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Warnings about new dentists practicing unethical dentistry are becoming more common

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Incis0r

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BeaverLover

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The recent media coverage doesn't help either...child dies while getting filling...man has all teeth removed
 

JLT223

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Just don't be a POS and you'll be fine :)
 

Mad Jack

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I had a dentist charge me for an unnecessary procedure once. Was a young dentist at one of those chains that caters to uninsured patients, and was too uninformed to know any better- he supposedly found a "pre-cavity" on one of my teeth that he drilled small hole in and filled. Had my regular (and very good dentist) look at the tooth later and it turned out no work was done on that tooth at all- no idea what the guy actually did but there is zero evidence that he did anything, either on x-ray or direct observation. Given that it wasn't noticed until years later, I never followed up on it, as it's far too much work for absolutely no personal benefit.
 
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doc toothache

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I had a dentist charge me for an unnecessary procedure once. Was a young dentist at one of those chains that caters to uninsured patients, and was too uninformed to know any better- he supposedly found a "pre-cavity" on one of my teeth that he drilled small hole in and filled. Had my regular (and very good dentist) look at the tooth later and it turned out no work was done on that tooth at all- no idea what the guy actually did but there is zero evidence that he did anything, either on x-ray or direct observation. Given that it wasn't noticed until years later, I never followed up on it, as it's far too much work for absolutely no personal benefit.
And of course, now that you are a predent, you are qualified to judge an "unnecessary procedure".
 

Mad Jack

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And of course, now that you are a predent, you are qualified to judge an "unnecessary procedure".
I'm a medical student that knows enough about oral pathophysiology to ask the right questions to my dentist. As far as he can tell, there was no procedure even performed on the tooth in question, and he can find no evidence on any of the oral XRs he's ever taken. Given that I have zero signs of either work being performed or dental pathology in any of my teeth (I've never had a cavity and none of my teeth, even the one in question, has any signs of erosion, let alone anything else going on), it seems like I was swindled. But hey, my experienced, UPenn-trained dentist that's been in the field for over 30 years and is regarded as one of the best in the area could be completely wrong. I'm just taking his word for it.
 
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tussiN1

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actually mad jack is a med student in the states, im always here to correct u doc toothache
 
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Confused1617

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I work as an assistant at a mini corporate chain. So here is what my opinion is on how corruption starts. We have 4 dentists that I have worked with. 2 of them have integrity and in my opinion do great work, and the other two not so much. I noticed the not so great dentists would continuously do pulp ssc's on children with the slightest cavities, while the 2 good dentists would just fill the caries as needed and do pulp ssc when needed. Obviously, I am not qualified, but I've been here for a year and one of the dentists taught me how to read x-rays (still not qualified but they would treatment plan it based on xray, before looking in the mouth).

Anyways, the not so great dentists make the highest production but the other 2 don't make as much... Turns out the 2 good dentists are being threatened to lose their jobs if they don't make more production.

This is where I think dentists begin to overtreat, they are pressured to bring in high production. Funny thing, is that many of the patients that are treated by the not so great dentists come back with fillings that fell off and need to be redone, crowns or ssc (on kids) that need re-cementing.

Anyways, its interesting to see this because this will be us in a few years. If we work at a corporate chain or even private where they aim a ridiculously high earning goal, production will be more important than providing great work.
 
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doc toothache

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I'm a medical student that knows enough about oral pathophysiology to ask the right questions to my dentist. As far as he can tell, there was no procedure even performed on the tooth in question, and he can find no evidence on any of the oral XRs he's ever taken. Given that I have zero signs of either work being performed or dental pathology in any of my teeth (I've never had a cavity and none of my teeth, even the one in question, has any signs of erosion, let alone anything else going on), it seems like I was swindled. But hey, my experienced, UPenn-trained dentist that's been in the field for over 30 years and is regarded as one of the best in the area could be completely wrong. I'm just taking his word for it.
Even better, but not to worry you will soon be in a position of having performed "unnecessary procedures".
 
