Dental Clinic Upsells/Ripoffs?

ivorystraws

Hi,

I arranged an appointment with<snip> I just wanted a scale and polish done. So I went in this morning yet they charged me for an exam and the scale & polish i.e. 90 euro. I've three questions around this:

1: On their price list, it states that an Exam, Diagnosis and Treatment Plan is 40 euro but that is claimable via PRSI contributions. So I am eligible for this free treatment that I never ordered but it was basically just the "dentist" having a 3 minute look at my teeth i.e. I didn't receive any dental x-rays, nothing in writing as regarding a diagnosis or plan - is this normal?

2: Can someone confirm that a scale and polish is covered by PRSI? If it is, I should be entitled but if not, I understand.

3: I can get the tax back on the non-routine dental procedure i.e. scale and polish, correct?

Thanks for any advice.

nompere

Scaling and polishing is routine - so no tax relief.

dudara

Moved to Dental Issues

dudara

helimachoptor

No Names Folks

btkm8unsl0w5r4

Scale and polish is not covered by PRSI. The Exam is covered if you have not had one in the last years and are entitled. If this was a new dentist for you X-rays should have been taken. Unfortunately routine treatment is not tax deductible. Exams, cleanings and fillings are classed as routine.

Unfortunately this low headline price is often not quite true, especially when the dentists doing the work have no control over the fees charged. However 90 euro is a fair price for an exam & scale and polish. However if no X-rays were taken (assuming there was an indication to take them) and the dentist spent little time with you then you did not receive a good service. Maybe you should complain you felt payment was not explained and treatment was substandard in your opinion.

By the way when you go to a new dentist you cannot just order a scale and polish. The dentist take a legal responsibility to you and needs to examine your teeth properly.

davo10

Bristol Bumpy Sarong wrote: »

If this was a new dentist for you X-rays should have been taken

Sorry Fitz, this is incorrect. X-rays should only be taken if there is a discernable clinical necessity, i.e you see something that warrants further investigation. We are no longer advised to take them for baseline records.

OP did you check to see if you were qualified for PRSI cover before going in?, this is the patient's responcibility but most clinics will do it for you if you request it.

Scaling is not covered as stated by PRSI, thank FF for that.

You cannot claim tax relief on routine treatment.

If you had your teeth cleaned and the dentist had spotted decay/gum disease/oral cancer, would you not expect him/her to tell you about it?, if the tissues are not examined then he/she would not have to tell you about pathology present.

All clinics now are required to have pricelists, you can check these easily before treatment.

btkm8unsl0w5r4

Bristol Bumpy Sarong wrote: »

(assuming there was an indication to take them) .

Yes I know that Davo and put that proviso in my post. Although how you can tell something invisible to the naked eye is not there without checking for it I dont know. Some peoples first cavity is interproximal.

Oral Surgeon

Bristol Bumpy Sarong wrote: »

Yes I know that Davo and put that proviso in my post. Although how you can tell something invisible to the naked eye is not there without checking for it I dont know. Some peoples first cavity is interproximal.

In my opinion, bitewings are mandatory for all new patients in the adult dentition with closed contacts. The diagnostic hit rate is massive for this simple test and spots caries long before pain/ clinical exam and can only benefit the patient through quicker treatment and appropriate diet advice....

OS

ivorystraws

Yes Fitzgeme, the Scale and polish is not covered by PRSI as it is a routine treatment and I have confirmation that the "Exam" is covered by my PRSI. This was not a new Dentist so I'm assuming they didn't provide any written diagnosis, treatment plan (despite it being detailed on their price list as part of the service) and/or X-rays is because they had my hostory from 4 years ago!!??

I know I should complain but this why I'm asking here first i.e. I want to establish what my entitlements are in this regard? But you are correct Fitzgeme, he dentist should have a legal responsibility to me to examine your teeth properly but how do I prove that now or do I even need to?

But then Davo10 you mentioned that X-rays should only be taken if there is a discernable clinical necessity - do previous root canals, fillings etc warrant this?

My main point is that I did not receive what I paid for - would everyone agree? Or is a conversation about possible treatment at a later stage enough of a treatment plan and shouldn't diagnosis be documented and recorded? Despite me not being a new patient, I would have thought that 4 years is enough of a gap to warrant a thorough investigation and service.

