Is fluoride just another upsell that isn't necessary?

IMO yes. We provide fluoride varnish on our patients at no extra charge. I know dentists that charge for it and personally I feel like that's nickel and diming patients.

Does it have its benefits , yes ! Is it worth $20 if you have good oral hygiene and low caries risk. Meh.

Deep cleanings as a thing is totally legitimate. Now, whether OP NEEDS a deep cleaning is the question. Without seeing periodontal charting (to see your pocketing levels) and x-rays (for bone levels and subgingival tartar) it's impossible to diagnose.

Is your dentist office owned by an individual or equity firm?
The equity firms that are buying dental businesses have a financial model that ensures you will have a cavity every visit.

Same thing happened to me a few years ago. Think I've only had 1 cavity in my life. But I hadn't gone to the dentist in a few years and my dentist had been sold to a corporate type of dental practice. I went in (they knew it had been a long time since I had done) and at the end they said I had 8 cavities and needed to get them filled. I had never heard of this scam and initially believed them. But something just seemed very weird about it. 1 or 2 and I likely would've believed them and chalked it up as stupid on my part for not going for a few years. But 8 just seemed excessive.

Thankfully I went to another dental practice where I knew one of the hygienists (who said the dentist was great) and he looked at the x rays and took new x rays and said I had no cavities whatsoever. Stayed with him after that.

So if I had let them do the work, what would they have done? Just drilled 8 of my teeth for no reason whatsoever?

Reminds me of the infamous 1997 article in Readers Digest which exposed many dentists as being the same as auto mechanics and air conditioning companies. If you find one you can actually trust, don't use anyone else.

https://www.rd.com/article/how-honest-are-dentists/

This is a great thread!

What do y'all think about red light/laser treatment? My dentist is always telling me I need it (something about bacteria) but insurance won't cover it. $75 for them to shine a light on each tooth for a few seconds seems wild to me, but I don't have the best tooth hygiene practices so I figure maybe it will help.

rynning said:

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Reminds me of the infamous 1997 article in Readers Digest which exposed many dentists as being the same as auto mechanics and air conditioning companies. If you find one you can actually trust, don't use anyone else.

https://www.rd.com/article/how-honest-are-dentists/

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I remember a pediatric dental scam back in the 80s, that's basically resulted in a lot of kids having a mouthful of silver teeth. I remember seeing classmates with that and thinking it was strange (even as a kid). IIRC, it targeted kids on Medicaid because the govt was paying for all the caps.

I'm headed back to my previous dentist this afternoon. My BF also suggested I try the office he uses, as he's been a client for years and is really happy with them.

It's been just over a year since my last cleaning. I have not missed any annual cleanings since I started seeing this dentist, but I don't go very 6 months, and the visit this year is a few months late.

TXTransplant said:

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rynning said:

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Reminds me of the infamous 1997 article in Readers Digest which exposed many dentists as being the same as auto mechanics and air conditioning companies. If you find one you can actually trust, don't use anyone else.

https://www.rd.com/article/how-honest-are-dentists/

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I remember a pediatric dental scam back in the 80s, that's basically resulted in a lot of kids having a mouthful of silver teeth. I remember seeing classmates with that and thinking it was strange (even as a kid). IIRC, it targeted kids on Medicaid because the govt was paying for all the caps.

I'm headed back to my previous dentist this afternoon. My BF also suggested I try the office he uses, as he's been a client for years and is really happy with them.

It's been just over a year since my last cleaning. I have not missed any annual cleanings since I started seeing this dentist, but I don't go very 6 months, and the visit this year is a few months late.

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Medicaid fraud was/is RAMPANT. There are stories of (corporate) offices that sent vans around to pick up preteen and teenage kids in Low SE neighborhoods, offer em money and take em to the clinic and do multiple fillings/stainless steel crowns etc. and just send em on their way and bill medicaid for them. Medicaid used to cover orthodontics pretty well until fraud got so crazy multiple clinics shut down and docs fined /possibly jailed? and now qualification criteria is very strict.

Howard Roark said:

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This is a great thread!

What do y'all think about red light/laser treatment? My dentist is always telling me I need it (something about bacteria) but insurance won't cover it. $75 for them to shine a light on each tooth for a few seconds seems wild to me, but I don't have the best tooth hygiene practices so I figure maybe it will help.

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Laser Bacterial Reduction is a procedure we run with our patients that have heavy gingivitis and bleeding. It definitely helps. The tip of the laser is placed into the periodontal pocket (the space between the gum and the tooth) and run all around it to kill inflammation causing bacteria that reside and hide in those pockets.

$75 is a little steep but if you have a history of gingivitis/periodontitis it may be worth it to keep things healthy.

Any preventive treatment done (LBR, fluoride, etc) is going to be rendered useless if your homecare isn't good. So keep that in mind ! Same goes for dental treatment. Crowns, fillings, etc can all fail prematurely with poor hygiene and or abuse on the teeth (clenching grinding eating ice and corn nuts and jaw breakers etc)

Back at the previous dentist. Hygienist did some measurements of my gums that are supposed to be between 1-3 mm. I had a few teeth with 4 mm and some plaque buildup on my x-rays. I do not think the other dentist did the measurements.

The diagnosis was scaling with some inflammation. I also had a decent amount of plaque/calculus that had to be scraped off, which is not surprising since my last cleaning was 18 months ago.

The hygienist did not recommend a deep cleaning, but rather to localize a more aggressive/thorough cleaning in the areas that needed it the most. Dentist agreed.

It was unpleasant, but I got it all done in one visit, no numbing required.

Will go back in 3 months so they can check the inflammation and bone loss. Depending on if it stays the same or gets worse, they will adjust treatment accordingly.