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Mad Jack

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Even better, but not to worry you will soon be in a position of having performed "unnecessary procedures".
So, how do you justify my dentist's assessment of the situation?

My assessment is pretty straightforward- guy fell to pressure from a dental chain that has a reputation for being a sweathshop, the sort of place this was talking about:
I work as an assistant at a mini corporate chain. So here is what my opinion is on how corruption starts. We have 4 dentists that I have worked with. 2 of them have integrity and in my opinion do great work, and the other two not so much. I noticed the not so great dentists would continuously do pulp ssc's on children with the slightest cavities, while the 2 good dentists would just fill the caries as needed and do pulp ssc when needed. Obviously, I am not qualified, but I've been here for a year and one of the dentists taught me how to read x-rays (still not qualified but they would treatment plan it based on xray, before looking in the mouth).

Anyways, the not so great dentists make the highest production but the other 2 don't make as much... Turns out the 2 good dentists are being threatened to lose their jobs if they don't make more production.

This is where I think dentists begin to overtreat, they are pressured to bring in high production. Funny thing, is that many of the patients that are treated by the not so great dentists come back with fillings that fell off and need to be redone, crowns or ssc (on kids) that need re-cementing.

Anyways, its interesting to see this because this will be us in a few years. If we work at a corporate chain or even private where they aim a ridiculously high earning goal, production will be more important than providing great work.
But, you know, the evidence being analyzed by a fully trained and experienced dentist means nothing, I'm sure. As to performing "unnecessary procedures" as a physician, no clue what you're on about. I'm going to be a psychiatrist or a hospitalist, neither of which is a particularly procedurally-oriented field.
 

Incis0r

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doc toothache

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Bad mouthing colleagues does not belong in any profession.
 
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doc toothache

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Badmouthing colleagues? This isn't "badmouthing," a lot of what is going on at some of these unscrupulous places is legitimately criminal behavior. That's worth discussing.
State Boards of Dental Examiners are usually entrusted with determining the presence of "criminal behavior".
 
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Mad Jack

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State Boards of Dental Examiners are usually entrusted with determining the presence of "criminal behavior".
No, the local and state criminal justice system handles that. Licensure boards deal with licensure concerns, not criminal behavior- people performing unnecessary procedures or not providing proper informed consent should be going to prison, not just losing their license. If people don't know what to look for, they can't report it, so the public knowing what to look for in regard to bad dentistry is important.
 
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doc toothache

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No, the local and state criminal justice system handles that. Licensure boards deal with licensure concerns, not criminal behavior- people performing unnecessary procedures or not providing proper informed consent should be going to prison, not just losing their license. If people don't know what to look for, they can't report it, so the public knowing what to look for in regard to bad dentistry is important.
An avatar wisely chosen.
 

Jbrowndds

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Know that there are dentists out there who are willing to put patients at risk for their own gain. Understand that their is a person attached to teeth so don't take advantage. We are healers. If I ever find myself in the position where someone is asking me to do unethical things I will report them and quit.
 
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Incis0r

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Mad Jack

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Personally, I'm more of a "give him a second chance" kind of guy.

People make mistakes- but why ruin their entire future over one mistake? Give them the chance to improve. If they resort to the same bad habits, THEN bring on the sanctions/punishments.
The trouble with giving everyone a freebie is that a large number of people will take it.
 
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Incis0r

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Mad Jack

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So when they make their first mistake, give them a consequence, but limit it to something that doesn't ruin their entire career. Don't let infractions go unpunished, but at the same time, make the punishments reasonable and not overly punitive.

One example of a suitable punishment could be probation with the local dental board- meaning that the local board would check in on the dentist/audit them every few weeks for a defined period of time, and make sure everything was going well.
Then you know you can abuse your license until you get caught- which might be never- and even if you are caught, you're merely on probation and have to play by the rules you would have had to play by anyways to be legit- basically the incentive is provided to make as much money as you can illegitimately, because the only penalty you'll face is working legitimately if you're caught.
 