Why would anyone go to the Dentist here after that i.e. I'd just avail of groupon deals and/or go to Belfast to get any further treatment necessary.

ballsymchugh

how much is the scale and polish on its own on the price list?

btkm8unsl0w5r4

There are plenty of great dentists in Ireland, you will just find they tend not to be the very cheapest on these headline treatment as they spend a lot of time. Unfortunately Belfast is not that cheap these days and the travel make it silly to go there.

Big_G

How is this a dental issue?

ivorystraws

ballsymchugh wrote: »

how much is the scale and polish on its own on the price list?

Price list states:
Scale & Polish: 50 euro
Prophyjet: 50 euro

Why? Does that make a difference?

ivorystraws

Bristol Bumpy Sarong wrote: »

There are plenty of great dentists in Ireland, you will just find they tend not to be the very cheapest on these headline treatment as they spend a lot of time. Unfortunately Belfast is not that cheap these days and the travel make it silly to go there.

Yes, I've no doubt there are plenty or excellent Dentists in Ireland and it's a fact that they're expensive for the headline treatments such as crowns, veneers or root canals but my point was combining Belfast (which has cheaper available options at good Dentists) with a groupon offer is a bargain and it's only 2 hours to Belfast. Knowing what treatment I have left to get done, I'd rather go there, pay less for a better service as we don't get any tax back on routine treatments here anyway.

ivorystraws

Big_G wrote: »

How is this a dental issue?

Becuase Big_G, I wanted targeted feedback on the dental service I encountered, why their advertised services didn't match up to the treatment that was actually provided to me and I wanted to discuss my options in this respect.

hg03 eyu

Regarding x-rays
Their price list states small x-rays €15.
Then for two bitewings would you have willing paid an extra €30???

btkm8unsl0w5r4

If you want cheap crowns they can be gotten in the south and are equally as bad as the ones you get on the NHS. You give out about not getting good treatment and want lots of attention & good service, and rock bottom price, and groupons, and then head off and have treatment in the cheapest possible place, choose either price or quality, you cannot have both.

ivorystraws

hg03 eyu wrote: »

Regarding x-rays
Their price list states small x-rays €15.
Then for two bitewings would you have willing paid an extra €30???

OK, so that confirms that it's not included in their exam - is that you're point? It still doesn't answer what exactly the exam, treatment and diagnosis plan was i.e. was that a brief conversation?

Oral Surgeon

ivorystraws wrote: »

OK, so that confirms that it's not included in their exam - is that you're point? It still doesn't answer what exactly the exam, treatment and diagnosis plan was i.e. was that a brief conversation?

Every dentist here knows exactly what they do for an examination/consultation and exactly how they justify their fees.... I think you need to have this conversation with the dentist who saw you as you feel hard done by....

ivorystraws

Bristol Bumpy Sarong wrote: »

If you want cheap crowns they can be gotten in the south and are equally as bad as the ones you get on the NHS. You give out about not getting good treatment and want lots of attention & good service, and rock bottom price, and groupons, and then head off and have treatment in the cheapest possible place, choose either price or quality, you cannot have both.

I don't want crowns of any kind, I'm just pointing out that headline treatments are cheaper in the north (in general) and that's a well documented fact (just google it). I'm not giving out but you seem to be. I'm simply pointing out the fact that I didn't get what they advertised. But yes, you make a good point, taking advantage of the UK dental prices and combining that with a groupon deal with a good dentist should result in a great service (as advertised), an unbeatable price and well-deserved attention (if they want a recurring customer).

You say that I have to "choose either price or quality, you cannot have both"... of course I can have both, that's why successful dentists are successful, regardless of where they're based and that's why "people" like you, make statements like that. Which one are you so if you believe it's not possible to have a great service at a great price?

ballsymchugh

ivorystraws wrote: »

Price list states:
Scale & Polish: 50 euro
Prophyjet: 50 euro

Why? Does that make a difference?

because....

ivorystraws wrote: »

Hi,

I arranged an appointment with<snip> I just wanted a scale and polish done. So I went in this morning yet they charged me for an exam and the scale & polish i.e. 90 euro. I've three questions around this:

should be moved back to consumer issues really.

if you clearly said to the dentist that you wanted a scale and polish only and not an exam, then you were overcharged but if a decayed tooth broke in the next few weeks that could've been picked up at the exam, then you've got nothing to stand on.
however, in this highly litigous area, the dentist was covering his ass by doing the exam.
say.... you had an non-healing ulcer for the past few months that needed attention, but since you only asked for the clean, should your attention be drawn to it?

