Dr. Hall,
I recently went to a dentist who wanted to give me amalgam fillings on the back bottom teeth. I would not let him. He claimed that the cavities were too deep for white fillings, so I walked out. I need to find a dentist who will give me white fillings in my area. My insurance is Denti-Cal. do you know of anyone?
-Marion from Los Angeles
Marion,
A couple of points in answer to your question.
First, that is a lame excuse, saying that the cavity is too deep for a white filling. The truth is that the deeper the filling, the greater the reason for doing a white filling. Amalgam makes a tooth more sensitive to hot and cold, and the deeper the filling, the deeper the heat or cold is conducted into the tooth. Plus a deep filling is likely also to be wide, leaving the walls of the cavity thinner than usual. A bonded white filling will strengthen those walls where an amalgam filling will leave the tooth more susceptible to breaking.
But your insurance is a problem. Denti-Cal is the government dental insurance plan in California, and that is what is screwing you. Not only does Denti-Cal not provide any benefits for white fillings (because amalgam fillings are cheaper), they actually prohibit you from paying the difference yourself. So the only way you’re going to be able to get a white filling is to pay for the whole thing yourself.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
I have what is probably a dumb question. Could a dentist just charge the insurance for an amalgam filling, while giving a white filling and letting the patient pay the difference, or is that fraud in the case of the insurance listed above? It seems unfair the patient can’t choose their treatment and pay the difference.
Answer by Dr. Hall,
No, actually that would be a perfectly fine way to do this and wouldn’t be considered fraud at all, if this were a true insurance company. The private insurance companies will actually let you bill for a white filling and they will then calculate what they would have paid for an amalgam. But the problem here with Denti-Cal is that it isn’t private insurance, it’s the government. In California, it is Denti-Cal. In other states it is Medicaid or Title XIX. The government plan doesn’t allow that flexibility and yes, it would be illegal for the dentist to collect the difference from the patient.