Fear of overtreatment/bad treatment/being deceived about a treatment

[NervousUSA]

Does anyone seriously fear overtreatment, bad treatment, or being deceived or misinformed about a treatment? How do you deal with it? Do you have any tips for me? I have spent a long time trying to work out and deal with my dental fears. What I have realized is that apart from a few red herrings like fear of sedation, fear of going to a new dentist, and social anxiety related issues, what I am mainly dealing with is fear of overtreatment/bad treatment/being deceived or misinformed about a treatment. I have this because of being given over the top and unecessary orthodontic treatment as a child that was presented to my parents being benign, risk free, very mild, and guaranteed to have great results, which ended up being an extreme treatment causing 100% negative effects, and lots of side effects which are still causing me trouble today. Even more information was withheld from me to the point I wasn't told braces are painful, or require use of retainers. Shortly after this, as a young teen, I started to be pressured to have a surgery to remove all of my unerrupted wisdom teeth. Nobody told me why this was supposedly suddenly urgent, or why it had to be done as a surgery to remove all of them with general anesthesia or sedation, or that there was any other option. I was just told vaguely that all my other teeth would somehow be ruined if I didn't do this. I didn't believe this, and was so freaked out I refused to go to the dentist again from the age of 15 onwards, I didn't go again until I was 34. Turns out I was right about the wisdom teeth. There was no need to have that done at that time, or that way, I was able to extract those just this last year, two at a time, with local anesthetic, and they had no effect on my other teeth. In a way, this proved my fear true, that I wasn't being given enough information. I have been trying to deal with my fear by the way suggested in the "common fears" section of this website, by seeking as much information about procedures and my issues as possible, asking Dr. Gordon, researching online, and using telehealth dentists on Denteractive for education, but the truth is, even with all that, I am still really stressed and suffer badly any time I am dealing with dentistry. I would be very grateful for any tips on dealing with this, to hear about how anyone else deals with this type of issue or fear.

 

[LittleLynnie]

When my dentist retired, he sold his practise to a new dentist and we then became a part of that new dentist's roster. I took my sons for their regular checkups, and was shocked to hear that one needed 3 cavities filled, and the other needed 5 (they were 9 and 13 at the time). Each boy had been going for regular checkups since they were 3, and each had had one lifetime cavity over all of the ensuing years. I immediately doubted the new dentist's assessment and suspected that he had found all of these cavities to fill in order to get as much money as possible from his new patients. While my jaw was still on the floor a few days later, and I hadn't decided what to do about the followup appointments that I'd felt pressured to make, my 9 year old's school class happened to have a visit from a dental hygienist at school who said that his teeth were all good. But since she wasn't a dentist, I decided to take the older son to my mother's dentist for a checkup, even though I would have to pay out of pocket for that. Guess what? No cavities! I then (obviously) needed to find a new dentist, so decided to ask friends and family about their own experiences. I was specifically looking for a dentist who didn't find work on every single visit, which seemed to be quite common, but for those who could go in, pay for the checkup and walk out after being told to come back for another check in 12 months time. If occasionally, a small cavity was found, that was fine, but again, I didn't want to sign up with a dentist who needed to find work in order to pad his wallet, or pay for expensive new equipment or his student loan. I then did a cost analysis and determined that a new dentist actually had to find a certain amount of $$$'s per patient, in order to cover his rent, staff, equipment, overhead (insurance, cleaners, phone, internet, etc.), and came up with a sum of about $250 per patient based on a downtown location in my city. I hate to be so cynical, but when I voiced my experience to other dental professionals, they weren't at all surprised. Also, my neighbour (a dental assistant), told me about how different the two dentists that she worked for behaved. It was a father and son operation, and the father only performed necessary work. The son however, found things to do that weren't necessary, and even billed $20 for each dixie cup of mouthwash! I suggest you ask around as I did, to find a dentist you can trust. And by asking around, you should also be able find one that you like personally as well.

