I went to a large dental chain that has several locations in the Houston area. I went to two of the locations and had a large amount of dental work done. I went to a new third location that was closer to my job last week for an annual cleaning and exam. Upon reviewing my x-rays the doctor asked me where I had gotten some of my work done previously and I told her the same company, just a different location. This left me feeling uneasy because she wanted to put a crown on a tooth that had received fillings just three months ago. By the end of the visit I was upset and wanted to go somewhere else.
I found an office with only one location and had another set of x-rays and exam done. The new dentist informed me that almost all my fillings would need to be redone and my crowns on two of my root canals were ill-fitted and needed to be redone.
Am I subject to a refund for all the work that needs to be redone? This is a large corporation and I have not yet requested the refund. I am seeking advice first.
– Anna Kay from Houston
(See Dr. Hall’s answer below.)
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It could be tricky to get a refund from this dentist, but I’ll see if I can help you. I think you’re going to have to put some pressure on this dental practice.
I would start by getting another second opinion. This is a large discrepancy between the two dental practices, and you want to be sure you’re on solid ground. If I were you, I would tell this new dentist something like this, “I’m really upset over this, and I believe you, and I want to get this work done, but I’d like to ask for two favors. First, I’d like you to help me get a refund from this other dental practice. And second, just to be sure, I want to get one more opinion.” You’re entitled to get a copy of the x-rays for that. Then I would find another dentist in a private, solo practice who has good online reviews some distance away. I wouldn’t tell them anything about any of the dentists you have been to or what they said but to just look at the x-rays, look you over, and tell you what they think needs to be done. We want this to be a “blind” second opinion.
If this new second opinion agrees with what you’ve been told, then I would ask your new dentist to call the dentist that did the original work, tell them you have two independent opinions that all this work needs to be re-done, and that you want a refund. Here’s the reason for that. To make a complaint about the quality of dental work, legally you need the opinion of another dentist that this needs to be re-done. And your just going in and saying that another dentist told you that isn’t good enough—you need to have the first-hand report of the dentist.
If the dentist who did the original work doesn’t cooperate, to give “teeth” to your request for a refund, you have three levels of things you can do. The first is relatively mild, and that is to threaten to tell your story in an online review. Stronger than that is to make a formal complaint to the state dental board. And your ultimate tool is a malpractice case. Though in your case, where there is no pain and suffering involved, the dollar value of your case wouldn’t be enough to interest most lawyers. If there is dental insurance involved, the insurance company could also help in providing leverage against the dentist.
So this isn’t a sure thing that you’ll be able to get a refund, but it’s worth a try. These corporate practices are profit-driven and I doubt that they are going to want to refund your money out of the goodness of their heart. You’re going to have to threaten some pain to get your money back. The threat of some kind of sanction from the dental board plus publishing an online review about the incident—that is what I think will be required to get some action.
The Problem I Have with Corporate and Chain Dental Practices
Dentistry, on the whole, is one of the most ethical professions there is. People tend to want to become dentists for the satisfaction of helping people in one-on-one situations. When I was in practice I got to know my patients well. I would keep notes on personal details that I wanted to remember and got great satisfaction out of seeing them year after year. I enjoyed it when parents would bring in their children and we’d get to know the whole family. I especially enjoyed doing smile makeovers, transforming an ugly smile into a beautiful one and how that changed my patient’s life. I also enjoyed it very much when I had a patient come in suffering from dental neglect because of fear of the dentist and I could help them overcome that fear and see them begin to come in now year after year with healthy teeth, unafraid to sit in the dental chair. These kinds of feelings are what motivate people to go into dentistry. Of course, they want to then make money and live a comfortable lifestyle, but generally, that isn’t the primary motivation.
Expansion into a group practice can be motivated by financial considerations, but in a group practice there is the added enjoyment and professional stimulation of associating with other dentists plus the convenience of having colleagues to back you up when you want to go on vacation or be out of the office for other reasons.
A corporately owned dental chain, on the other hand, comes about by the drive to make a lot of money. In addition, the dentists they hire can tend to not have a long-term commitment to the practice. Especially where they have patients rotating through different dentists, you’re taking away from the joy that attracts many dentists to the profession. Plus, management tends to be very profit-oriented and they can put pressure on the dentist to produce and to cut the amount of time they spend on procedures.
I want to be careful about making sweeping generalizations here because there are some very caring, capable dentists who work in a corporate setting. I know some of them. But generally, you’re going to see a higher level of ethics, caring, and professional skill in smaller practices.
Anna Kay, I hope in this new dentist in the single-location practice is one you are comfortable with and you can develop a long-term relationship. If so, that will help provide you with quality care for years to come.
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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.