Am I Being Overtreated Question...?

[SandwichMonster]

All,

Thank you for taking the time to read this -- Essentially, I recently decided to use my dental insurance to look into my teeth (as I was experiencing throbbing jaw pain, possibly from grinding my teeth, as it runs in my family apparently). My question will delve into suspicion that I am being over-treated possibly for profit. I will provide some background information about me/my habits, as well as x-rays taken before I had work done, as well as what work was performed to the best of my memory, and then why I have these suspicions. If any experts could chime in, it would really help me with this quasi-investigation!

I'm prior military, and had fillings performed during and before my time in service, some of these fillings having fallen/chipped out, or were replaced while I was in the Air Force (2006 to 2012). My dental hygiene wasn't great. I seldom flossed and brushed only once a day (I'm now flossing after dinner and brush twice a day with fluoride, I am 31 years old). I have only gone to the dentist before in 2017 where I needed a filling re-filled, and it was discovered I needed an additional filling in the neighboring tooth (My top right incisors, next to the front teeth (12 and 13, I believe). The dentist was affordable, suspected I may need a root canal in them but I told him to do his best with the filling. Since then, they've been fine (until this most recent dentist).

I went to a dentist around January 2019 for the pain I mentioned earlier (the potential teeth grinding), where they took a full X-ray of my jaw (attached, hopefully below). They determined I needed approximately 12 fillings in my entire jaw. Four in my top front teeth (to include 12 and 13 as well as 22 and 23), four along my upper right molars, and then four more (I can't recall which part of my jaw, as I have not had them filled yet). They did inform me I'd need no root canals. Though the dentist did want me to undergo a full cleaning prior to the fillings (where they go under your gums, I think?). However, when I arrived for the cleaning the nurse/assistant(?) only felt I needed a simple cleaning and didn't need to go as deep.

I had the front teeth filled, as well as the top right of my molars. They insisted on removing/re-filling 12 and 13, which I originally had filled by the dentist in 2017. I believed them and let them do it. Perhaps a month ago (two months after they filled 12 and 13), I awoke to throbbing pain around 12 and 13, which wasn't unbearable, but made it hard to sleep and concentrate. Concerned for my teeth, I scheduled an appointment that day and they concluded I needed a root canal in 12. I was fairly annoyed/upset, as the tooth was fine originally before they re-filled it, and now I was being told I'd need a root canal I'd have to pay for (the quote was around $500 after my insurance).

It was around this time I read some articles about over-treatment, something I'd never considered a possibility before -- Doctors should be trusted. Sure, my dental hygiene wasn't good -- But to have upwards of 12 cavities which needed filling? And I must've mentioned I suspected I grind my teeth at least three times during varied appointments with this dentist/office, and they never once suggested a mouth guard or any real concern. None of my teeth currently hurt (the "root canal" pain went away after about two days, after the pain was isolated to 12 for one day and then felt completely fine by the third day). None of my teeth even really hurt when I first went to this dentist (aside from the suspected teeth grinding pain that was off and on randomly).

So I requested my x-rays, to try and look at what they saw, and I cancelled my remaining appointments until I can figure this out. However, the x-rays they sent me honestly look like something out of some Top Secret document with lines being redacted. I reviewed some guides on how to view dental x-rays, but I'm hardly qualified.

Can anyone advise on what they think is happening, am I being ripped off or is it all in my head? Thanks for your time!

 

[honestdoc]

I do see cavities between your teeth. How did you know to go to this new dentist? I do agree that many dentists over treat teeth unnecessarily...how else will they produce income? Unfortunately so are many other fields like auto mechanic, veterinarian, etc. Find a dentist you trust, brush, floss (to reduce between the teeth cavities), and cut back on sugary beverages like soda, flavored coffee, and energy drinks.

 

[Busybee]

Sandwich monster I would suggest you seek a second opinion on your current situation. Unfortunately what your dentist did cannot be reversed but you can find out whether the work can be improved upon so that you are no longer in pain.

It's impossible to say whether you have been over-treated but it certainly sounds as though you had poor dental treatment whilst in the armed forces. You are right to be cautious about undertaking any more extensive work. You are where you are and the priority is to get you to a place where you feel comfortable again.

Try to look for a "minimally invasive" or "conservative" dentist who should try to find a good solution for you with the least invasive treatment method. Anyone who is using a minimally invasive label should be ethical because their whole ethos is to retain your dental health whilst doing as little as possible.

 

[SandwichMonster]

Sandwich monster I would suggest you seek a second opinion on your current situation. Unfortunately what your dentist did cannot be reversed but you can find out whether the work can be improved upon so that you are no longer in pain.

It's impossible to say whether you have been over-treated but it certainly sounds as though you had poor dental treatment whilst in the armed forces. You are right to be cautious about undertaking any more extensive work. You are where you are and the priority is to get you to a place where you feel comfortable again.

Try to look for a "minimally invasive" or "conservative" dentist who should try to find a good solution for you with the least invasive treatment method. Anyone who is using a minimally invasive label should be ethical because their whole ethos is to retain your dental health whilst doing as little as possible.

