Do you think dentists are educated crooks?

[PrincessPerky]

T.....Many dentists
have told my husband to have his 25 year old silver fillings
replaced. They said mercury was leaking. None of them were
able to explain how they came to that conclusion. He's never
had any problems with any of them, and has never had a deep
cleaning, just regular 6 month cleanings. Too bad his old
dentist is no longer around. He did a heck of a job.....

I don't really know anything about fillings, but it strikes me that mercury would not be noticed by a dentist...don't you have to get a blood test to find it?

Maybe the reason the dentists say they leak is cause mercury tends to do that?

[Scanner]

DisneySteve,

I appreciate the comraderie in saying medicine, dentristry and chiropractic are comparable in that it's an art. . .but I think the last 2 do have a ways to go to catch up.

Case in point. . .someone comes into me with low back pain and some disc degeneration. . .it could be a recommendation of "Come in when it hurts" or "3x/week" or "3x/week + exercise rehab." Even the manipulations themselves vary greatly. It isn't very standardized. It's a huge problem we have tried to address but it's difficult for a multitude of reasons beyond the scope of this thread.

Since it's about dentristry. . .I think it's the same thing.

Someone comes into you with excessive thirst and they're spilling glucose in the urine. . .you are going to run a battery of lab tests. . .medicate with glucophage (or whatever, I don't know what pharmaceuticals you use), institute follow-up lab work, check for co-morbidities, counsel on diet.

I would imagine most family physicans, it would be a similar experience. Sure. . . maybe one family doc is really big on diet and goes hogwild on the counseling to cut out carbs but for the most part, you get a standard experience as a patient.

I think there is a legitimate beef the public has with the non-plenary physicians but I am not sure what the answer is except to ask questions and get second opinions when you have to.

Try not to dismiss an entire field because of a bad experience. I know I have really lucked out with just about all of my dentists (and I have a good chiropractor too. . .yeah, people find that funny that chiropractors need chiropractors, when I tell them).

I have found this thread really fascinating from my field standpoint because my profession has been waayyyyyyy sensitive about this issue and trying to weed out the chafe/quackery from the science. To hear the criticism levied at dentistry. . .it's fascinating.

[Scanner]

Sorry, one more thing. . .I find this thread fascinating from a personal standpoint too.

I had a neighbor who wanted me to go into dentistry. . .I could have probably been handed his practice, as I was very close with his son and his family. He's a multimillionarie.

I joke with my father sometimes about reimbursement and say, "I should have went into dentistry dad. . .no insurance. . .mostly cash."

But I was young, ill-informed. . .you make "young" decisions. . .I chose chiropractic because I couldn't imagine "working in people mouth's all day."

He flipped - "Chiropractors are quacks. They're crooks! You don't want to go into that. At least go into osteopathy!" Oh, my. . . you should have heard him rant on and on (again, being young. . .I didn't care, LOL).

Oh my, how it's come full circle. . .now here I am defending his profession's honor (he was a good dentist) . LOL. I wish I could print this thread for him.

But I have heard him grumble to my father that the profession has changed for the worse. . .hard to tell it that's the grumbling of a curmudgeony old dentist or an accurate interpretation of matters deteriorating.

[disneysteve]

people find that funny that chiropractors need chiropractors

Not sure why anyone would think that odd. You can't adjust yourself. Just as a dentist can't work on his own teeth and I can't examine my own ear.

[Scanner]

I don't know. . .when I tell my patients I am going to or had seen my chiropractor they all kinda laugh in amazement and sort of have an epiphany sitting there.

I ask what they find amusing and I can't get a straight answer.

After all, 40 is around the corner and this is physically demanding. I'm getting more cranky like my favorite doctor here:



My hands are wearing out. II'm losing my patience more and more like Bones. It's a young man's profession which is why I want to plan an exit here and often talk of it..

I don't see me doing heavy manual adjustments when I am 60 years old. I know a lot of orthopedists limit their surgery as they age as it's physically demanding.

I think a lot of people don't understand (and ins. co.'s don't care) that from a physical standpoint, you could be the last patient I work on. I could be disabled (blown ligament in hand, blown disc in back) and that's why it costs so much.

Sorry if I hijacked the thread, everyone but I think making sure your doctor is fairly reimbursed is part and parcel of these issues. They are tied at the hip. If you hand your doctor, dentist, etc. an insurance card and say, "Here. . .good luck", it just bodes bad. This is part of the reason you see a lot of these problems.

