My dentist is ripping me off.......

[jerseygirl07067]

Or at least I think he is. I switched to him recently since I moved to a different part of town. He heavily advertises that he does a lot of cosmetic dentistry, in addition to general dentistry.

I have always gone to the dentist every six months and have never had any cavities. Now all of the sudden I go to this guy, he says I have four cavities and he tells me that I should get all of my old mercury fillings removed, and switched to porcelain, to the tune of almost a thousand dollars. He says not to worry, insurance might pay for a good amount of it. Then my DH goes, and they say he needs a root canal, has four cavities, and then needs to get his fillings switched out too. WTF?

Well that's not even the point!!! I work in healthcare, and I am so over healthcare providers taking advantage of the insurance companies. IMO that is part of the cause of the current healthcare crisis in our country today, but that is a whole additional topic.

Please enlighten me if you know anything about this filling thing. Is this really necessary? I have 10 old fillings from when I was a kid and my DH has about the same. (At least the dentist had the decency to tell me that he wants me to be done nursing first because of the potential mercury exposure). I would do it if it was really going to benefit me in the long run, i.e. like I could keep my teeth for life and not wind up with a mouth full of dentures like so many people.

I am not sure if this topic will generate much interest but I figured I'd give it a try. :)

Marcy

[Momof3Labs]

My dad is a dentist and has not replaced any of the fillings that I have had since childhood (I'm now 31), and I know that he would if there were a problem. I actually have quite a few fillings, not because I didn't listen to my Dad and not brush well, but because my teeth are shaped pretty weird. Some of the fillings were actually preventative dentistry in the days before sealants were available. But I digress...

I'd agree that the fillings thing sounds like a rip-off. And it would make me question everything that he is saying, too!!

[Marisa6826]

I had all my amalgam (silver) fillings replaced a few years ago. A similar type of dentist told me the old ones were shot, and I was putting my health at risk.

After several thousands of dollars later, my teeth still aren't the same. I've consistently had sensitivity problems, and when I finally went back to my good old original dentist, he said there was never any reason to change the silver ones out.

Get another opinion and RUN!!

-m


BTW - is this guy in NJ by any chance?

[mteve]

Marcy-

I would strongly urge you to get a second opinion- preferably from your previous dentist. Although I haven't personally seen your mouth or examined you (I'm a dentist), I would be very wary about replacing existing mercury fillings unless there is recurrent decay (a cavity forming around the existing filling). Same goes for your husband - although I suspect if they recommended he needed a root canal he probably does. While tooth colored fillings look nice, they have their downside - frequently patients notice increased sensitivity and discomfort chewing for several weeks to months after the fillings are placed. That said, I place both silver/mercury fillings and tooth colored fillings, and the placement depends on the tooth being filled, size of filling, the patient's level of dental hygiene and whether or not they tend to grind or clench their teeth, and whether their insurance will cover it at all. I rarely replace existing mercury/silver fillings unless there is recurring decay or the filling has a big crack in it, and then I may or may not put a tooth colored filling in it- for the reasons previously listed.

Like many healthcare professions, the practice of dentistry is filled with different schools of thought. I wouldn't say your dentist is necessarily intending to rip you off, but he has been trained to practice dentistry in a certain way - as you stated "he heavily advertises that he does a lot of cosmetic dentistry". Many dentists who practice "Cosmetic dentistry" will likely provide you with a cosmetic treatment plan. Kind of like there is surgery that is necessary and there is plastic surgery, KWIM? I'm guessing you are looking more for a dentist who is of the "if it ain't broke, don't fix it" school of thought - and your previous dentist might be more in line with that kind of training. Maybe call his/her office and see if the can recommend someone to you who has a similar practice style.

As for the mercury exposure from your current fillings - I'd worry more about tuna. The exposure from the fillings would likely be greater upon their removal.

HTH

Eve

[jerseygirl07067]

Thanks Eve! Your post was very helpful. I am going to get another opinion from my original dentist.

I did want to ask another question though.....my current dentist said the reason he replaces mercury fillings with pocelain is because the mercury contracts and expands over time and can eventually cause teeth to crack. Is that correct?

Thanks for your input!

Marcy

[August Mom]

Definitely get another opinion. When I was new to this area, I went to a new dentist. I had never had any cavities in my entire life (including childhood). He says I have 3 cavities and wants to seal all the rest of my teeth. He also wanted to do all kinds of work on DS. We switched dentists and its been like it used to be. No work for me and occasional work on DH's teeth.

[amp]

I went to a dentist one time who did way more xrays than I'd ever had, tried to talk me into teeth bleaching and getting that coating on my teeth to prevent getting cavities even though I've never had one in my life. he also tried to tell me that I HAD to get my molars removed even thought they never came in and have never posed a problem before. And it was pretty high pressure "Would you like to schedule that now? You really need to have this taken care of or something terrible could happen" kind of tactic. Needless to say, I never went back.

[JenaW]

Although everyone else has already given good advice, I wanted to mention that I had a similiar problem. I have NEVER had any cavities either. Went DH and I got married and I moved and went to a new dentist, he told me I had 3 cavities and suggested several hundred dollars of cosmetic work. We did not have ANY dental insurance at the time. I was so put off by all of his "corrective suggestions" that I never went back for my fillings. About 6 months later DH and I bought a house and found a new dentist. I told them that the previous guy said I had two cavities. They took bite wing x-rays and did the usual exam and said I had NO cavities! So I would definitely go back toyour old dentist or another one and get another opinion.


Jera
Mom to Carter ~ 05.13.03
Cautiously pregnant with #2 ~ EDD 10.13.04

[jerseygirl07067]

No, the dentist is actually in Florida, which is where I live now. (Originally from NJ though!)

