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Saturday, September 29, 2018

Dr. Oz Says Dentists Are Scamming You!

Dr. Oz says dentists are scamming you!

I've written about Dr. Oz's dental segments several times before.  My opinion of his "journalistic acumen," clinical accuracy, and advice has not been flattering.  He seems to have it in for dentists, sometimes.  Though, I understand the financial incentives of making "good television."  I also understand that there ARE instances of the story being told in this new segment about inconsistencies in the dental profession. 

Yesterday's "Dr. Oz" episode (Sept 28, 2018) featured a segment, "Undercover Investigation:  Could Your Dentist Be Scamming You?"

https://www.doctoroz.com/episode/undercover-investigation-dental-scams-are-you-being-overdiagnosed-and-overcharged?video_id=5841028832001
Screenshot from video preview.  Click on the image to go to Dr. Oz's site.  I'll add the video if it becomes available.


A correspondent went to multiple dentists and got multiple treatment plans, some of them quoted with significantly high costs.  This isn't the first such report.  Many years ago, Reader's Digest, did a similar report that got national attention.  PBS did a similar expos√©.

 

Is Dr. Oz right?

As a dentist who is passionate about the profession, I can't help cringing when I see these reports.  I cringe for two reasons.  First, I cringe because I know that MOST dentists are consummate and dedicated professionals, driven by a calling to help their patients.  These reports are often sensational, rife with inaccuracies, and perpetuate dental mythologies resulting in fear and avoidance of important dental care.  Even Dr. Oz can get it wrong.  And, that's not good.

The second reason I cringe, is because I know that there is some truth to the reports.  There ARE dental offices that engage in dubious practices that may be driven purely by the desire for financial gain.  I've seen it in my 30 years of dental practice.  I hate it.  But, I've seen it.

The implication of Dr. Oz's report is that if the treatment plan is more expensive, then it must be wrong.  Of course, that's simply not true.

So, who is telling the truth?

Boynton Beach Dentist Dr. Michael Barr
I'd like to first point out that there CAN be differences in opinion between two or more dentists, yet they can all be correct.  There is acceptable latitude in diagnosis and treatment planning (within some limits, of course).  Diagnosis, and particularly treatment planning, can occupy a spectrum that depends on the dentist's training and experience.  It can also depend on the patient's history (medical and dental).  Dentistry is primarily scientifically-based.  But, it can be reasonably argued that the practice of dentistry is a bit of an "art," as well.

For example, when is a "cavity" really a "cavity," and when should it be treated?  The answer is, it depends on many factors.  It depends on how it looks to the dentist.  Is the dentist using magnification (surgical telescopes) and a bright headlight?  (He or she should be.)  X-rays can help, too, but they are not the only test.

White fillings by Boynton Beach dentist, Dr. Michael Barr
Magnified view of a cavity that appears very small on the surface, but is much bigger underneath. 
(Actual case by Dr. Michael Barr at Palm Beach Smiles.  Learn about white fillings here.)


It also depends on the patient's history.  Is the patient 25 years old with half of his / her teeth already filled (lots of cavities in the past), three root canals, two teeth missing, and shows up at the dental office infrequently and usually only when something hurts?  Or, is the patient 45 years old with only two fillings in his / her entire life and never misses a 6-month preventive care appointment?  The first patient should be treated differently than the second patient.  Small cavities might be more aggressively addressed and treated in the first patient.  The first patient may also need more preventive professional care and a strict home care regimen.  A very small cavity in the 2nd patient might be monitored, instead.

Which dentist to treat your teeth?  Trust your gut!

I have long advised people who ask me (both in office and socially), to trust their instincts!  If you don't feel comfortable with a dentist, get another opinion.  A good doctor-patient relationship is CRITICAL.  Is the dentist listening?  Is the dentist taking TIME with you?  Or is the dentist rushed?  Is the dentist discussing the diagnosis and treatment plan with you?  Or is that delegated to someone else like the assistant or business manager?

What is Corporate Dentistry?

There is a trend in dentistry that has followed medicine and optometry.  That is the "corporatization" of dentistry.  Corporations and investment groups are buying up and building multiple-location, large group practices.  These "dental chains" or "dental mills" employ a team of dentists and market heavily.  They are usually "in network" with all the insurance plans, making them attractive to those patients.  "They're on my plan!"   BEWARE.

I've written about Corporate Dentistry previously on this blog.

In a large group practice, you should ask:  Who owns the practice?  Is it a dentist?  If so, where is that dentist?  Does he or she practice in this location (or at all)?  If it's NOT a dentist owner, who is it?  Will I see the same dentist every time I visit?  (These McDentist offices typically have a very high turnover of staff.) 

I've been a dentist for 30 years.  I've seen it all, and I don't like what I see with corporate chain dental offices.  The treatment decisions are often made by MANAGEMENT.  The worker-bee dentists don't get much say.  If they try, they don't last long at the job.  These offices often have "unspoken" rules about treatment planning.  I'll use their words and then explain.

