I will tell you our experiences and you decide: my 22 year old son is now on his own and living in Pittsburgh. He had seen the same dentist for his entire life, but he is not able to get back to our home for an appointment, so he is finding his own docs and dentists, as he should. My son, B, works at UPMC and asked around for the best dentist. We have great dentists in our family and he was proud that he found a great dentist, Dr. Hart, in Pittsburgh. B told me all about the fancy office and upscale equipment and the staff. His initial appointment was REALLY expensive, 3D x-rays, etc. I was surprised by the cost but ok (I am still paying at this point). B had one cavity when he was 7 and he had his wisdom teeth out and that was the extent of any dental intervention he had needed up to the age of 21. He got excellent care from our home dentist. B called me after the appointment with Dr. Hart and said the new dentist had found that some fillings were needed. I was fine with that because that sometimes happens. I saw the charge before they did the fillings-- four of them, which I thought was a lot, and they charged top top dollar. Our insurance covered a small part of any of this. That was ok, because it needed to be done and was being done. But, then, when I logged into the insurance website to check on the first bill, another "pre-approval" was posted for another four fillings for B. I called B and he said, yeah, unfortunately, the dentist found 12 teeth in all that needed filling and it may go as high as 16. The dentist isn't also isn't sure whether one of my back molars needs a crown, B said. This seemed very odd to me and I was worried about B's losing valuable tooth material unnecessarily. I called Dr. Hart's office and asked to have the Xrays and treatment plan forwarded to B's home dentist for a look. After some back and forth, they agreed to send the Xrays but would not send the treatment plan "that's proprietary information" (that alone ordinarily would send me running; why not send a treatment plan if it is sound? all I was looking for was confirmation that the work needed to be done.) It seemed very odd to me that a child who had fluoride in his water from birth, checkups with the dentist every six months and with a lifetime history of 1 filling would suddenly at age 21 need 12 or more full fillings and perhaps a crown. The receptionist at the home dentist said that it would take some time for B's dentist to take a look at the films and he probably could not give that much of an informed opinion since he hadn't seen B in a year. However, she called back about five minutes after the films were sent to them. My experience is that health care professionals NEVER criticize one another. There may be some kind of professional code. The home dentist said was, "it's possible that this dentist doesn't get B's teeth the way I do after working with B since he was 3 years old. He may be misinterpreting some ridges and pits that are natural to B's teeth as cavities when they really aren't. The teeth in these films look like what we took a year ago." I asked the local dentist's office what they advised and they said "find another dentist, don't do the work until B can have a 'more conservative' dentist give a second opinion." B cancelled the other fillings and is probably not going back. He will find another dentist in his area, and of course, it is possible that he needs work done. That is not the question. The question is how it is possible that a kid who has had no pain and no issues with his teeth could SUDDENLY need 12 or more teeth drilled and filled. I totally believed four teeth might need it but the higher number begs examination. I am NOT advising anyone else about what to do with this information, just describing my family's experience. And by the way, we live very close to San Francisco, our local dentists are among the best in our area. We are not living in a backwater. read more
