(the article I am referencing is found at:http://www.motherjones.com/environment/2014/09/dentist-ripping-you-off)


I will admit to being particularly sensitive to news or articles that are negative to the field of dentistry, or cast it in an unflattering light.  It’s human nature to protect and defend things close to us;  obviously dentistry is a large part of my life, so I am always wary of criticism leveled at my profession.   Especially when it is unfair or grossly exaggerated.   Even worse when some of the criticisms are true.

I recently had someone ask me about a blog article they were directed to titled “Is Your Dentist Ripping You Off?”  Some of these issues in the blog have been raised before; I remember a Reader’s Digest article from the early 90’s with a similar theme.   This blog, however, really seems to imply that the field of dentistry is experiencing a crisis of “creative diagnosis”- unnecessary care.   Let’s look and see if this article is raising a legitimate alarm or is merely blowing smoke.

The author states she became interested in the topic when her own dentist commented on how he could improve her smile (presumably with veneers) and then wanted to do a “deep cleaning” on her husband.   The clear implication of the first paragraph is that these were unnecessarily prescribed, and, indeed, they might have been; the author provides no evidence that can elucidate the issue either way.  The suggestion of improving the author’s smile is cosmetic in nature;  esthetic improvements are often offered or suggested in the healthcare field, mainly because people are interested, but, yes, cosmetic procedures are “unnecessary.”   As for the “deep cleaning,”  the author never provides any evidence to the contrary that her husband needed this special type of cleaning.  From my experience, the majority of patients who are diagnosed with a need for a periodontal scaling and root planing, or “deep cleaning,” are unaware they need it.   I’ve seen people who are about to lose all their teeth think everything is healthy and normal.

The author then looks into dental continuing education, where she finds what we are apparently supposed to believe are shady or even dishonest courses designed to help dentists with prescribing unnecessary care.   She found a ” lecturer at a privately operated seminar called The Profitable Dentist ($389) aimed to help “dentists to reignite their passion for dentistry while increasing their profit and time away from the office.”   I’m not quite sure what is questionable there-  it seems like a lecture aimed at two common goals of all businesses:  more profit and less time invested.   How evil!  Then she aims her sights at organized dentistry (with similar results).  The author says she uncovered that the “ADA’s 2014 annual conference offered tips for maximizing revenue: ‘Taking time to help our patients want what we know they need,” notes one session description, “can drive the economic and reward engine of our practice.'”  Again, not sure what is so incriminating here- a class to help dentists increase patient acceptance of what “they need,” to increase income and satisfaction at work.   Horrible!

The author’s next few sections hold a little more merit.   She begins by discussing the student loan debt of new dentists, which is ultimately a concern of anyone graduating these days in many professions.   She then focuses on corporate dentistry, and it is here where I think her arrows finally find the mark.   It is true that many corporate, chain dental offices have performance marks their dentists have to meet.   It is true that many chains can turn practitioners into salespeople rather than diagnosticians.   Have I seen this type of care?  You bet.  Is it common?   I wouldn’t say that, but common enough at these corporate chains to make it a legitimate concern.

So, what is the lesson?   What is our takeaway from all this info?  Ultimately, in any profession, there are both honest, hardworking people and others who lack the moral compass to act in the best interest of those they serve.   I wish dentistry could be free from professionals who do poor work, don’t act in the best interest of their patients, who have decided to treat dentistry as more sales than healthcare.   Unfortunately, this will never be;  dentistry, like every other profession, must have a certain percentage of practitioners who behave poorly simply because a certain percentage of the general populace does the same.   This has always been true, and always will be.

What can patients do?   My best advice:  beware corporate, chain dentistry.   It seems harsh, and may indeed be unfair to many offices, but there is a large enough body of evidence to suggest that chains rely on  loss leaders, up selling, and bonus commission structures that degrade the quality of care you receive.   Dentists are professionals, not used car or furniture salespeople.  We diagnose disease, not follow monthly sales quotas.  My experience with patients who have been treated at corporate chains is almost always negative, as I have heard stories of deceptive billing and have seen unnecessary treatment.

As for Dental Health Associates of Streetsboro, we strive to provide the best possible care honestly, never forgetting that we are treating people, not just teeth.  If you ever have a concern about a diagnosis we have offered, please don’t hesitate to voice your concerns.   Don’t hesitate to get a second opinion.   Ultimately, we are here to serve you. We treat families, not checkbooks.  We treat you, not a wallet.  We take your trust very seriously, and thanks for being a patient.


Matthew Kremser, DDS

Owner, Dental Health Associates of Streetsboro





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