  • "All occlusal fillings become occlusal-facial-lingual fillings."  (There are no 1-surface fillings allowed.  1-surface cavities get turned into more expensive 3-surface fillings.)
  • "All MOD (mesial occlusal distal) cavities get crowns."  (A back tooth that can be adequately restored with a 3-surface filling is turned into a more expensive restoration.)
  • "Most new patients need 'deep cleanings'." (Baloney!  Ask to see your periodontal charting.  Are there multiple deep pockets?  Is there bone loss evident on the x-ray?)
In layman's terms, they are turning a less profitable service into a more profitable service by overstating the diagnosed condition and over-treatment planning.  I hate to say it, but it's true.  And, it's bullshit!  Of course, there are patients who DO need a crown or "deep cleaning."  The question is whether the recommended treatment is driven by corporate motivations, maximizing what can be billed to insurance, or by the dentist's professional judgement?

These "McDentist" clinics have monthly production quotas enforced by "corporate."  Believe it or not, the profit margins in dentistry are fairly thin.  So, when you add layers of people (corporate) who are getting a slice of the pie, you've got to crank up production.  In a traditional solo private care dental practice, after all expenses are paid, there is only the dentist to pay (from profits).  With corporate McDentistry, there are MANY people who need to be paid (who aren't even present at the dental office nor involved in the care of patients).

How do I find the right dentist for me?

Find a Private Care Dentist with whom you feel COMFORTABLE.  Get personal recommendations from friends or coworkers.  Research them online.  Read reviews.  What do the majority of reviews say?  Are they credible reviews?  Look at the dentist's website.  Does the message resonate with you?

Boynton Beach Dentist
The Palm Beach Smiles team!
Dr. Michael Barr, Sandy, Jo-Ann, and Kim

 Once you're in the office, what is the "vibe?"  Is the team happy?  Is it a positive vibe?  Or, do they seem rushed and bothered?  Do they know your name?  Are they running behind with a reception room full of people waiting?  Did the dentist answer your questions?  Did the dentist listen to you?  Were you presented with alternative treatments along with their advantages and disadvantages?  Were the fees explained BEFORE you begin treatment?  Again, trust your instincts.

Thanks, Dr. Oz!

I believe Dr. Oz engages in sensationalism, and his "advice" should be taken with a giant grain of salt.  Especially his dental advice!  Dr. Oz once recommended brushing with lemon juice to whiten your teeth.  Don't EVER do that!  But, I appreciate the opportunity to address the problems he revealed in this episode in a proper, professional context.

Feel free to visit our website at:  Palm Beach Smiles- Boynton Beach Dentist.  Or give us a call at our Boynton Beach dental office:  561-736-2377.  You can also schedule an appointment online by clicking on the button below!

Click here to schedule your appointment online!

3 comments:

David Bennett said...

Dr. Oz - Physician turned Snake Oil Salesman:

Controversy

Oz has faced criticism due to his tendency to feature non-scientific and pseudoscientific advice.

June 2014 Senate hearing
During a Senate hearing on consumer protection, Senator Claire McCaskill stated that by airing segments on weight loss products that are later cited in advertisements, Oz plays a role, intentional or not, in perpetuating these scams, and that she is "concerned that you are melding medical advice, news, and entertainment in a way that harms consumers."[54] Mary Engle of the U.S. Federal Trade Commission (FTC) criticized Oz for calling green coffee extract "magic" and a "miracle", stating that it is difficult for consumers to listen to their inner voices when products are praised by hosts they trust.[54]

One of the products Oz was promoting, Green Coffee Bean Extract, was found to have no weight loss benefits. Two of the researchers who were paid to write the study admitted that they could not back their data so they retracted their paper. The FTC filed a complaint that the Texas-based company Applied Food Sciences (the promoters of the study) had falsely advertised. The FTC alleged that the study was "so hopelessly flawed that no reliable conclusions could be drawn from it" so Applied Food Sciences agreed to pay a $3.5 million settlement.[55][56]

Lack of scientific validity
File:McCaskill Takes Aim at Diet Scams That Are 'A Crisis in Consumer Protection'.webm
Oz was heavily criticised by Senator Claire McCaskill in a hearing on consumer fraud in diet product advertising.
Popular Science[57] and The New Yorker[58] have published critical articles on Oz for giving "non-scientific" advice. These criticisms include questioning if he is "doing more harm than good"[58] and pointing out his "irresponsible and dangerous" treatment of eating disorders.[citation needed]

The James Randi Educational Foundation has awarded Oz with their Pigasus Award, an award intended "to expose parapsychological, paranormal or psychic frauds that Randi has noted over the previous year."[59] The award consists of a silver flying pig and refers to claiming something so doubtful that it will only happen "when pigs fly". Oz has been given this award on three separate occasions, more than any other recipient:

In 2009 for the promotion of energy therapies such as Reiki.[60]
In 2010 for support of faith healing and psychic communication with the dead, among other controversial practices. Oz became the first person to receive a Pigasus Award two years in a row.[61]
In 2012, Oz won "The Pigasus Award for Refusal to Face Reality" for his continued promotion of "quack medical practices, paranormal belief, and pseudoscience".[62]
Oz has also been supportive of homeopathy.[63]