 

[NervousUSA]

@LittleLynnie Thanks for sharing that experience, and the advice! I feel like my dentist is as trustworthy as any dentist can be around here. In fact just like you, I moved to this practice from another where the dentist wanted to do too much. I should remind myself that when getting freaked out about treatments. However he just hired another dentist to work for him, so that person is an unknown quantity

 

[LittleLynnie]

If you trust the dentist you have now, then you could probably trust whoever he hired.

 

[NervousUSA]

Probably, but I am not sure if the person is a subordinate or has free rein or what. I would certainly trust them more than a random dentist at a new office, but not as far as the other dentist. Like you said, at that one practice your neighbor worked at, the father was honest, but the son was overdoing things for money, so even if they work together, one might be better than the other. My dentist mostly hires good people, but he has at least one assistant who is very rough and kind of callous, and one hygienist who is rough, so I don't know that everyone he hires is as good as him. Thanks for your advice, and for taking the time to talk to me and tell me your experience!

 

[LittleLynnie]

I think that the father son is a different dynamic though. The father probably won't fire his son, but in your case the owner would probably hire someone with methods similar to his own, and definitely fire someone who ripped people off under his own good name. Maybe your dentist thinks that the assistant and hygienist do good work though, and doesn't even realize that they aren't gentle/civil enough?

 

[NervousUSA]

It's complicated. I think he would fire someone who went far enough, but the dentist is spread thin and does a lot of delegation. There is a very large number of hygienists and assistants at this office, more than I have ever seen at one office, and the dentist is very friendly with them, like a very casual buddy dynamic. I also know it is hard for dentists to get staff here, and it was hard for my dentist to find another dentist to work there, so he would be affected by that pressure of it being hard to replace people. The rough assistant roughly and pretty extremely pulled down my lip during a procedure because the dentist had pinched it and I had reached up and moved it with my hand, and she pulled so hard she split it in two places and made me bleed and that was right in front of him, so I don't know what he thought of that. She kept it pulled down hard enough to keep me in pain the rest of the procedure, and I ended up with blood on my face. That was actually a really bad experience. The rough hygienist is interesting, about half their google reviews talk about her great personality, and she does have a wonderful personality, and also people thinking she is very thorough, but the teeth cleaning she gave me left me in pain for about 9 or 10 days even though she said I had really clean teeth, I had never had one so rough or had any discomfort more than a day from a cleaning before. I also had a strange experience where she diagnosed me and picked my treatment, with no input from the dentist except the word "OK" and I ended up having wrong treatment on my plan that would have ended up hurting me if it had actually been done. I had to ask Dr. Gordon to help me figure out what to do, and then have an unpleasant interaction with the dentist where I had to ask him if he agreed with her diagnosis and treatment choice, then point out the issue with the treatment, and have it changed. I don't think he would have gone through with the wrong treatment, and I think it was some kind of communication problem, certainly caused in part by me freaking out with anxiety while the treatment plan was first being made by the hygienist, but it was pretty weird. Nobody is perfect, and I still think this is by far the best dentist I have ever been to, one of the best in the area, and the most willing to cater to my needs, and anxiety/phobia issues but I don't totally trust the staff, and don't think the dentist is necessarily completely overseeing them or in total control of them. It's OK though, I think this is probably the best I can do right now, and I will just have to deal with this new person and possible issues with them if something comes up. Hopefully I don't need any more serious treatment for a while, too.

 

[LittleLynnie]

I hope that your next appointments go well then.

 

[NervousUSA]

Thanks! I am now up to 15 appointments in the last 10 months, hopefully this dramatic stretch of dentistry is at an end very soon.