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Incis0r

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Mad Jack

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Fair point. Perhaps a more stringent punishment then- I can see what you're saying, but I don't want to go around shooting down careers that people have spent 8+ years after high school building and that (many) have taken out more than half a million dollars to finance.
If you willfully disregard the duty you have to do the best by your patient, you deserve to have your career ruined forever. That's the biggest part of what being a professional is, historically, and violating it once is one time too many. To allow even the potential of it happening a second time would be violation of our boards' duties to do their best for our clients and the public.
 
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Incis0r

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deleted738762

Do you think it's possible some of those branch chain dental clinics maybe promote unethical things. What if a new graduate dentist got hired and was forced to do some unethical things to bring in more money for the company, I can only assume it would be hard for him to quit.
 
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Mad Jack

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I agree with you that anyone who doesn't put his/her patient's best interest as the #1 priority should face consequences, but I think that such people can change, and eventually end up being some of the strongest, most ethical providers in the profession.

I believe that people can improve, and that even those who made severe mistakes in the past can repent and end up becoming one of the best role models.

If I were on a state dental board, I would lean towards giving people a second chance (unless the violation was particularly egregious).
I don't doubt that people can change, I just don't believe that people should have a free shot at screwing up the doctor-patient relationship for their own gain. That's a bad message for the public to know exists, as they would know that anyone they were working with that didn't have a record could very well screw them over with little to no real consequence. That's why boards are often harsh with violations of things like informed consent- it's considered a fairly high degree of offense. Some minor things, sure, go get a second chance. Hell, even moderately egregious things are often amenable. But violating the basic tenets of being a professional is not something that you get a free pass for.
 
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Mad Jack

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Do you think it's possible some of those branch chain dental clinics maybe promote unethical things. What if a new graduate dentist got hired and was forced to do some unethical things to bring in more money for the company, I can only assume it would be hard for him to quit.
"I'm just following orders" generally isn't an acceptable excuse.
 
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deleted738762

"I'm just following orders" generally isn't an acceptable excuse.
I completely agree. However, I don't think it's too far fetched that those kind of things happen, and I wonder how new graduates would respond. Very sad.
 

Mad Jack

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I completely agree. However, I don't think it's too far fetched that those kind of things happen, and I wonder how new graduates would respond. Very sad.
I agree. I did some things I don't feel fantastic about in sales, and it was entirely because of corporate pressure. They even made me feel good about what I was doing, gave me awards, etc. But At the end of the day I know I was taking advantage of people that didn't know any better by exploiting their fear and trust. I guess that might be a part of why I feel as strongly as I do about this- I was selling products and services that couldn't harm someone or affect their health, but I easily could have done the same in a medical context. People are easy to exploit if you know the tricks of the trade, and doing that in the context of not just someone's expendable income, but their health (and the trust they place in a profession), is unforgivable.
 
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LaughingGas

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The sad thing is, many of new grads and upcoming new grads will be forced to take those jobs that may be running unethically. The school tuition screw us over, the government with ridiculous interest rate screw us over, and that leave many of us with very few choices financially. It just sucks we get the short end of the stick.
 

JLT223

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The sad thing is, many of new grads and upcoming new grads will be forced to take those jobs that may be running unethically. The school tuition screw us over, the government with ridiculous interest rate screw us over, and that leave many of us with very few choices financially. It just sucks we get the short end of the stick.
You're never forced to be an unethical person. It's a conscious decision. Solution: work hard and network and you won't be stuck working in a terrible practice.
 
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Soleus715

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There's been dentists that lost their license over a something that seems very small... like
You're never forced to be an unethical person. It's a conscious decision. Solution: work hard and network and you won't be stuck working in a terrible practice.

Definitely agree that one chooses to become an unethical person rather than being forced to.
But in reality, how many will choose to stay ethical and take the more difficult road? I really hope most will choose to do what's right..
 