[flavor]

Silver amalgam is an alloy of silver, mercury, copper, tin, and zinc.
It has been used as a dental filling material for a century and a half and still is the filling of choice for back teeth. Billions of amalgam fillings have been used successfully, with fewer than fifty cases of allergy reported in the literature since 1905. Poor work dentists want silver fillings replaced, usually with plastic, which are more expensive and not as good as silver amalgam and, although generally safe, are still more potentially toxic than amalgam.

"Amalgameter", is the electronic device (essentially a voltemeter) which poor work dentists claim to use to reveal the presence of positively or negatively charged fillings. The FDA forced the dentist who manufactured these devices to stop production, but many of these and similar phony devices are still in use. If silver fillings did leak mercury, they would quickly disintegrate.

[flavor]

m3racer wrote: Troll alert!!! Your comments are intirely ignorant!!!! Why don't you learn something about a particular profesion before you make a moronic statement.

In the past 30 years, American dentistry has seen many great changes, some for the better, but many for the worse, as well as the attitudes and traditions of practice. It was the norm for practices to have long-standing patients who kept their teeth, and except for wisdom teeth, extractions were rare. Dental restorations (fillings, bridges, etc.) enjoyed substantial longevity. In Dr. Poorwork's practice, patients suffer through repeated dental procedures (all of them done hastily, continuing discomfort and pain, and repeated expense, and finally wind up with full or partial dentures.

When the good dentist fills a tooth, he drills deeply enough to remove ALL DECAY, trying to avoid pulp involvement, and to prepare the tooth properly for restoration. During the procedure xray is taken to show if any decay remains. If all decay is not removed, the tooth, in a few years will require at least a costly root canal treatment with possibly a post and crown, or the tooth may not be restorable and will have to be extracted.

Dr. Poorwork does not take the time to properly clean the tooth of all decay. His next patient is waiting.

So, a simple cavity, if not done properly will lead to extraction of tooth in a matter of 6 years. If done properly, with good care can last a lifetime.

Why do good dentists turn bad? Money.
The good dentist is the one with a regular house and regular car. Making honest money on teeth has always been hard, especially these days. The Poorwork dentists believe your coverage is money owed to them. They just need to find a way to bill for it on procedures you will agree to. Its called patient compliant.
The non-complaint patients are a problem to these dentists. They are the dentists' adversary. Whole seminars are held to aducate those dentists on how to extract more money from you , how to confuse you when explaining the diagnosis, how to keep you from suing for negligence, etc.

Also, the dental profession is the number one suicidal profession. Depression is the cause.

[Scanner]

Also, the dental profession is the number one suicidal profession. Depression is the cause.

I don't necessarily disagree with all you wrote but I think that's an urban legend.

[Scanner]

You know. . .I have knocked this subject around a lot on my closed to the public chiro. forums.

I have said this to be met with much controversey:

"Being a doctor (whatever type) was never meant to be a path to riches."

You wouldn't beleieve the crap I get from my colleagues on that. So I do agree that a dentist should drive a regular car and have a regular house. I do think there is a pervasive attitude of greed and entitlement.

I have been accused of being socialist for such a comment but here's how I look at it.

I think being a doctor should "entitle you" (hate that expression because it's loaded) to an upper middle class lifestyle, not an upper class lifestyle.

What does that mean? I guess that means being able to get a new car every 3-7 years, have an average house, being able to afford braces for your daughter and college, take a nice vacation 1x/year.

I am seeing a disturbing trend though - doctors aren't even hitting the middle class, let alone the upper middle.

One family doctor was lamenting after his capitated contracts, he took home $23,000 in 10 months.

If you don't think this affects your health care, your dental care. . .you are burying your head in the sand.

I am not saying being underreimbursed should give a dentist carte blanche to overrecommend but you have to think. . .you have a borderline case of a root canal or a filling. . .where are you going to come down? Unless you are a saint, you may one day say, "Let's do the root canal" when the day before you may have said, "Let's just fill it."

So, you say, "It's about money!!!"

Many doctors would say, "You're damn right it is."

If that makes doctors bad people, let's get it out on the table.

[disneysteve]

I am seeing a disturbing trend though - doctors aren't even hitting the middle class, let alone the upper middle.

So, you say, "It's about money!!!"

Many doctors would say, "You're damn right it is."