 

[Anne2021]

NervousUSA - I believe that I had a dentist almost thirty years ago now that over-treated me. I had been going to a dentist who did not find fillings needed every time I went in. He usually complimented my teeth. He did, however, do one crown that seemed too tight on one side and too loose on the other. When someone recommended this other dentist, I went and he agreed that the crown should be re-done. He called the first dentist and told him that he should re-do the crown for free. I went back there and the first dentist did. He seemed very nervous the whole time, but he did a great job. The new crown fit better. This inspired trust in me for the second dentist. So, I started seeing him. Suddenly, I needed so many fillings. It was about two years of one filling after another - maybe 10-12 teeth needing work. I did it all. Then I started noticing how he and the hygienist spoke during the appointments. It was like a commercial for how great he was and felt weird. I grieve now at the loss of tooth structure that I probably experienced for no reason. That office was the first time I started feeling panicky in the dental chair. I was also dealing with other things in my life that were leading to an eventual diagnosis of complex PTSD, which all culminated in a phobia of the dentist, due to the vulnerability there. A few years later, I was looking for a new dentist, and I tried a few. Each one had certain teeth they thought needed filling. Some of them crossed over and agreed on certain teeth. Then each had a tooth or two that the others didn't mention. So, my phobia won and I avoided. I am now losing one tooth after another and have lost six with two more scheduled to go and two others in danger. I see the dentist next week - another new one - because the one I finally found and was at least kind to me five and a half years ago retired a year ago. I was still avoiding, but managed to do two fillings with him. I look at all this loss and I wonder how much is because of that one dentist - both in terms of destroying my ability to trust and in the amount of my teeth he drilled away for no reason. I almost can't stand it when I think about it. I will be getting partial dentures, and my quality of life is severely diminished, and it's not fair.

 

[Thephilsblogbar]

I trust my current dentist , had this dentist about 12 years

 

[NervousUSA]

@Anne2021 Thank you so much for sharing your experience. It really means a lot to me to hear from someone else whose fears actually began with overtreatment or bad treatment like mine, it makes me feel a lot less alone. I am sorry that happened to you. I understand when you talk about how it feels to look back on the past, at your loss of trust and the damage to your teeth and feel it is not fair. I sometimes think how because of the orthodontics done on me, my teeth will never fit comfortably together again, my teeth will never look good again, and it is very likely that my condition will worsen to needing crowns or veneers on most of my incisors, thanks to that orthodontist. Sometimes I wonder if the problem is him personally, or just general overuse of orthdontics in cases where it is not really needed, or shouldn't be used, like a problem with the system. I wonder if he got careless, or how this happened. I will probably never feel comfortable with dentists either because of my loss of trust and get really angry and sad about it sometimes. I hope this new dentist you are going to turns out to be good, and honest and things improve for you. Thanks again for sharing your story.

 

[Anne2021]

@NervousUSA Thank you so much for your kindness. I am so sorry, too, for what happened to you from the orthodontic treatment. It's not right that you should be suffering for years from that. I never had braces, but my son and my daughter did. I listen carefully at appointments and ask a lot of questions, and I can tell you that I had no idea that the retainers were permanent until the day my son was getting his off, and I asked how long he had to have the wires glued to his teeth. They said for as long as he wants them to stay this way!? Why weren't we warned?

Sometimes, I wonder how much is oversold by dental professionals who are not trustworthy (no offense to the many dental professionals who are excellent and trustworthy, like the awesome dentists on this forum and many others out there) or by the culture. I have a story from when I took my youngest (son) for orthodontic evaluation. His brother and sister had gotten them for legitimate reasons, not just the pursuit of perfection. His brother had a bite issue - or at least that is what we were told and I always believed it. His sister's teeth were very crowded and crooked/turned. I was concerned about my youngest being able to tolerate them due to his personality as well as the fact that his plan was going to be much more involved and lengthy. I ended up getting four opinions because none of them were the same. The first one - the one who did his siblings - wanted to remove his upper wisdom teeth early, (come to think of, I think it was all four wisdom teeth early), as well as the second upper molar on each side - molars!! - then put 2 or 3 mini-implants in his palate! that would have an appliance fixed to them for at least two years! I thought - no way. When we went in a second time to ask more questions because this was so involved, I asked about the implants and he said the holes close after they come out?! Then I asked about infection and he actually looked excited - he loved this new cutting-edge procedure, and when I asked about the possibility of infection - his face lit up as he said - up until now, I haven't seen it, but we've had our first patient last weekend who is in pain and has an infection! - like it was cool to be part of the newness of it. No way. It made me wonder about choosing him for my first two kids. Then the second one wanted to do the same basic plan, pulling two molars in addition to the wisdom teeth, except no screws in the palate. He had a pendulum device that would hook to the teeth. Then the third was all into postural issues and changing the way his jaw lined up, as well as shaving the edges of the teeth and I don't remember what all. So, we went to the orthodontist that was part of the faculty practice at the dental college (we have the state university dental college in our city - it's an excellent college and a good, respectable resource). She was from India, I think. I told her about all the plans we were hearing. She said that if you go to eight different orthodontists, you could get eight different plans and opinions. (Orthodontists - not dentists). She said that though his teeth weren't perfectly aligned, there was nothing about them, other than appearance, that required braces. His bite was fine. If he had no problems chewing, they didn’t need to be changed. She commented on the American obsession with perfect-looking teeth. It was all so mind-blowing. We stopped and he never got braces. His teeth aren't perfect, and at this point, that's okay. If he wants them in the future, I'll help financially, but I don't think he would consider it worth the suffering.