Marcy

[mteve]

Marcy-

It is true that mercury fillings will contract and expand slightly - but that is largely a function of temperature and the size of the filling. However, the same is true for tooth colored fillings. Much of the sensitivity found with tooth colored fillings has to do with the fact that tooth colored fillings shrink during placement and leave a very minute gap at the filling/tooth interface. Mercury fillings expand on placement- leaving no gap. I believe the jury is out on whether placing a mercury filling is later on going to cause a crack in your tooth. I think a better indicator of whether or not your teeth are going to crack later on is a serious clenching or grinding habit. I have seen a patient with a perfectly good tooth - no fillings at all- crack the tooth due to grinding and clenching.

Also, just so I can make it clear as I explain the nuances of dental fillings - there are two types of white/tooth colored fillings. The first is composite, and only requires one visit for placement - the tooth is prepared and the filling is placed. The second is porcelain, and it requires two visits a couple weeks apart. The first visit is for preparation and the second visit is for cementation. Porcelain restorations are generally very expensive - anywhere from $400-$900 a tooth, whereas a composite filling will be anywhere from $150-$450 a tooth. I would assume your dentist was recommending the composite fillings to replace the amalgam fillings.

Hope all of that wasn't too detailed!

[smilequeen]

Hey there, I'll give you another dentist pov. Although, I agree completely with the other dentist :) I can't tell you what is actually in your mouth, but I can give you my personal philosophy.

I personally don't replace amalgam fillings unless they need to be replaced. I also do not place any amalgams anymore, haven't in 4 years....but the mercury has nothing to do with that choice. Like the other dentist said...I'd be more concerned with tuna :) They DO expand and contract and over time they CAN cause cracks in the teeth, but that possibility in and of itself is not a reason for ME to replace amalgams...if there is already the sign of a crack, well that IS a reason. But without a crack, an open margin, or new decay, I don't replace them, unless the patient prefers to switch. So I'd ask WHY they need to be replaced and see if the answer is satisfactory.

As for finding cavities after years and years of nothing...Part of it is sometimes philosophy...For instance, I am the type of dentist who will diagnose and treat a small cavity not sit and watch and wait for it to grow, but some dentists want to see it reach a certain size first or wait for a stain to turn into a stick. This guy, if he's a big cosmetic dentist with all the toys, can probably use an intraoral camera or show you these cavities on x-ray if you ask. If you want a second opinion, I'd go to an entirely new dentist and not your previous dentist...a fresh opinion is probably in your best interest. Honestly, just the other day I had to sit and go through xrays and intraoral pictures with someone whose previous dentist gave them a clean check up 6 months before but who had 12 cavities (and they were ALL on the xrays the other dentist sent too :(). I HATE giving people the news that they have that many cavities after years and years of nothing...HATE it, and I'm always prepared to go over the details with the patient.

And ask the dentist what made him diagnose that root canal. He should be able to show you a deep cavity or an indication of an abscess that made him advise that treatment.

My guess is not that he's trying to rip you off, but that his philosophy is cosmetic...he wants everything to look perfect and white as well as taking care of any cavities or other dental problems. That's why he advertises that way. He doesn't want to see silver in your mouth because it's not cosmetic. But I could be wrong.

Let me know if you have any other questions :)

[jerseygirl07067]

Thanks again! You and the other posters have been so helpful. (My DH initially laughed at me when I said I was going to post this question on the board.)

Marcy

[jerseygirl07067]

Thanks Karen!! I appreciate your point of view and it makes a lot of sense too. I will ask, as you suggested, the reasons behind the switching of the fillings. If I recall correctly, I don't remember him mentioning any of the above reasons, but I will double check to make sure.

I didn't realize there were two dentists on this board! We are all such a diverse group!!

Marcy

[workaholic]

I've had the opposite experience.
My old dentists practice was bought out by a new and upcoming dentist. Her husband was a dentist also. My old dentist retired at a very young age because of complications with diabetes. Anyway, it seems liked everytime I went to the dentist for years I had something wrong. My parents have been spending thousands of dollars on my teeth since I was in 2nd grade to straighten my jaw, widen my palette and to help give me beautiful teeth as an adult. Needless to say these two doctors were always drilling them. Then...I had to have a root canal done because one of my fillings irritated a nerve and the nerve died. The pain was worse than giving birth (natural). The doctor (#2) started the root canal the next day, after all night of pain. I was ready to blow the tooth out of my head with a pistal. I switched to a dentist someone in my family recommended to finish the job. We tried for months to get the other dentist to send over my dental records. Finally, my mom, who is a manager for a major healthcare company, went down to the office and demanded them. When the doctors office received them. The only x-rays were from when I still had baby teeth. I was 21 at the time. I haven't had a cavity since the change. Only recently did the now wonderful dentist offer to fix some fillings which are apparently "leaking". I know that it's in my best interest. I'm sure dentistry is an easy profession to scam patients. We fell we have to take their word for it because a second opinion can be almost as costly.

However, in your case; I'd get a second opinion...


Aimee Larsen
Momma to Cooper
Crossing fingers for another...
Owner: Ella-Bags

[beej]

i have several silver(?) fillings and this is my experience. my dentist told me that over time they can shift and can cause tiny fractures in the tooth. then they need to be replaced bf decay sets in and you get alot of problems. i have replaced some but others are fine. sounds alittle weird that they all need to be done now. some of mine have to be like 15-20 years old.
as far as the insurance thing...my insurance does partial coverage for the tooth color filling bc it is in the back of the mouth. it still adds up to be a nice amount for me to pay. if your going to get a second opinion check with your insurance co to make sure they will pay for it. your looking out for them but they dont always see it that way.
good luck with it all....

beej
edd...6/20/04 SOON!

[jd11365]

I sent you an email with some local info...

Jamie
Mommy to Kayla
May '03