Are Some Dentists Corrupt Mechanics? (The Value of a Second Opinion)

Mechanics get a bad wrap. There are multiple good ones; in fact, a good friend from college’s dad is a great mechanic with an excellent rapport in the community of Charleston – but it seems for every good mechanic there are at least 10 greedy ones. They’re a modern day pirate, of sorts; they hold your car hostage until you fork over an insanely large amount of cash in payment for “critical” repairs that are subjective at best, if not completely falsified. It’s hard to shed any light on these shady practices, and so they continue and give reason for all of the horror stories.

Dental Coupons…Possibly a Mistake?

Back in the spring, I purchased a $45 LivingSocial coupon for a dental exam, including x-rays and a cleaning. I hadn’t been to the dentist since before college, and so this seemed like a good, inexpensive way to get the update on my teeth. And so, I scheduled an appointment with Paddock Place in Mt. Juliet.

When I saw the exterior of the building, I was a little suspicious. It was one of those made-to-order stand-alone buildings that have propagated near malls in recent years, and a gaudy “NOW OPEN” banner was strung across the archway.

It was 8:30 in the morning, and there wasn’t a person in the waiting room. This should’ve been my first clue.

The benefit to being the only person in the place was that I didn’t have to wait very long at all. A pleasant dental hygienest led me to the back, and everything was very new and state of the art. Each dental chair had a small 18-inch flatscreen TV affixed to the wall across from it, and the interior decoration was very hip and modern. It was all quite swanky.

The dental hygienest was a sweet girl, but kept being distracted by the flatscreen TV as she prodded around in my mouth with the x-ray tool. It struck me as unprofessional at best, plus she kept misplacing the x-ray device and having to readjust it after I’d bitten down once.

She pulled out a new tool, a laser that can read the size of the cavity in your tooth. Anything above a 20 is a cavity, evidently. She poked each tooth with the laser, with one reading a 39. No other tooth registered above 20. “The laser isn’t registering the cavities,” she explained, and I wondered — what’s the point in having such fancy technology if it isn’t accurate? Aren’t lasers super accurate?

She then pulled up my x-rays, asking me if I knew how to read them. I said No. She pointed out a few problem areas, suggesting I probably had at least 6, but she didn’t know for sure.

The dentist arrived, finally, and he didn’t seem to be much older than I. He too prodded around in my mouth as dentists do, offering no comments or consolation as he did so. Once he was done, the x-rays from my teeth flashed up on the screen.

“Do you know how to read an x-ray?” the dentist asked me.

According to Google, this is a cavity.

“I’ve seen them before, but I guess not really,” I conceded, shrugging a little.

He proceded to point out several tiny black triangles nestled on either side of almost every tooth. “See these? These are cavities.”

My heart sank. I couldn’t count them all. “Is that…every tooth?!” I asked in shock.

He smiled. “Well, not EVERY tooth, but you have eleven cavities.”

ELEVEN CAVITIES?!

I knew I’d eaten a lot of Skittles in college, plus at least one soda per day on most days I’d been on set. All that sugar was adding up, and now I had to pay for it. But something didn’t seem right.

The dentist explained I could only do one tooth at a time if I wanted to, or as many as I wanted at once if I wanted to. He was flexible. No sooner had he left did another lady come in with an itemized treatment plan. My eyes were immediately drawn to the total at the bottom. $1,100.

“So, this is the estimate for your first four teeth,” she explained.

I almost choked. $1100 for FOUR TEETH. How would I afford this?! That’s nearly $3,000 for all eleven teeth!

“And we can do as many or as few as you want to – a little bit at a time seems to be best,” she said with a reassuring smile. When I didn’t say anything, she pressed me further. “We can get you started right away, today.”

I nearly laughed at her, but composed myself. “Ummm, I have to go to work,” I managed, thinking who are these people that think I can just hang out all day at the dentist’s office?! Are they out of their minds?! I hadn’t overheard anyone else come into the building in the hour and a half I’d been in there. It was all making me feel very uncomfortable. I knew I had to leave.

I made it out of there that day, scheduling an appointment to have two teeth fixed for a whopping total of $450.

On my drive from the dentist’s office to work, I began thinking of I how I was going to pay for all of this. Spread over 6 months it wouldn’t be as bad — but $3,000 is quite a chunk of money! I began thinking of sacrificing a future trip, and how I’d seriously need to start thinking of finding a new gig immediately after my stint on Day Jobs came to a close. I told my mother the bad news, and she was just as disheartened as I was. Things were looking rather bleak.

It wasn’t until I talked it all over with Jeanette, my colleague and former dental assistant, that I began questioning the legitimacy and decency of this dentist.

“Eleven cavities?” She shook her head. She didn’t believe it. “When I was a dental assistant, even the people who never brushed their teeth didn’t have that many cavities. You don’t strike me as someone who never brushes their teeth. I’d get a second opinion. Three grand is a lot to spend. It couldn’t hurt.”