Again - I'm so sorry for what happened to you. Sometimes I wish we could go back in time with what we know now.

 

[NervousUSA]

@Anne2021 Thanks so much for your sympathy. I often think about time travel too, and wish I could talk to my younger self. I know my parents wouldn't have forced me to have orthodontics, they knew it was supposed to be cosmetic/enhancement and I didn't need it, they just thought it would make me look better. I wish I could go back and tell child me to cry and say no. I'm really sorry to hear about what you had to go through with your kids, and thanks for sharing that story. Just like you said, it is mind blowing! That is terrible that you and your son weren't told about permanent retainers until they were actually being glued in! That was really unfair to both you and him. The story about your third son is really something too! Especially the part in the end where it turns out all of the suggested procedures were not even needed. I am so happy you didn't end up getting an extreme treatment done when it wasn't actually needed. In early 2022 I received two opinions that my bite was going to destroy all my front teeth, and I also knew that I was going to lose a tooth, so I started to consider orthodontics as a possible treatment, research it in detail, and get consultations with orthodontists (I have had 4 in the last 9 months). The opinions and treatment options I have gotten have all been extremely different, to the point of seeming almost unrelated. I have researched Quora, a site where dentists, orthodontists, orthodontic assistants, dental assistants, and other dental professionals often answer patient's questions and I have read again and again statements by these people that different orthodontists treat very differently and have totally different approaches. Very much like the university dental college orthodontist told you. Her comment about American views on teeth, I think is true too, I believe, from my online research, that wisdom tooth removal and orthodontics are done a lot more in America than in the UK and maybe other countries in Europe. What happened with the orthodontist getting excited about something happening to a patient that was bad for them just because it was new is just horrifying. It really sounds like that orthodontist had stopped seeing his patients as real people. When I was a kid, my orthodontist tried to change plans midway through braces to extracting some of my teeth and he seemed really happy and excited too, it was blood curdling, he said something like he could "do great things" if these extractions were done with a big smile on his face. However I think he might have been trying to be convincing, and that he knew things had gone badly wrong and thought this might be a way to fix it. At the next appointment he was storming and angry, yelling at my mom about how messed up my teeth, gums, and profile were. From my research, my experience as a child, and the appointments I have been to in the past year, I do believe there is a problem in America with patients not being given enough information about orthodontics, including side effects, risks, the need for retainers, and how the procedures work. At one of the consultations I had recently as an adult the orthodontist didn't bring up any side effects but when I asked if I would get more gum recession from the treatment he said yes, it was guaranteed. Would he have even mentioned it to me if I didn't ask? The other doctor who offered to treat me (2 out of 4 didn't want to treat me) didn't mention side effects at all. None of the doctors who x-rayed me mentioned the common side effect of orthodontics root resorption to me, even though I have it from my previous orthodontics and it is visible on my x-rays. I really wish they would give people all the relevant information. I am sure they would like to have all the information themselves. It has been so hard dealing with this, and with it worsening my trust issues as well as having to have 5 extractions and dental implant surgery over just this last year. I don't think I would have made it through the mental pain it has caused me without this forum and people on here, for which I will be forever grateful. I am telling myself that my current dentist has been honest with me, been kind, and done what he could to make me comfortable and give me what I want and need to deal with my fear, so I have to be more trusting and there are good doctors around. Again, thanks for sharing the story of what happened with your son, your own story, and thanks for your sympathy! It is so nice to talk to someone with some similar experiences to mine.