Oral Surgeon

I don't agree with the doctor knows best mentality but also, patients should not solely dictate treatment. It's not a menu, sure you can choose to have the fillings or not or have the crown or not but dental professionals should insist on doing a full examination of the mouth before treatment and this includes a cleaning....

Would you go into a car dealer and tell them to change your engine oil, no don't bother with the filter- I know best and just ignore the advice of the mechanic???!!!

You may just want the cleaning but a check up is needed first. Dentists don't like polishing decay....

OS

davo10

Oral Surgeon wrote: »

In my opinion, bitewings are mandatory for all new patients in the adult dentition with closed contacts. The diagnostic hit rate is massive for this simple test and spots caries long before pain/ clinical exam and can only benefit the patient through quicker treatment and appropriate diet advice....

OS

This may be good practice in your opinion OS but the RPII disagrees. If you routinely expose patients to x-ray radiation un-necessarily just to have baseline x-rays in the absence of signs or sypmtoms of pathology then this could be problematic for you.

OP have I missed something?, you are annoyed about the lack of a diagnosis and treatment plan, did the dentist find any diagnostic problems and advise you of the neccesity for further treatment?, if he said he could find (diagnose) no problems then did you want him to type a page with "you do not need dental treatment" on it just so you could have a "written treatment plan". Written treatment plans outline the number and type of fillings/extractions/root fillings/crowns etc necessary, in 20 years I have never been asked to write a treatment plan by a patient who did not need treatment.

The fact that you had root canal treatments previously does not mean you need x-rays every time you have a check up if they are symptomless unless of course you want to be exposed to x-ray machines un-necessarily.

Could I ask OP, would you have been happier if the dentist had told you, you needed 5 fillings and then wrote out a treatment plan?, would you have felt you got better value for your exam?

ivorystraws

ballsymchugh wrote: »

because....



should be moved back to consumer issues really.

if you clearly said to the dentist that you wanted a scale and polish only and not an exam, then you were overcharged but if a decayed tooth broke in the next few weeks that could've been picked up at the exam, then you've got nothing to stand on.
however, in this highly litigous area, the dentist was covering his ass by doing the exam.
say.... you had an non-healing ulcer for the past few months that needed attention, but since you only asked for the clean, should your attention be drawn to it?

Exactly, I did state that I only wanted a scale and polish and that's all I wanted. But why are you referring to a decayed tooth etc... who cares if all my teeth fell out of my mouth and could have been picked up by all various types of investigations, naturally, I wouldn't attribute any of that to the dentist who did the scale and polish.... so unless there's some kindof obligation on the dentist and/or unless the dentist were covering their ass, I don't understand why it was done? If the dentists want to cover their ass then why do they price such treatments seperately?

ivorystraws

davo10 wrote: »

OP have I missed something?, you are annoyed about the lack of a diagnosis and treatment plan, did the dentist find any diagnostic problems and advise you of the neccesity for further treatment?, if he said he could find (diagnose) no problems then did you want him to type a page with "you do not need dental treatment" on it just so you could have a "written treatment plan". Written treatment plans outline the number and type of fillings/extractions/root fillings/crowns etc necessary, in 20 years I have never been asked to write a treatment plan by a patient who did not need treatment.

The fact that you had root canal treatments previously does not mean you need x-rays every time you have a check up if they are symptomless unless of course you want to be exposed to x-ray machines un-necessarily.

Could I ask OP, would you have been happier if the dentist had told you, you needed 5 fillings and then wrote out a treatment plan?, would you have felt you got better value for your exam?

When treatments/services are listed, such as the exam, diagnoses and treatment plan (that I didn't ask for), I expect exactly that - wouldn't you? So to answer your question, yes, the dentist did find some diagnostic problems and advised me to organise further appointments with the front desk, which I subsequently didn't. Further treatment did involve one filling to the side of one of my top teeth and internal bleaching to the teeth which root canals were carried out on.
I would have been happier if the dentist did what their pricelist advertised and I probably would have felt like I received a professional service and would be more inclined to return.

ivorystraws

Oral Surgeon wrote: »

I don't agree with the doctor knows best mentality but also, patients should not solely dictate treatment. It's not a menu, sure you can choose to have the fillings or not or have the crown or not but dental professionals should insist on doing a full examination of the mouth before treatment and this includes a cleaning....

Would you go into a car dealer and tell them to change your engine oil, no don't bother with the filter- I know best and just ignore the advice of the mechanic???!!!

You may just want the cleaning but a check up is needed first. Dentists don't like polishing decay....