Very true. Many people have a very outdated concept of what doctors earn. They still assume all doctors are rich, live in McMansions and drive shiny new BMWs. I've been in practice for 14 years. I live in a 43-year-old colonial in an older suburb, drive a 1998 Toyota and clip coupons from the Sunday paper. The neighbor to our left works at a car dealership. The neighbor to the right works for the local utility company. My daughter goes to public school and we shop regularly at thrift shops and yard sales. That's just not what the average Joe thinks of when he hears "doctor".

A lot of this has to do with decreasing reimbursement, HMOs, rising office overhead, malpractice insurance, etc. It also has a lot to do with student loan debt. I graduated in 1990 with $102,000 in loans. Today's graduates routinely finish school with upwards of $150,000 in loans. It takes 25-30 years for many to pay that off, just like a mortgage.

I don't know a lot about dentistry, but I suspect there are a lot of similarities.

[Taribor]

I've had a couple bad experiences with dentists (including one who wanted to fill about 10 cavities that didn't exist). I've been very wary of dentists since then and if something doesn't feel right, I won't go back. Right now I drive 100 miles to see a dentist just because I like and trust him. I don't worry about how expensive or inexpensive he is, I just want someone I can trust.

What happened to you?

That's a common scheme. Another trend (among the small percentage who cheat) is to target low income medicaid recipients and perform dental work on small children in order to get the reimbursement. In situations like the one you experienced, you should contact the state medicaid investigators or call the U.S. Dept of Health and Human Services hotline to register a complaint. It is difficult to pursue these types without help from the actual patients who get scammed, but once your complaint is registered, it is easier to interview other patients, pull billing history, and get him/her prosecuted if they are bad.

Personally I love my dentist. Then again, he knows I investigate healthcare fraud for a living. Actually, I'm in my 30's and never remember having a bad experience with a dentist.

There is a difference between bad service (change dentists and move on) versus healthcare/dental fraud. Many of the fraudulant ones are tied to organized crime, group scams, and all kinds of weird crap you would never suspect. Often times they are on a quota for the number of cavities they need to fill and are fired very quickly if the stat isn't met.

Just my two cents.

[disneysteve]

target low income medicaid recipients and perform dental work on small children in order to get the reimbursement.

God, I wish there were dentists around here who performed dental work on Medicaid children, or adults for that matter. I work in a poor area and my patients have horrible dental disease and just can't find any dentists who will accept Medicaid. The couple who do are impossible to get appointments with. One of the very few local Medicaid dentists doesn't even take appointments. If you want to be seen, you show up at 7am and wait, sometimes for 5 or 6 hours.

[Taribor]

God, I wish there were dentists around here who performed dental work on Medicaid children, or adults for that matter. I work in a poor area and my patients have horrible dental disease and just can't find any dentists who will accept Medicaid. The couple who do are impossible to get appointments with. One of the very few local Medicaid dentists doesn't even take appointments. If you want to be seen, you show up at 7am and wait, sometimes for 5 or 6 hours.

The ones I am referencing strap small children into chairs, make the parents wait in the lobby, and perform very invasive (and painful) dental procedures that are clearly not needed nor indicated.

I agree with you though, low income families have a hard time finding dentists, but I also can't blame the dentists; at the end of the day they have a business to run and reimbursement issues with state sponsored insurance has most of the good ones running for the hills.

[aida2003]

Remind me not to go to a dentist in Canada.

I am VERY sure that if Consumer Reports did the same experiment with dentists/mechanics in the USA, we'd hear exactly the same conclusions about this country too. I this the US is no different than Canada or any other country.

It reminded me a good article in BusinessWeek a couple of weeks ago about cholestorol and what BIG bucks the pharma co. reap thanks to biased trials, conclusions, doctors, etc. I think I almost lost respect for Pfizer due to that article and I'm its investor

[BabyBear]

I LOVE my dentist. I just went Wednesday and had a filling. I have been going to him since I was a little kid and before that I went to his father.

There have been many times when he puts a "watch" on a tooth and they check it out at my next exam. There are times that they find nothing and times that he does feel that he needs to take care of it.

I don't think he charges a lot for what he does. I've talked to others about their dentist's fees and mine seems like he is right in line. And really I need to work harder at keeping my teeth in better condition so I don't have to fork over so much money. That's one of my goals for this year!! I opted not to get dental insurance with my new company (it doesn't really cover anything at all) so it's all out-of-pocket from here on out.