JLT223

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There's been dentists that lost their license over a something that seems very small... like


Definitely agree that one chooses to become an unethical person rather than being forced to.
But in reality, how many will choose to stay ethical and take the more difficult road? I really hope most will choose to do what's right..
Not many. But at the end of it all, people will remember you for the type of person you are, not how fast you can prep a crown. I'd rather be remembered as a humble person and drive the cheaper BMW any day.
 
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saintguitar

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I'm a medical student that knows enough about oral pathophysiology to ask the right questions to my dentist. As far as he can tell, there was no procedure even performed on the tooth in question, and he can find no evidence on any of the oral XRs he's ever taken. Given that I have zero signs of either work being performed or dental pathology in any of my teeth (I've never had a cavity and none of my teeth, even the one in question, has any signs of erosion, let alone anything else going on), it seems like I was swindled. But hey, my experienced, UPenn-trained dentist that's been in the field for over 30 years and is regarded as one of the best in the area could be completely wrong. I'm just taking his word for it.

Not trying to cover for the "new dentist" whom you think did unnecessary procedures nor am I saying it does not happen BUT sometimes it is hard to tell if a procedure was performed or not without previous dental/medical history and radiographs regardless of what school your old dentist graduated from, how many years he has practiced for, how he's regarded in the area.

On a different note, it is absolutely crucial to LEARN how to practice ethically and STAY that way not just while in school but even after. The focus ALWAYS has to be the patient, not your student loan.
 
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Mad Jack

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Not trying to cover for the "new dentist" whom you think did unnecessary procedures nor am I saying it does not happen BUT sometimes it is hard to tell if a procedure was performed or not without previous dental/medical history and radiographs regardless of what school your old dentist graduated from, how many years he has practiced for, how he's regarded in the area.

On a different note, it is absolutely crucial to LEARN how to practice ethically and STAY that way not just while in school but even after. The focus ALWAYS has to be the patient, not your student loan.
Now I'm just curious and want to pursue this legally for the lulz to make sure I wasn't screwed over, since I'll be back home indefinitely in a month. Time to do some digging and some phone calls. I really just want the truth.
 

Soleus715

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Not many. But at the end of it all, people will remember you for the type of person you are, not how fast you can prep a crown. I'd rather be remembered as a humble person and drive the cheaper BMW any day.

I'll be driving my honda until it breaks down :shifty:
 
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saintguitar

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Now I'm just curious and want to pursue this legally for the lulz to make sure I wasn't screwed over, since I'll be back home indefinitely in a month. Time to do some digging and some phone calls. I really just want the truth.
Not sure what you mean by legally but just call the dentist who did the procedure and tell him that you have been told by another dentist that the procedure was not performed. Give him/her a chance to explain and see you were indeed ripped off or not. If you are still not convinced, then you can always contact the state dental board.
 

Incis0r

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Mad Jack

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Not sure what you mean by legally but just call the dentist who did the procedure and tell him that you have been told by another dentist that the procedure was not performed. Give him/her a chance to explain and see you were indeed ripped off or not. If you are still not convinced, then you can always contact the state dental board.
Nah, I'm a go hard or go home kind of guy. I want their copies of the X-rays to look over with my dentist, and potentially my lawyer. Screw the dental board, this is a legal issue if things don't add up and I'm going the battery route.

As to talking to the individual dentist, I doubt he's even still employed there to explain himself- they have extremely high turnover at this place, so all I'll likely get is records.
 

saintguitar

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Nah, I'm a go hard or go home kind of guy. I want their copies of the X-rays to look over with my dentist, and potentially my lawyer. Screw the dental board, this is a legal issue if things don't add up and I'm going the battery route.

As to talking to the individual dentist, I doubt he's even still employed there to explain himself- they have extremely high turnover at this place, so all I'll likely get is records.
Okie dokie
 

cacajuate

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The sad thing is, many of new grads and upcoming new grads will be forced to take those jobs that may be running unethically. The school tuition screw us over, the government with ridiculous interest rate screw us over, and that leave many of us with very few choices financially. It just sucks we get the short end of the stick.