As well, Oz's image and quotes have been used in many weight loss product scams. While he himself has not been found to be involved in these scams, he has made statements that were exploited by scammers.[64]

Oz has stated that he is a proponent of alternative medicine and that he makes great efforts to inform viewers that he neither sells nor endorses any supplements.[54]

A study published in the British Medical Journal on the effectiveness of Oz's medical advice found that only 46 percent of his recommendations had any scientific backing or rationale.[9] The study showed that 39 percent had no supporting scientific evidence, while the remaining 15 percentage points went directly against scientific evidence.[65]

In April 2015, a group of ten physicians from across the United States, including Henry Miller, a fellow in scientific philosophy and public policy at Stanford University's Hoover Institute, sent a letter to Columbia University calling Oz's faculty position unacceptable. They accused Oz of "an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain".[66]

David Bennett said...

June 2014 Senate hearing
During a Senate hearing on consumer protection, Senator Claire McCaskill stated that by airing segments on weight loss products that are later cited in advertisements, Oz plays a role, intentional or not, in perpetuating these scams, and that she is "concerned that you are melding medical advice, news, and entertainment in a way that harms consumers."[54] Mary Engle of the U.S. Federal Trade Commission (FTC) criticized Oz for calling green coffee extract "magic" and a "miracle", stating that it is difficult for consumers to listen to their inner voices when products are praised by hosts they trust.[54]

One of the products Oz was promoting, Green Coffee Bean Extract, was found to have no weight loss benefits. Two of the researchers who were paid to write the study admitted that they could not back their data so they retracted their paper. The FTC filed a complaint that the Texas-based company Applied Food Sciences (the promoters of the study) had falsely advertised. The FTC alleged that the study was "so hopelessly flawed that no reliable conclusions could be drawn from it" so Applied Food Sciences agreed to pay a $3.5 million settlement.[55][56]

Lack of scientific validity
File:McCaskill Takes Aim at Diet Scams That Are 'A Crisis in Consumer Protection'.webm
Oz was heavily criticised by Senator Claire McCaskill in a hearing on consumer fraud in diet product advertising.
Popular Science[57] and The New Yorker[58] have published critical articles on Oz for giving "non-scientific" advice. These criticisms include questioning if he is "doing more harm than good"[58] and pointing out his "irresponsible and dangerous" treatment of eating disorders.[citation needed]

The James Randi Educational Foundation has awarded Oz with their Pigasus Award, an award intended "to expose parapsychological, paranormal or psychic frauds that Randi has noted over the previous year."[59] The award consists of a silver flying pig and refers to claiming something so doubtful that it will only happen "when pigs fly". Oz has been given this award on three separate occasions, more than any other recipient:

In 2009 for the promotion of energy therapies such as Reiki.[60]
In 2010 for support of faith healing and psychic communication with the dead, among other controversial practices. Oz became the first person to receive a Pigasus Award two years in a row.[61]
In 2012, Oz won "The Pigasus Award for Refusal to Face Reality" for his continued promotion of "quack medical practices, paranormal belief, and pseudoscience".[62]
Oz has also been supportive of homeopathy.[63]

As well, Oz's image and quotes have been used in many weight loss product scams. While he himself has not been found to be involved in these scams, he has made statements that were exploited by scammers.[64]

Oz has stated that he is a proponent of alternative medicine and that he makes great efforts to inform viewers that he neither sells nor endorses any supplements.[54]

A study published in the British Medical Journal on the effectiveness of Oz's medical advice found that only 46 percent of his recommendations had any scientific backing or rationale.[9] The study showed that 39 percent had no supporting scientific evidence, while the remaining 15 percentage points went directly against scientific evidence.[65]

In April 2015, a group of ten physicians from across the United States, including Henry Miller, a fellow in scientific philosophy and public policy at Stanford University's Hoover Institute, sent a letter to Columbia University calling Oz's faculty position unacceptable. They accused Oz of "an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain".[66]

neil millikin said...

One of the greatest dentists who ever lived, Dr. Harold F. Eissmann (Reno, NV) used to tell this story to each freshman dental school class at UCSF (my alma mater):

Imagine that God, after cleaning up the shop late on the sixth day, realized that teeth were going to be a problem.... plagued with disease, and difficult to clean and maintain. And so, at the 11th hour, He in his wisdom, created dentists.

Many years later, in checking how things were going, He noted that dentists were all driving nice cars, living in nice homes, and traveling in style..... yet the mouths of their patients were still riddled with disease. "You are failing me !"..... He declared.

"Here's the deal" He boomed from above. "I don't care what procedure codes you use, what fees you charge, or what type of procedure you use (amalgam, composite, inlay, only, crown, etc.). I am going to come back and check, and if you haven't improved the health of your patients' mouths, then I will come and smite you into a smoldering pile. Now... go forth and heal"

Dentists spend far too much time criticizing the methods, materials, fee structures, practice ownership, and treatment planning habits of their peers, and way too little time evaluating the results they achieve.

Smoldering pile, indeed.