Reform of dental industry

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How is all the upselling legal? When I go to an MD or NP or PA they don't upsell other services?

So much of dentistry is unregulated and seems like invented procedures to make more money like two phase braces for most kids, selling expensive electric toothbrushes, in office whitening, insisting you need crowns when a filling will do, etc.

Because some are purely cosmetic.
Because some treatments are on a sliding scale. For example, I have a problematic tooth and there are multiple ways to handle it.

I will say, imo, it depends on the dentist. I've switched many times due to "upselling" of things I don't need or want, or bc of HUGE estimates for work. I don't hesitate to get a second opinion. I'm with my current dentist now for years and do not have this issue. This is a local place, though, and not one bought out by a corporate entity. THAT is the main problem here.

But we manage that in healthcare.

Dental disease is linked to heart disease, and abscesses can send people to the ICU.

That goes to coverage, which I agree it should be covered, not to the fraudster aspect. I was speaking tot he latter, which wasn't clear in my post.

[Anonymous]

I’ve had wonderful dentists — about 8 in all — in three different Mid-Atlantic cities. All were relatively to very conservative. No upselling, no out of the ordinary fees. I do agree that basic dental care should be covered under general health insurance. (One of my dentists was hospital based and talked a LOT about the relationship between dental health and other medical issues.) I also think that a reasonable amount of vision care should be as well.*

*My plans that cover vision care allot reasonable amounts for single vision glasses, and often charge extra for examinations for contacts. So my exam for glasses will be covered — but my actual glasses are quite expensive just for the lenses alone. My contact lenses are much more reasonably priced, but I have to pay for the exam (not a huge deal), but can’t be without a pair of backup glasses. I don’t think it’s a scam, but I think it’s a plan that does much better by the larger number of people with simpler prescriptions than it does by those of us who really need our glasses to function.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How is all the upselling legal? When I go to an MD or NP or PA they don't upsell other services?

So much of dentistry is unregulated and seems like invented procedures to make more money like two phase braces for most kids, selling expensive electric toothbrushes, in office whitening, insisting you need crowns when a filling will do, etc.

This is the biggest scam. Every single NW DC family I know just ponied up the $15K for this and they all started with reasonable teeth. So ridiculous.

Yes. My older child had horrible teeth and I do think two phase made sense for her. I was scammed by doing two phase with my younger. I’m still trying to figure out how to respond. The last day of my younger DS’s treatment, the ortho asked if we wanted to roll right into phase 2. Why would it even be separated out if it could start right away??

It can make sense sometimes but seriously look into this. It’s not needed unless there are major major issues.

The need for two phases is that your child is still growing

Same reason why they won't do serious orthognathis surgery or nose jobs until a child's face stops growing

That's it. That's the answer.

They need to make sure the teeth / nose / jaw fits your child's face for a permanent lifetime

Do you realize you pointed out how scammy it is. Do plastic surgeons do two phase nose jobs? No they wait. Just like they used to do with braces.

Scholarly articles point out it’s a scam:
Results
All the evidence advocates that two-phase treatment does not outperform one-phase treatment in skeletal correction, treatment stability, or reducing treatment complexity in Class II malocclusion. Early intervention can be beneficial in a few scenarios, but it typically prolongs treatment duration, increases costs, while reducing patient compliance.

[Anonymous]

My oldest child ever had a cavity. When he was about to age out of our dental insurance suddenly the dentist claimed he had 10 cavities. We stopped going there and they spam us with calls and emails constantly.

And yeah, my adult child's new dentist found no cavitiies.

[Anonymous]

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[Anonymous]

Anonymous wrote:PP here. Forgot to add that I do think it's criminal that dental and eye care is not covered. These are part of health and wellbeing and no excuse for what we have here in the US.

Especially because life expectancy has risen.
And the American food system is less whole. Even if you eat mostly healthy, we’re now exposed to many more of these soft/mushy/cakey foods that surround the tooth. Goldfish needs to be flossed much more than chicken or pork!

With us living longer, we need our teeth to last us longer!

[Anonymous]

So you all think your medical insurance should cover dental treatment? For no additional charge?

Sorry. Doesn’t work that way.

There is dental insurance on the market. Buy it if you want.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How is all the upselling legal? When I go to an MD or NP or PA they don't upsell other services?

So much of dentistry is unregulated and seems like invented procedures to make more money like two phase braces for most kids, selling expensive electric toothbrushes, in office whitening, insisting you need crowns when a filling will do, etc.

