tell the patient about the most pressing needs and save the rest for another vist when they have gained the trust of the patient; again, they don't want to scare anybody off. And there will always be the dentists who cater to the lowest common denominator - only doing what is bound to be hurting in the next couple of months. Of course, these are the dentists that the shows who thrive on sensationalism assume are the "honest" ones.

You just have to decide for yourself: Do I want the Escort Hatchback with 180,000 miles that I'll be replacing in 3 yrs, the brand-new Lexus, or somewhere in between? Talk to your dentist and get an idea of his philosophy on dental care. Odds are that he'll come right out and tell you, and if what he provides doens't match what you want, he'll probably give you the name of someone who does. It's just not practical for a dentist to set up an office and train a staff to do every type of dentistry available. Do some research, make your own decisions, and don't let John Stossel run your life. 😉


Oh, and don't assume that the dental school is the best bang for your buck. Iatrogenic etiology. Look it up.

 

[DrJeff]

Originally posted by Kalel
I boycotted going to the dentist for some 7 yrs, before I decided to go to my dental school for my dental care because I assume that because they are academic, they are more honest there.

We LOVE your type, those that don't go for along time. Decay is in general a slow, chronic disease that once it starts will almost always(especially if dietary habits don't improve) enalrge over time. Therefore, those lesions that very likely would have been picked up on regualr exam and x-rays during those 7 years, that through diet education may have even been stopped before any treatment was needed got bigger and bigger and bigger. And, we as dentists bill out fillings by the size that they are(i.e. how many surfaces of the tooth is involved), so you helped make that school in your case more money

I think that I am going to stick with the dental school residents (one year post-graduate training fellows) from now on. They are cheap and they seem pretty competent.

As a former resident(2 years in my case), your appreciated by those in the clinic. However, I can also add that after 5 years of private practice since my residency, there are 2 BIG differences between what is done by a resident and a private practitioner:

#1 speed of procedure, after doing a few THOUSAND more fillings since residency you get more efficient(and one could argue better in alot of cases, because hey practice makes perfect)

#2 Available materials. Lets face it, most residencies aren't exactly overflowing with extra operating budget dollars. Do they have some good materials, yes, do they have the ability all the time to spend $$ and get the latest technology(i.e. hard tissue lasers that ELIMINATE the need for anesthesia and allow us to prepare teeth more conservatively)

As a whole, dentistry is far from shady. I mean we've become very, very aggressive(and successful) at preventative techniques such as topical fluoride, sealants, and extensive lecturing about the ill effects of gum disease. Sure, there are a some of us out there "overtreating" some cases and recommending extensive cosmetic treatment(you can thank TV shows such as "Extreme Makeover" for this one), but as a whole we're a very trust worthy profession.

 

[toothache]

the sad thing is dentistry is a health service for the people. i think it's a little different comparing to business people extra.. i have a friend who knows a dentist who did some shady business because valentines was coming. i guess he did some root canals which were not needed, making about $10 grand in one day. i think in dentistry it's easy to get greedy, just like gambling in vegas. the more money you make the more you want etc..... it's something that we future dentist have to step back and watch ourselves. we are here to provide service to the people not take money away and get rich.. i can see why dentist get such a bad reputation, who wants to go to the dentist anyway.

 

[toothache]

Supernumerary
i agree that there are many different ways to restore teeth, just like there are many ways to restore a car. you can get really cheap parts and charge 10 times the value, or replace parts that aren't necessary, or say your car needs new gaskets, headers, etc, etc..... now if you are not a mechanic you wouldn't know a darn thing and just break your wallet. i think the government needs to crack down in dentistry and keep them in check. it's sad to hear when your friend who is a dental hygienist says the dentist doesn't know what he is doing sometimes.

