Fighting Tooth And Nail To Get Your Money
BAD BEHAVIOR, CALIFORNIA, DENTIST, USA | HEALTHY | JANUARY 28, 2019
(I’m on Medicaid since I’m working at an unfunded startup and don’t have any income — I got a sizable equity stake to compensate — nor does the company offer any insurance. I haven’t been to the dentist in a couple of years since my previous job’s dental coverage expired, and I’ve finally overcome my laziness to find a new one. There are only a few dentists in the area I have moved to in the interim who take Medicaid; I look them up on Yelp just to get a general idea of people’s experiences, and pick the one that had the best reviews.)
Dentist: “Your front top and bottom teeth are clicking against each other, when the top ones should be in front of the bottoms. This is causing your bottom teeth to be pushed out of alignment and is producing some gum recession.”
(This seems reasonable, and I have noticed that the gums around my front bottom teeth are thinning a bit.)
Dentist: “This is a serious problem that you should address immediately. You should set up an appointment as soon as possible for us to get you on [Name-Brand Clear-Aligner Orthodontic Treatment].”
(Denti-Cal, California’s Medicaid dental coverage, isn’t that comprehensive; I doubt they’ll cover a multi-thousand-dollar orthodontic treatment for an adult, and I don’t have that kind of out-of-pocket money at the moment. Also, while this dentist does apparently do both dentistry and orthodontics, from childhood I’m used to seeing a separate orthodontist.)
Me: “Thanks for letting me know, but I don’t want to do that procedure at this time.”
Dentist: “You need a deep cleaning since it’s been so long since your last cleaning.” *shows me x-rays* “If we just did a regular cleaning, we might not get all of this plaque that’s built up under the gum line. I don’t see any infection, but a long-term plaque buildup could lead to one.”
(This also seems reasonable, since it has been a couple of years, and the last time I went that long between cleanings I also needed a deep cleaning. At the time this takes place Denti-Cal doesn’t cover deep cleanings, so I have to cover the $400 charge out of pocket, but figure that’s my burden for waiting so long. Wanting a second opinion on the tooth-alignment issue, I schedule to see my childhood orthodontist when I’m home seeing my parents a few months later. I haven’t seen him in at least a decade, and there’s no chance of him getting any business from me since he’s on the opposite coast.)
Orthodontist: “Your teeth have shifted a fair amount since we last saw you. No, that clicking isn’t ideal, but the gum issues aren’t that bad and aren’t an immediate concern. You should probably address it in the next few years, but I’d recommend seeing someone who only does orthodontics, not a dentist who does orthodontics on the side.”
(Maybe there’s some professional snobbery involved with that last comment, but I’m more focused on the so-called “immediate issue” not being that much of an emergency, which I had suspected. At the next dentist appointment
Hygienist: “You know, your teeth are rather discolored. I think you should have us do a whitening procedure!”
Me: “My teeth aren’t that bad, and I’m not that concerned about my appearance. Also, in case you weren’t aware, I’m on Denti-Cal, which I’m pretty sure wouldn’t cover that, and which means I don’t really have hundreds or thousands of dollars to spare on a cosmetic procedure. So, no, I won’t be doing that.”
(Ten minutes later
Hygienist: “I really do think you’d look so much better if you got your teeth whitened! We’d do a really good job of it!”
Me: “I already said I both didn’t want to and couldn’t afford that.”
Hygienist: “Okay. Well, the dentist recommends you get a gum irrigation while you’re here, for the infection.”
Me: “What infection?! When I was here last time I was told I didn’t have any, and that I should do a deep cleaning to avoid any notable chance of one.”
Hygienist: “Well, no, you don’t have an infection, but the irrigation would further ensure you don’t get one.”
Me: “I was told last time that a deep cleaning was sufficient, and it seems that it was. I don’t like the insinuation that I have a problem when there’s not actually a problem. If I don’t have an infection, this sounds like an unnecessary procedure, and I’m not paying for it.”
(The hygienist finishes my regular cleaning.)
Hygienist: “Are you sure you don’t want your teeth whitened?”
Me: “No. I do not. Want. My teeth. Whitened. I said that twice already in no uncertain terms. Don’t ask me again.”
(The dentist comes in for the post-cleaning check.)
Dentist: “So, when do you want us to remove your wisdom teeth?”
Me: “Is there something wrong with them?! They came in several years ago, there’s enough room in my jaw for them, and I haven’t had any issues with them to date.”
Dentist: “No, but many of my patients get them removed just to avoid any complications.”
Me: “I’m currently 28. My dad didn’t have his removed until his 50s, and that was in response to some tangible problems he was having. I’m on Denti-Cal, and this probably isn’t covered. I’m not paying that kind of money right now to possibly avoid some problem that may never crop up, or may not crop up for decades. Please stop trying to sell me a bunch of unnecessary procedures, especially when you should know, from my insurance, that I probably don’t have much money to fritter away on things I don’t absolutely need.”
(I am rather annoyed by this whole ordeal, but I make an appointment for six months later since they at least seemed to do a capable job of cleaning my teeth. My usual inertia about switching dentists leads me to not find another one in the interim, so I go back. The cleaning is shorter than usual, possibly since I’ve started using a water flosser in addition to brushing.)
Dentist: “You know, that under-bite hasn’t gotten any better. You should really get [Clear Orthodontics Product].”
Me: “I’m still on Denti-Cal. It’s still not covered as far as I know, and I’m still not in a position to afford that. If and when I do decide to fix the problem, I will see a full-time orthodontist.”
Dentist: “All right, then. Next time you come in, you should do a deep cleaning, because I see some noticeable plaque buildup under your gums.”
Me: “I’ve been using a water flosser for several months now. You showed me the x-rays you took before the cleaning and there were maybe two tiny spots of plaque under all of my teeth put together. While Denti-Cal now covers deep cleanings, I’m not going to do that when there’s absolutely no reason to. I’m sick and tired of being pressured and cajoled into all manner of questionably necessary, or flat-out unnecessary, procedures. No other dentist I’ve ever been to has ever behaved like this. I’m not coming back.”
(I actually didn’t come back this time, and when they called me six months later to remind me of my next appointment, I told them again that I was never setting foot in their door.)