Thanks! But to be clear -- I am in no pain currently. The "teeth grinding pain" is sporadic and random, and lately not as common. I was just beginning to suspect my current dentist was looking to drill whatever they could to take advantage of my insurance/profits, etc.

 

[Busybee]

I do agree that many dentists over treat teeth unnecessarily...how else will they produce income? Unfortunately so are many other fields like auto mechanic, veterinarian, etc.

That's appalling. Why are ethical dentists not calling such charlatans out? Patients are not automobiles. Patients can only trust dentists if their peer group expose them when they act unethically.

 

[SandwichMonster]

I do see cavities between your teeth. How did you know to go to this new dentist? I do agree that many dentists over treat teeth unnecessarily...how else will they produce income? Unfortunately so are many other fields like auto mechanic, veterinarian, etc. Find a dentist you trust, brush, floss (to reduce between the teeth cavities), and cut back on sugary beverages like soda, flavored coffee, and energy drinks.

I just looked in my area and saw they had a few good reviews -- I was trying to get my teeth looked at ASAP as I wanted them handled before New Years, and the first one I went to wasn't available.

 

[Busybee]

Thanks! But to be clear -- I am in no pain currently. The "teeth grinding pain" is sporadic and random, and lately not as common. I was just beginning to suspect my current dentist was looking to drill whatever they could to take advantage of my insurance/profits, etc.

Hi Sandwich monster you should still seek a second opinion because not being in pain does not always mean that there is no underlying problem. A second opinion does not cost much and it may be that you can make a complaint if it is found you were overtreated.

 

[Busybee]

I just looked in my area and saw they had a few good reviews -- I was trying to get my teeth looked at ASAP as I wanted them handled before New Years, and the first one I went to wasn't available.

Good online reviews mean little. Go by personal recommendations. A lot of practices strive to delete negative feedback on search engines.

 

[honestdoc]

Sandwich monster I would suggest you seek a second opinion on your current situation. Unfortunately what your dentist did cannot be reversed but you can find out whether the work can be improved upon so that you are no longer in pain.

It's impossible to say whether you have been over-treated but it certainly sounds as though you had poor dental treatment whilst in the armed forces. You are right to be cautious about undertaking any more extensive work. You are where you are and the priority is to get you to a place where you feel comfortable again.

Try to look for a "minimally invasive" or "conservative" dentist who should try to find a good solution for you with the least invasive treatment method. Anyone who is using a minimally invasive label should be ethical because their whole ethos is to retain your dental health whilst doing as little as possible.

One shouldn't assume the Air Force provides poor dental care. I was an Air Force dentist and we had to go through quality controls and many hours of continuing education and specialized training. We cannot have military personel experience any dental problems while on missions.

 

[Busybee]

One shouldn't assume the Air Force provides poor dental care. I was an Air Force dentist and we had to go through quality controls and many hours of continuing education and specialized training. We cannot have military personel experience any dental problems while on missions.

I'm not assuming anything. We don't know in which country the OP was treated or who they were treated by. But if several fillings break or fall out that IMO is poor dental care, whosoever administers it. I am sure you agree.

 

[honestdoc]

I think the easiest method of finding a good trustworthy dentist is to ask family, friends, coworkers, neighbors, etc. A sneaky way to find a good dentist is to check out a dental lab and ask the technicians which dentists do good work. Other good source (if you are in the US) is to go through Academy of General Dentistry and look up providers in your area. Members have to keep up with stringent continuing education requirements. Even better is combining all of the above.

 

[Busybee]

I think the easiest method of finding a good trustworthy dentist is to ask family, friends, coworkers, neighbors, etc. A sneaky way to find a good dentist is to check out a dental lab and ask the technicians which dentists do good work. Other good source (if you are in the US) is to go through Academy of General Dentistry and look up providers in your area. Members have to keep up with stringent continuing education requirements. Even better is combining all of the above.

Hi honestdoc that's what I suggested - personal recommendation. I am not sure that good technicians are easily accessible to patients or that they would tell patients who they work for. Certainly not sure if they would in the UK. After all they don't know who you are or your motives. But I do think that this information should be in the public domain to improve patient decision making. Perhaps the way forward is transparency of dental pathways and subcontracting routes, so practices should be revealing their business partners. I don't see why that would be contentious given they work on humans. NB CPD IMO is not relevant as it's a tick box for most professionals. It does not test competence or outcomes.

 

[honestdoc]

From my observations and experience, it can be very hard to find a dentist you can trust. In the US, most people choose their dentist based on who their 3rd party dental insurance will cover. I'm in a unique situation where I don't have to over treat to make a good living. My modest student loans 21 years ago is paid off by the US government. I work on state sponsored poor people and I make more than many private dentists who have to pay for their operating expenses. Many of my contemporaries have student loans approaching or surpassing $400,000! I don't know how to set up transparencies for the public. However, in order to get credentialed for 3rd party dental insurance plans, dentists have to go through lengthy application and background processes.