 

[Supernumerary]

Toothache, I am not saying there are not unethical people out there. There are shmucks everywhere you look; dentistry is no exception. I just don't think the situation is as dire as you and John Stossel make it out to be. If people think they have got a stinker for a dentist, they should definitely go get a second opinion. For one thing, most dental diagnosis isn't like interpreting EKGs or lab numbers. The dentist can often take a picture or x-ray and show the patient what is wrong. Patient education is part of the job, and things should be explaned to the patient if there are question. Anyhow, I'm sorry you have gotten such a bitter taste for dentistry; that is not what this profession is about at all. 🙂

 

[Rovert]

I'm not a fan of these "I heard from a friend that a doctor gave 400 brain surgeries at $100,000 a pop, or the dentist gave 25 kids braces who didn't need them" type stories. For all you know, toothache, all the patients really did need root canals. Maybe the dentist schedualed a day like that on purpose for some reason. And as far as 20/20 reports are concerned, are journalists really the most honest and ethical group of people in our society? Personally, I'd stick them somewhere between used car dealers and politicians as far as honesty is concerned. The reporters on shows like 20/20 love to make issues out of nothing, and completely bend the truth in order to improve their ratings.

On the other hand, as a first year dental student, I am curious, what kind of safegaurds exist out there to make sure that our patients are not getting ripped off? Is there some sort of peer review system set up in dentistry or does something else exist that I havent heard about yet?

 

[critterbug]

Originally posted by Rovert

On the other hand, as a first year dental student, I am curious, what kind of safegaurds exist out there to make sure that our patients are not getting ripped off? Is there some sort of peer review system set up in dentistry or does something else exist that I havent heard about yet?

A second opinion maybe?

 

[aphistis]

Originally posted by Rovert
I'm not a fan of these "I heard from a friend that a doctor gave 400 brain surgeries at $100,000 a pop, or the dentist gave 25 kids braces who didn't need them" type stories. For all you know, toothache, all the patients really did need root canals. Maybe the dentist schedualed a day like that on purpose for some reason. And as far as 20/20 reports are concerned, are journalists really the most honest and ethical group of people in our society? Personally, I'd stick them somewhere between used car dealers and politicians as far as honesty is concerned. The reporters on shows like 20/20 love to make issues out of nothing, and completely bend the truth in order to improve their ratings.

On the other hand, as a first year dental student, I am curious, what kind of safegaurds exist out there to make sure that our patients are not getting ripped off? Is there some sort of peer review system set up in dentistry or does something else exist that I havent heard about yet?

Sure there are. I imagine just about every dental society in existence has peer review boards to handle exactly those sorts of events.

 

[stdent9972]

I agree with you. There have been many reports of shady dealings of dentists creating "metal mouths" in welfare kids and collecting from Medicare. I've seen many, many stories on the subject just do a Google search. Lots and lots hits.

There seems to a large even split in the industry. Very honest, conservative, even religious types, and the greedy types with little regard to morals and ethics. Just so you know.

 

[ItsGavinC]

Originally posted by Rovert


On the other hand, as a first year dental student, I am curious, what kind of safegaurds exist out there to make sure that our patients are not getting ripped off?

It's called your patient base. They may not be educated on the oral cavity, and they may not ever be able to see their own mouths, but they sure as heck will find out if you are doing poor work, using shady materials, or overbilling/doing unecessary procedures.

Word of mouth will travel fast.

 

[DcS]

Originally posted by ItsGavinC
It's called your patient base. They may not be educated on the oral cavity, and they may not ever be able to see their own mouths, but they sure as heck will find out if you are doing poor work, using shady materials, or overbilling/doing unecessary procedures.

Word of mouth will travel fast.

I do agree that word of mouth is a type of built in quality control. However, I disagree with your statement about a patient's ability to recognize quality work. A majority of patients will have no idea if you used an inferior material, they have no idea if that amalgam you just did has overhangs, open margins, is short etc. The only thing a patient knows is pain, and how long a restoration will last. Otherwise, most have no idea about dental work, and even fees. There have been a lot of patients who I have seen who have absolutely horrible work, but they have no clue because they haven't caused them any problems. An everyday person has no idea what a proper restoration should look like, what type of retention if any was used, etc. And as far as cost, many patients are clueless. They may find out through word of mouth, but that number is small. I worked in an office once where the dds charged almost 600 bucks for bleaching trays and a kit. A lot of patients happily paid that, without knowing they could go down the street to another office and get it for half the price.