This is the biggest scam. Every single NW DC family I know just ponied up the $15K for this and they all started with reasonable teeth. So ridiculous.

I have 3 kids. For one of them, the orthodontist said — it’s just cosmetic, I could fix it in 3 months if you care. We opted not to bother. For another, they said it’s a minor issue and can be fixed in 6-9 months. For the third, she had every problem you can have and it took years to get it fixed. So my experience was that they didn’t just sell all us on the most expensive plan in all cases.

I also have a dentist that never upsells me. I always think the price of the cleaning is actually a really good deal considering how important it is.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How is all the upselling legal? When I go to an MD or NP or PA they don't upsell other services?

So much of dentistry is unregulated and seems like invented procedures to make more money like two phase braces for most kids, selling expensive electric toothbrushes, in office whitening, insisting you need crowns when a filling will do, etc.

This is the biggest scam. Every single NW DC family I know just ponied up the $15K for this and they all started with reasonable teeth. So ridiculous.

Yes. My older child had horrible teeth and I do think two phase made sense for her. I was scammed by doing two phase with my younger. I’m still trying to figure out how to respond. The last day of my younger DS’s treatment, the ortho asked if we wanted to roll right into phase 2. Why would it even be separated out if it could start right away??

It can make sense sometimes but seriously look into this. It’s not needed unless there are major major issues.

The need for two phases is that your child is still growing

Same reason why they won't do serious orthognathis surgery or nose jobs until a child's face stops growing

That's it. That's the answer.

They need to make sure the teeth / nose / jaw fits your child's face for a permanent lifetime

Do you realize you pointed out how scammy it is. Do plastic surgeons do two phase nose jobs? No they wait. Just like they used to do with braces.

Plastic surgery is not performed on growing children.

[Anonymous]

Part of the challenge is the ecosystem that has grown up around dentistry. Dental schools are big business for universities. Not to mention the dental tool / device industry. And then people involved in these related enterprises are invested in making dental health a big deal as part of human nature to want to make meaning in their work. And the result is more visits (when I was young routine care was once a year, now it’s twice with X-rays annually) where it seems like a new service is added pushed each time I go.

I didn’t go to the dentist for 3 years but took very good care of my teeth at home. No issues when I had a cleaning this year. I have gone when I’ve had issues (crossing teeth corrected through Invisalign, sensitive patch on gum, weird bump that was a bone spur, etc) but I’m not at all convinced cleanings are needed for adults who take good care of their teeth at home.

[Anonymous]

I believe 2 stage is necessary in some cases due to genetics. I got my dads small mouth and my moms large teeth. Back in the day the solution was to pull teeth, so my siblings and I are all missing quite a few teeth but the ones we have are straight. FF my kids, nieces and nephews that needed braces went through 2 phase with a palate expander. They have gorgeous smiles in mouths that fit their faces, while their parents all have narrow faces.

Anyhow, my fed medical insurance covers two cleanings a year and we all brush and floss daily. I'm pretty happy with this ie personal responsibility daily and 2x yearly check. The upselling drives me nuts, but no is a complete sentence.

[Anonymous]

Humans need healthy teeth and gums. Dental health should be included in healthcare. Cosmetic procedures are elective and paid by patient/consumer unless medically necessary.

Same with vision.

No reason either of these should be separate from healthcare.

[Anonymous]

Our largest out of pocket expenses are for dental and veterinary care.

[Anonymous]

Anonymous wrote:My oldest child ever had a cavity. When he was about to age out of our dental insurance suddenly the dentist claimed he had 10 cavities. We stopped going there and they spam us with calls and emails constantly.

And yeah, my adult child's new dentist found no cavitiies.

I'm 60 and have never had a cavity in my life (go for cleanings probably once a year). About 15 years ago the dentist I had been going to for years sold his practice. The first time I saw the new dentist who bought the practice, she told me I had a mouth full of cavities and had to come back and get them all filled. I went to a different dentist who said I had absolutely no cavities. I wish I had reported her to whatever licensing board exists for dentists. This was just criminal!

On another note, private equity is getting into the dental (and vet) business big time. My brother-in-law was a dentist on the west coast for 30+ years. Last year he retired and sold his practice. 95% of the interested buyers were private equity firms who were buying up tons of dental practices and turning them into PE-backed chains. He ended up selling to a single dentist who wanted to expand her practice.

[Anonymous]

Anonymous wrote:I agree that dentists are scammy and the whole industry is out of control.

Vision is also kept out of health insurance for some reason but the industry isn’t so scammy.

I feel like vision is scammy! They should be required to give a PD as part of the RX