I began replaying my visit to Paddock Place over in my head. Clue I: No patients. Clue II: Fancy equipment that couldn’t have been paid off yet. Clue III: “Can you read x-rays?” Clue IV: “We can get you started today.”

The Value and Importance of a Second Opinion

You hear it a lot in movies – people get second opinions for dire health problems. I hadn’t really considered doing it – ever – until Jeanette raised the red flag over Paddock Place.

I scheduled an appointment with Bill Robertson over in Bellevue. He came highly recommended from a good work comrade of mine, and he’d been in the business for well over two decades.

Dr. Robertson’s daughter greeted me cheerfully at the front desk. I asked her some preliminary questions about costs, and she was extremely honest and helpful. She could see I was a bit nervous. “My dad is great,” she promised. “Of course, I’m biased, but he really is good at what he does.”

That put me at ease a little. A middle aged man came out of the dentist’s chair, and shook hands with Dr. Bill. It was obvious they’d known each other for years. I was feeling more at home.

Dr. Bill was professional and nice; immediately likable in a genuine way. He commented on the x-rays I’d brought and how they hadn’t been taken very well. I laughed as I remembered the dental hygienist fumbling around with the x-ray prod.

After he studied my x-rays and looked in my mouth, he reached his conclusion.

“You don’t have eleven cavities,” he said.

“I don’t?”

“You have two. I have no idea where they got eleven from.”

Yep, that’s my mouth.

I lept out of the chair and did a little dance in celebration, and Dr. Bill laughed at my jubilation. I suppose he’s not used to people celebrating when they find out they have cavities, but TWO is a hell of a lot better than ELEVEN.

I was even more ecstatic when I found out the price: $265. That’s it – for both teeth. Apparently I have one tooth with two bad surfaces, and another tooth with one bad surface. I compared it to my four-tooth treatment plan from Paddock Place. Each tooth had at least 3 affected surfaces, according to him – and that was just for the first four teeth.

Malpractice or Fraud, Anyone?

I’m currently building my case to report the Paddock Place dentist to the Tennessee Board of Health. The guy is a crook. How many other people has this guy duped? Likewise, how many dentists are defrauding the American public every day? How many health professionals are prescribing unnecessary treatments or surgeries just so they can pay off their new equipment (or, ironically, their malpractice insurance?)

It’s just like taking your car to a corrupt mechanic. Of course you need that new serpentine belt for $450, we’ve already fixed it for you, pay up… only instead of a hunk of metal that ultimately means nothing, it’s you.

Anyway, this was a long-winded post with a very simple message:  If you find yourself met with an unbelievable diagnosis and even more incredulous bill in the realm of health – especially in the dentist’s office – seek that second opinion. For an extra $50, I saved myself at least $2700 — plus any future costs of crowns that I would’ve needed as a result of the Paddock Place guy tearing up almost all of my teeth.

The other moral of the story is to stay away from Paddock Place Dental in Mt Juliet, TN and check out Dr. Bill Robertson. If every dentist were like Dr. Bill, the general loathing of going to the dentist wouldn’t exist!

Author: Laryssa

Laryssa has spent 6+ years working on an assortment of film and television projects. She writes about her experiences to help (and amuse) others. If she's not working, she's either traveling, reading or writing about travel, or planning travel. Follow , Twitter, or Facebook.

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5 Comments

  1. This article is beyond accurate. There are as many crooks out there for every good dentist, and people need to be aware of that. Another tip: if a dentist keeps asking for your insurance information even though you’ve given it twice, and orders a root canal “just in case,” (hint: they are much more expensive) that’s probably an indication that they are crooks as well. Also if they tell you their equipment is “state of the art” and that the other dentist you’re thinking of asking for a second opinion- his or her equipment may not show the “cavities” quite like theirs does…. Ah, what a world.

    Good for you for standing up for yourself and getting that second opinion.

    On a different note, I loved the tone of this article and your writing is excellent- it flowed very well. You have a wonderful sense of humor too- something very necessary in this life-force-sucking society, (:P) and also something that makes this piece so enjoyable. Keep it up!