Sucks we get the short end of the stick? Save the entitled pity party dude. You're entering a profession that has one of the highest potential salaries while working decent hours. Those big loans arent forcing you to do anything unethical.

Every profession has bad apples, unethical behavior isnt exclusive to dentistry. Why are we wasting our time bitching about a couple anecdotal situations?
 
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Soleus715

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First part of your post; 100% agreement.

Second part of your post; yes, every profession has bad apples, but dentistry is not like most professions. Trust is crucial, and as a collective group our mistakes and sins are far, far, far more heavily magnified than our successes. We need to do everything we can to make sure that there are as few anecdotal situations as possible, because that's precisely what low information mouth breathers feed off during witch hunts.

The easiest way to reduce the number of people complaining about dentists is give them as little as possible to complain about.

Yeah few unethical dentists can have great impact on the profession of dentistry as a whole...

One day, I had a walk-in patient that wanted his partial clasp to be fixed. Told him we'll need to send it to the lab and that his costs will be lab fee + $20 for the visit.
He got pissed and said something along the lines of "oh I see, so that's how you want to take advantage of old people like me. that's the way you're gonna do it, you can go screw yourself. it's something you can fix right here in 2 minutes and you don't want to do it. I know what people like you do. overcharge and overtreat seniors because we're easy"

Now I was thrown off because he was extremely friendly at first, and I could have gotten really defensive because my boss is the complete opposite of someone who's after money.
But I realized that he already had his negative view of dentists from previous experiences and I began to understand where he came from.
I tried to explain to him but his mind was made up about us already after a minute conversation. He said he'll go glue it together himself and left.. :(

So yes, I despise people giving my future career a bad name.
 
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LaughingGas

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Sucks we get the short end of the stick? Save the entitled pity party dude. You're entering a profession that has one of the highest potential salaries while working decent hours. Those big loans arent forcing you to do anything unethical.

Every profession has bad apples, unethical behavior isnt exclusive to dentistry. Why are we wasting our time bitching about a couple anecdotal situations?
What's up with the hostility. I'm not asking anyone to have pity. Yes we enter the profession that is very rewarding in many aspects but the truth is there is not many options that protect students financially while everyone else gets benefitted from them.

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doc toothache

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Nah, I'm a go hard or go home kind of guy. I want their copies of the X-rays to look over with my dentist, and potentially my lawyer. Screw the dental board, this is a legal issue if things don't add up and I'm going the battery route. As to talking to the individual dentist, I doubt he's even still employed there to explain himself- they have extremely high turnover at this place, so all I'll likely get is records.

You first claim to have had "an unnecessary procedure done", then you provide expert witness opinion suggesting that nothing was done. If no dental procedure were done, it is not clear where that leaves your claim of "unnecessary procedures". Assuming you do not run into issues with the statue of limitations for claims/record keeping and the DA takes up your case, perhaps you can post the resolution on SDN or will this be an episode on Judge Judy or Milian?
 

Mad Jack

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You first claim to have had "an unnecessary procedure done", then you provide expert witness opinion suggesting that nothing was done. If no dental procedure were done, it is not clear where that leaves your claim of "unnecessary procedures". Assuming you do not run into issues with the statue of limitations for claims/record keeping and the DA takes up your case, perhaps you can post the resolution on SDN or will this be an episode on Judge Judy or Milian?
Sure enough, I tried to get my records and the clinic doesn't exist anymore. The reason why? The guy operating it is currently serving 8 years in prison: https://www.justice.gov/usao-ct/pr/...ty-health-care-fraud-and-tax-evasion-offenses

http://www.nbcconnecticut.com/troubleshooters/LWRD-165223396.html

"Massachusetts Attorney General Martha Coakley obtained a judgment against Anusavaice in 2010, claiming Anusavice and others lured patients in with deceptive marketing, pressured patients to agree to costly dental treatments, then failed to complete the procedures or provided shoddy treatment."
 
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