Cleaning only required my $50 deductible. That's compared to the $600+ all OOP the other dentists proposed for the deep cleaning.

Also no cavities.

I will go back in 3 months, and since I'm entitled to 2 visits any time in one calendar year, I can go in for a 6 month cleaning in Jan. I promised to floss every day.

That sounds like a very reasonable diagnosis and treatment plan given what you've described.

If other dentist/hygienist did not do any periodontal probing or readings and diagnosed a deep cleaning then that's irresponsible, fraud, negligent…one or all of the above.

What about dentists that push tongue tie release? Apparently that's becoming more common.

In infants? Good idea if there are feeding issues. Lasers used these days are super non invasive and quick with very little post op.

lazuras_dc said:

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That sounds like a very reasonable diagnosis and treatment plan given what you've described.

If other dentist/hygienist did not do any periodontal probing or readings and diagnosed a deep cleaning then that's irresponsible, fraud, negligent…one or all of the above.

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They took x-rays and put a camera in my mouth. The dentist did a visual exam and looked at the photos from the camera. But the probe measurements today were a little uncomfortable, and there was nothing uncomfortable about my visit to the other guy last week.

I think they made the diagnosis off of the X-rays and camera/visual inspection only. Unless they did something that I didn't feel.

Good to hear TXTransplant.
Your suspicions were confirmed. It's scary what kind of treatment plans are presented to patients sometimes.

Lazarus_dc and other dentists on this thread: what toothbrush do you recommend?

I've been using a Colgate hum rechargeable (have previously used various iterations of Philips, Sonicare, and Oral B).

Dental hygienist thinks the Colgate isn't powerful enough. She recommended Oral B iO series 7 or higher.

The 7 is a $200 toothbrush. The versions higher than that go up to $380.

I looked at the 6 (on sale for $100) and the 5 (on sale for $80), and they all have the same number of brushing modes (5). The main differences appear to be only the 7+ has magnetic charging and the 6 and 7 have an "interactive black and white display" but the 5 has "LED mode visualization".

All supposedly have AI brush recognition.

I bought the 5, but I was wondering why they specifically recommended 7 or higher when the "extras" seem to just be for convenience/style. Do they get kickbacks for promoting Oral B products? Or maybe this hygienist just prefers the faster mag charging?

Thanks for all the advice and help on this thread! I'm so glad I posted and hope it helps someone else.

fantastic information on this thread.

Sonicare is a great one but I'm currently using the Oral B iO. It's got some unnecessary gimmicky features like Bluetooth connectivity, but I like the timer, pressure sensor/indicator, and settings for brushing intensity.

My favorite brush I've ever used was a Sonicare. It was totally different from the type they make now. Went through one and had bought a backup after they discontinued it because I liked it so much. Then one day I dropped it and it stopped working. Hadn't found one I like as much until I tried the Colgate Hum.

bert harbinson said:

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You were wise to go back to an office you're familiar with, despite the revolving door of dentists. The "deep cleaning" is corporate dentistry 101 for maximizing production from a new patient (unfortunately there are individually owned practices that do this too). Sure, many people need this treatment, especially if it's been years since their last cleaning. But even in relatively healthy mouths, if they probe one pocket of 4 mm, or one spot that bleeds on probing it's "hold on, this isn't a routine cleaning."

The cavity issue is another red flag, though there are differences in interpretation on whether or not a tooth needs a filling. A conservative dentist might choose not to fill some teeth that a more proactive dentist might want to treat right now. But this does leave the door open for the unscrupulous dentist to justify their aggressive treatment plan. The fact that they wanted to do the treatment right away is a huge red flag for me. Red flags mean get a second opinion, or simply get out of there if you're not comfortable. I've had many patients come in for a second opinion and it's sad, if not criminal, what some offices are pushing on patients.

End of rant!

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This thread is timely... same thing happened to me last month.

I went to the closest dentist that took my hmo insurance. It was PE owned. The dentist gave me sleeze vibes early and then I got a similar pitch as the OP. I had one cavity... but one you could not see on xray (I asked to see it) and was "clinical". I also needed the deep clean for 1000.

I also asked for my routine cleaning.. I figured how could I go elsewhere for a cleaning only since they billed the visit/xray.

I really would love to get a 2nd opinion somewhere.. but will anyone just do a cleaning/look?

Also, in medicine we have a board you can complain to. Do dentists?

TSBDE. It's unfortunate but the further you fall down into the DMO, PPO, DSO pit the more you run into this. It's not different than medicine IMO.

Sorry but any office that takes HMO is going to be a dental mill and probably sketch in my book. And it's starting to get that way with offices that are in network with PPOs even. Don't let insurance dictate your health. Go find a trustworthy reputable dentist. Switch your insurance if possible or forgo it and and pay cash or find a trustworthy office that offers a membership plan.

lazuras_dc said:

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Sorry but any office that takes HMO is going to be a dental mill and probably sketch in my book. And it's starting to get that way with offices that are in network with PPOs even. Don't let insurance dictate your health. Go find a trustworthy reputable dentist. Switch your insurance if possible or forgo it and and pay cash or find a trustworthy office that offers a membership plan.

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I second that…This is the ABSOLUTE best advice that you can get

Dental upselling / fraud seems to have ramped up in the last 5 years.

We brush / floss after EVERY meal and hit the waterpik every night.

If we have an issue, we go to the dentist and have that issue taken care of.

No dental plan. We get a check up every two years. They always offer / recommend the option of derp cleaning and scaling. We decline.

No dental insurance as we have an HSA account that is our deFacto insurance. If we have an issue, money comes from there.

Dental insurance = 2500 per year x 2 = 5K per year. We haven't had an issue in 6 years when my wife needed a crown. Paid 1500.00. Dental insurence would have paid 50% after the deductible. Just awful.