 

[MountainMama]

I have this distrust as well. I never had cavities as a kid. I had one after braces were off (from a loose band). Then in my late 20’s, when my husband and I had no money, I went to a chain dental place and was told I had cavities in four molars. I didn’t know better and had them filled. Then a year later, more cavities. I ended up having all my molars filled within two years, mostly small fillings. It ruined my teeth. The fillings were poorly done and several years later I had to have them redone. Then I had a molar break where a filling had been done twice, and needed a crown, which was also very poorly done. The crown was too big but instead of sending it back, the dentist ground off all the porcelain on the bottom in one area, down to the metal, then ground down all the cusps on my molar below it.

In the next few years, we got better insurance and could go to nicer dentists. I had regular cleanings and have never had a cavity since. One of my dentists said that I most likely didn’t have cavities and that a lot of those places fill do fillings on any little stain on the tooth.

For me, the main issue is trust. I have truly trusted my last few dentists. I want to hear that they are conservative with treatment, and that they really listen.

 

[NervousUSA]

@MountainMama Thanks for sharing this, and sorry this happened to you. I have heard about dishonest corporate dental chains doing things like this, and filling things that don't need to be filled. I am sorry you had so many bad things happen to your teeth caused by those people, that is very unfair to you. I am grateful for you sharing a story of forming distrust from this type of experience, though, I feel like I am so weird about this stuff sometimes, so it is really good to hear similar stories from others. It is really great you have dentists you can trust now, and are listening to you, and are conservative. I am happy for you and I find it inspiring that one day I can be like that and in that situation. I had been feeling pretty good about my current dentist and think I had almost gotten to where you are with your dentists with him, and with some, but not all, of his staff, but have been worried lately because I found out there is another dentist at the practice now, so there are two of them and I don't know the new guy or anything about him. Luckily I think I am finished with intense treatment for a while so maybe I don't have to have work done by the new guy soon. I am glad you have been having good dentists now that you can trust.

 

[retroboy]

Just to add I think sometimes dentists aren't necessarily 'creating' work just for financial gain but more to do with how they are trained to attempt to 'fix' everything and a maybe a little too keen to fire up the drill. The problem for us patients is many aspects of dentistry is based on calculated guesswork. Traditional x-rays can only give a rough idea of what is occurring and of course much of it is down to the individual dentist on what they consider an issue or not depending on their own experience.

I had situation where a minor cavity ended up needing a crown ,crown prep traumatised the root needing a root canal, root canal failed and got infected.... and finally that tooth was extracted. It's not the necessarily the dentists fault, he was just following what he's been trained to do. But very frustrating all the same.

 

[NervousUSA]

@retroboy I think you are right about the idea of the calculated guesswork, and I like how you phrased that. I have read alot about the concept that dentistry is as much an "art" as a "science" and is often not an exact science, so many times dentists are guided by personal philosphies or experiences, not evidence based knowledge or training. My understanding is orthodontics is even more like this than dentistry. Certain dentists are "aggressive" too, in their philosophy, and want to try and "fix" everything, maybe it is how they are trained, as you say. You are right, it is a problem for us patients. My personal belief is that dentistry doesn't get as much study as something like, say, treating cancer, or treating heart disease, because dental problems are mostly non-lethal, so knowledge of how to treat dental problems just hasn't come as far as other medical knowledge has progressed. I'm sorry about what happened with your tooth, and that you ended up losing a tooth to treatment that went wrong. My similar experiences sometimes make me feel dentistry is really a double edged sword in some ways. What I try to do is be the most educated and informed patient possible, so I can do the best possible job of advocating for myself. It is still frustrating, and never enough, though.