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  2. I’m a recent graduate of dental school and have been practicing dentistry for 6 months. I looked at your X-rays and counted 9 carious lesions (cavities). Insurance would definitely pay for these filling and they would be acceptable for a dental licensing exam. Most of the cavities are small and just barely past the enamel. Once past the enamel you can’t clean the area with a toothbrush or floss, you can slow it down with plaque removal from brushing and fluoride in toothpaste but you can’t stop it. One of the largest dental experts in the world, Gordon Christensen, stated that the best thing we can do for cavities like this is get them out and fill them. The smaller the filling, the longer it lasts. With your cavities being as small as they are it would take years for them to hit the nerve and become a root canal, especially if you brushed regularly. These cavities could of started a long time ago, maybe during a time when you were not as diligent with your brushing habits, like teenager years. I had a 15 year old girl come in my office with the same situation. I told her parents we would start with the biggest ones first then proceed to the other ones over time. Since she had insurance, she decided to do half the mouth last year, and we are doing the other half this year. Insurance paid every single filling. Insurance won’t pay for a filling that they can’t see on an X-ray.
    I like to read these articles because I like to understand what patients think. I like to diagnose honestly and let my patients know what is going on. I have been accused of over diagnosing and being crooked, because of my diagnosis, however I know I can back up my diagnosis from dental literature and studies. There are many more dentists who under diagnose in hopes of making a sale to the patient. They under diagnose because they feel that once a patient moves forward with treatment, it will be easier for them to return and get the other cavities taken care of later on.
    It’s a tough call for us dentists. When we correctly diagnose, we get called crooked. When we under diagnose and tell the patient what they want to hear we get praised. For me, it’s more important to be honest, explain the situation to the patient and let them decide what they want to do.
    I support you taking these X-rays to the dental board, they will give you an honest answer. Let us know what they say.

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    • Hi there. This is fascinating stuff. I am also a dentist. I graduated in 1999 and worked in a small town for the first five years, before returning to the city.

      I completely agree with Dr. T.
      Even without the xrays showing any detail between your front-top six teeth (from canine to canine), it’s clear that you have far more than two cavities.

      When I was a new grad, I would diagnose everything “by the book” with no consideration for the patient’s age. With time, and experience, I realized that a “medium-sized cavity” in a teen-ager, is far greater risk of developing into something nasty, than the same cavity in an adult or middle-aged person.

      A big part of it is genetics. From my personal experience, I’ve had almost every tooth filled, about nine root canals, and about as many crowns. I’ve had three of the crowns replaced because the dentist who placed them didn’t do them to my personal standards (loose fillings and crowns create areas where food gets packed in between teeth, which is incredibly annoying).

      From my own personal experience, upper molars at the back are the most common area where major cavities develop. The xrays, even at the low resolution visible here, show that the two upper right molars have “definite cavities”, and the three upper left back teeth (two molars and one premolar) show definite signs of decay.

      But, you are an adult. you aren’t a teen. These have likely developed since you were in grade….8-10. It’s not like these things have grown overnight. I explain this to the patient.

      I also advise the patient that in my experience, patients’ cavities tend to grow from 10-25 years old, but beyond about 25 years, as your mouth and mouth chemistry evolves, cavities tend to go into a semi-hibernation state.

      In a case like yours, I might recommend doing the “two worst ones” and see how bad they are in reality. when I’m in there, I will pull out my iphone and take a nice macro photo to better show the patient after the filling has been done, “how bad it really was”.

      do you have eleven? possibly.
      Do you have two? for sure, no.
      do the cavities need to be done “right this minute?”. No, for sure not.
      But is the second dentist doing the patient ANY favours by just telling you that you “just have two?”

      nope, that’s under-diagnosis in my books. That’s not giving the patient the full explanation. And some might call THAT malpractice.

      nowadays, it’s all about legality. It’s all about informed consent. I teach my patients how to look at their own xrays, and let THEM be the judge of what to proceed with, and when.

      I see a lot of second-rate dentistry. I’ve reported it too. All it’s gotten me is grief, and a big bullseye on the back of my head. I’ve learned that the state Boards, really don’t want to hear about it.

      Dentistry is no different than the medical business. It’s all a business, and oftentimes, it’s BIG business.

  3. Well written article – should be read by dentists everywhere. As a dentist and a lawyer I have to chime in here about an epidemic in dentistry (and healthcare in general). The epidemic is the standard of care – or rather its absence. You have gone to two different dentists, received very different diagnoses and then heard from others on your blog message board – how are you to know who to trust? Worse yet, are they all right?

    There are far fewer dishonest dentists out there than you might think. The problem lies in the healthcare system. Healthcare needs to get its act together and provide doctors with stronger research, faster implementation, and clear guidelines for diagnosis and treatment. Two dentists should be able to look at the same set of X-rays and not have a 500% variation in diagnosis.

    Especially in this digital age, patients deserve to know the standard used in their diagnoses and the strength of the supporting science. There is a reason why we use terms like the basketball standard (always 10 ft) or the gold standard (always measured against the value of gold). Healthcare needs to review the meaning of “standard.” Only then will care improve and trust be rebuilt.

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    • Where I come from, the guideline threshold for drilling a cavity is when the carious lesion has reached half the distance to the pulp. That is the immediate indication for drilling a cavity.

      Otherwise (cavity has reached less than half of the distance to the pulp), I inform the patient about the situation, and let him/her choose whether to try stopping the lesion by proper self-care, or give him/her the choice of drilling the cavity in a prophylactic manner.

      Special situations arise when the patient is incapable of adequate self-care, and/or has inherited hyposalivation and/or medication derived hyposalivation, when the threshold for drilling a cavity should obviously be lower.

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