OS

I understand what you're saying and you make a good point plus I like the car analogy and have thought of using that myself but in response:
- Dental professionals can insist on doing certain treatments/services as all professionals can but whether the client has an obligation to accept it is a different matter.
- Of course I'd go into a car dealer and tell them specifically what I want or don't want done and I'd know what to expect - would you not? The mechanic/dentist can offer you advise but it's upto the client whether to take it on board, as it is in most industries.
If a checkup is needed first, it should be made mandatory and clearly stated on the pricelist - that solves a lot of potential problems.
- Some mechanics don't like polishing rust but they do it and get away with it i.e. there are good and unscrupulous "professionals" in every industry.

ivorystraws

Oral Surgeon wrote: »

Every dentist here knows exactly what they do for an examination/consultation and exactly how they justify their fees.... I think you need to have this conversation with the dentist who saw you as you feel hard done by....

You're are correct and I like the way you've highlighted that "Every dentist here knows exactly what they do for an examination/consultation and exactly how they justify their fees"... that should be the case for every professional everywhere not just "here". So you're solution is basically to ask the dentist why they didn't carry out the treatment as advertised on the pricelist - correct?

ballsymchugh

ivorystraws wrote: »

Exactly, I did state that I only wanted a scale and polish and that's all I wanted. But why are you referring to a decayed tooth etc... who cares if all my teeth fell out of my mouth and could have been picked up by all various types of investigations, naturally, I wouldn't attribute any of that to the dentist who did the scale and polish.... so unless there's some kindof obligation on the dentist and/or unless the dentist were covering their ass, I don't understand why it was done? If the dentists want to cover their ass then why do they price such treatments seperately?

because, in all reality, there is that obligation. in the uk, there's a legal firm dedicated to taking cases against dentists. they occasionally have guys with sandwich boards on main streets looking for people who may have been to the dentist that day or a few days before. if they picked you out, and found that you needed more work done besides the cleaning, and you weren't informed, then you'd have a case against the dentist.
the last question is between you and the dentist you went to. personally, if i saw something that needed to be done, i would've told you, but made sure that your next appointment was the check up. it's easier to examine clean teeth too.

AnonDentist

OP what would you have done if you got just your scale and polish and paid your €50 but noticed your lower front teeth were loose (they weren't like that when I went in?) you go to the local cafe to have a cuppa to think about what to do(oh that hot drink really hurts all my teeth!!) you pop into the loo to look at what has being done to you (oh my God my gums are raw and bleeding!!)
I'm getting onto my solicitor that butcher has destroyed my gums and loosened my teeth - No you have chronic periodontal disease but don't know this cause you didn't want an exam or to be told if there was anything wrong!!!

Would you walk into your GP after 4 years and demand a new prescription for blood pressure tablets (cause that's all your paying!) and expect to get it without an examination?

The most likely reason the scale and polish is listed separately is for the patients who return on a frequent timescale eg every 6 months and have a low caries rate and who warrant an exam on a yearly basis.

Oral Surgeon

davo10 wrote: »

This may be good practice in your opinion OS but the RPII disagrees. If you routinely expose patients to x-ray radiation un-necessarily just to have baseline x-rays in the absence of signs or sypmtoms of pathology then this could be problematic for you.

I'm gonna look into this now, no really I will, sorry if this sound sarcastic- I'm right on it.

AnonDentist

ivorystraws wrote: »

When treatments/services are listed, such as the exam, diagnoses and treatment plan (that I didn't ask for), I expect exactly that - wouldn't you? So to answer your question, yes, the dentist did find some diagnostic problems and advised me to organise further appointments with the front desk, which I subsequently didn't. Further treatment did involve one filling to the side of one of my top teeth and internal bleaching to the teeth which root canals were carried out on.

So you got a diagnosis and a verbal treatment plan? Is that not what was listed?
I personally give any patient requiring further treatment a written treatment plan but I know many that just give verbal ones.

Btw If you thought you were entitled to the S&P for free due to your PRSI how come the examination wasn't covered?

davo10

Oral Surgeon wrote: »

I'm gonna look into this now, no really I will, sorry if this sound sarcastic- I'm right on it.

Start here:

http://www.dentalcouncil.ie/files/ionisingradiation/Protocols%20for%20Standard%20Radiological%20Practice%20-%20SI%20478%20of%202002.pdf

The full text can be found on RPII site.