 

[DrJeff]

Originally posted by DcS
I do agree that word of mouth is a type of built in quality control. However, I disagree with your statement about a patient's ability to recognize quality work. A majority of patients will have no idea if you used an inferior material, they have no idea if that amalgam you just did has overhangs, open margins, is short etc. The only thing a patient knows is pain, and how long a restoration will last. Otherwise, most have no idea about dental work, and even fees. There have been a lot of patients who I have seen who have absolutely horrible work, but they have no clue because they haven't caused them any problems. An everyday person has no idea what a proper restoration should look like, what type of retention if any was used, etc. And as far as cost, many patients are clueless. They may find out through word of mouth, but that number is small. I worked in an office once where the dds charged almost 600 bucks for bleaching trays and a kit. A lot of patients happily paid that, without knowing they could go down the street to another office and get it for half the price.

100% pecent true. For most patients what makes a dentist good verses bad is the following:

Essentially painless injection + Good personality = Great dentist

Pain + Little/no personality = Bad dentist

Case in point, there was a pedodontist in my town who just recently passed away. Clinically his work was awful(if we see patients from his practice, step #1 90% of the time is take out all his work with secondary decay all over the place and redo it If he was doing ortho on the kids, very often iits refer over to the orthodontist in town for retreatment. Parents come in with kids with missing fillings saying that he had replced the filling 2 or 3 times ) But he was one of the nicest, most caring human being you could imagine, and his patients and their parents loved him and kept going to his practice😕

We also have another dentist in town, Pankey Institute trained, absolutely gorgeous work all the time, but he's often very demanding and condescending towards his staff/patients, and when we get patients from his office coming over to ours, the reason almost all of them give is that they don't like hims mannerisms around them/his staff.

Patients know what they like, sure they may gripe about a fee (its almost impossible to find a patient who subconsciously doesn't think your fees are too high), but they don't know the difference between a 30 micrometer margin on a crown and a margin that's 1mm short What they do know, is did it hurt, and was I treated nicely in the office.

I've said this before, but the key towards establishing a successful practice is to treat your patients like you'd want to be treated while your in the chair. It sounds so simple, but its someof the best patient management advice out there!

 

[JoeNamaMD]

Personally, I think physicians are a lot worse than dentists. I recently visited my internist and he was talking about me trying these new pharmaceuticals. His nurse was also trying to pitch to me and asked about my prescription drug coverage. Usually most people just see a general dentist for a cleaning and that rarely costs more than a $100. A visit to an Internist can be a lot more expensive because he will probably draw blood and run a bunch of tests to get money from the insurance companies.

 

[toothache]

joenama do i see an md after your name.

 

[toothache]

shady

 

[Bickle]

Originally posted by toothache
joenama do i see an md after your name.

Maybe he's from maryland??😀

 

[Calculus1]

The region that your dental board is in IS your peer review. For example, I'm from Texas and if I do something "shady" I can be reported to the Southwestern Regional board. They can then take action and review me or if the complaint is unfounded they can choose to dismiss it.

Calculus1

Baylor College of Dentistry Class of '08

 

[rchuloholla]

In the USA, dental practices that are located on the north side of medical/dental centers can be somewhat shady. Then there are the real schizos who set up practices at or above the arctic circle. They are totally shady in winter but submit to the full light of day during the summer.

LMAO had to bump this up lol

 

[rambo2006]

When I used to be an EKG tech in a hospital, we had a doctor who gave practically everyone a pacemaker and a cath. He was doing over 10 pacemakers a month when other people do 2 in a population less than a million people. Why? Because that's how you pay for a $1,000,000 house in cash. So which is worse, taking a tooth out, inserting filling, perhaps, or tubing your vessels, or sticking a pacemaker in you and have you all jumpy near metal detectors and cell phones?

My father is a physician and he tells me about stuff like that a lot. It happens sooooo freekin much at hospitals. Its interesting how sometimes they hint point to the more invasive procedure and help you understand or assumer that it is the safeest way.

Hmmmm just to make sure and be on the safe side lets do a spinal tap and be sure everything is alright. (when an MRI will be just as good for diagnosis but it just costs them more so they point you in the spinal tap direction.)

now thats screwed up. Abuse of knowledge exists in all professions.

 

[Empty pockets]

you know the more i do research on dentistry and the more i know, it seems to me that dentistry is really a shady business. it's just a money game.... and the thing is you can make lots of$$$$... the reason i bring this up is that i have some friends who are practicing and i hear lots of crazy things. i guess the people who really have a passion and desire to be a great dentist are ideal, and the other people are the shady ones. let me know what you guys think.

i dont think we should ever discuss this topic. EVER.
I want paid, period.