OP, the dentist diagnosed ongoing pathology (decay) in your mouth, what if she had spotted a cancerous lesion?. Some dentists including myself will not do a scale & polish as a stand alone treatment for a new patient without an exam first as the diagnosis of pathology should come before the removal of pathological material from the mouth.

btkm8unsl0w5r4

ivorystraws wrote: »

I don't want crowns of any kind, I'm just pointing out that headline treatments are cheaper in the north (in general) and that's a well documented fact (just google it). I'm not giving out but you seem to be. I'm simply pointing out the fact that I didn't get what they advertised. But yes, you make a good point, taking advantage of the UK dental prices and combining that with a groupon deal with a good dentist should result in a great service (as advertised), an unbeatable price and well-deserved attention (if they want a recurring customer).

You say that I have to "choose either price or quality, you cannot have both"... of course I can have both, that's why successful dentists are successful, regardless of where they're based and that's why "people" like you, make statements like that. Which one are you so if you believe it's not possible to have a great service at a great price?

You have already found out that low price and quality dont go hand in hand. The best dentists dont need to groupon, the best dentists are not cheap. Good dentist dont do crowns for 350 euro or sterling equivalent, the best dentists have successful practices because they are good, not cause they are cheap. Cost and value are two different things, you have found this out yourself.

You you want to fraction out individual parts of treatment to many lowest bidders you will find you will not receive the best integrated long term treatment.

ivorystraws

AnonDentist wrote: »

OP what would you have done if you got just your scale and polish and paid your €50 but noticed your lower front teeth were loose (they weren't like that when I went in?) you go to the local cafe to have a cuppa to think about what to do(oh that hot drink really hurts all my teeth!!) you pop into the loo to look at what has being done to you (oh my God my gums are raw and bleeding!!)
I'm getting onto my solicitor that butcher has destroyed my gums and loosened my teeth - No you have chronic periodontal disease but don't know this cause you didn't want an exam or to be told if there was anything wrong!!!

Would you walk into your GP after 4 years and demand a new prescription for blood pressure tablets (cause that's all your paying!) and expect to get it without an examination?

The most likely reason the scale and polish is listed separately is for the patients who return on a frequent timescale eg every 6 months and have a low caries rate and who warrant an exam on a yearly basis.

Well I've never heard of such Dentists or people who've encountered such problems but maybe you so that does happen in 1% to 5% of cases if I had to guess. I wouldn't think what you've described is as common as certain Dentists (like other professionals) confirming that the client needs more/additional services than are genuinely required.

Don't GP's have a legal obligation to complete an exam based on what you state your symptoms are? I don't know of any GP's that you could go into and ask for any kindof medication and get it without an exam but that's all part of the visit to the doctor i.e. it's not charged separately.

That's a likely reason but is it the reason? How does any dentist know how often or which dentist any person visits? Nobody has to go to the same dentist all the time and it's easy to ask for a printout of the work which any dentist has carried out (basic listing with dates and treatment) and bring it along to another.

ivorystraws

Bristol Bumpy Sarong wrote: »

You have already found out that low price and quality dont go hand in hand. The best dentists dont need to groupon, the best dentists are not cheap. Good dentist dont do crowns for 350 euro or sterling equivalent, the best dentists have successful practices because they are good, not cause they are cheap. Cost and value are two different things, you have found this out yourself.

You you want to fraction out individual parts of treatment to many lowest bidders you will find you will not receive the best integrated long term treatment.

No I haven't found out anything!? The dentist completed the scale and polish and discussed possible further treatment but I'm asking is that the extent of the listed "Exam, Diagnosis and Treatment Plan". You make a very ignorant statement i.e. You know for a fact that regardless of economy, overheads, experience and reputation that every single good dentist, the world over is never cheap and they'll never do crowns for 350 euro (as you've completed extensive searching of pricing for all dentists in Northern and Southern Ireland) and that great dentists are always more expensive and that price and quality ALWAYS go hand in hand. Don't you think this is a very general statement from you about every other Dentist and the quality and pricing of their work i.e. the fact that you even make such a general statement is a reflection of what you believe and how you communicate with your clients.

I don't want to do anything, I'm simply questioning the services and treatments available and what should/can be expected in Dublin. Most people on here gave valuable and honest advice, not general sweeping statements about the dental industry and quality of work on the whole island of Ireland or anywhere else for that matter!

ivorystraws

davo10 wrote: »

Start here:

http://www.dentalcouncil.ie/files/ionisingradiation/Protocols%20for%20Standard%20Radiological%20Practice%20-%20SI%20478%20of%202002.pdf

The full text can be found on RPII site.

OP, the dentist diagnosed ongoing pathology (decay) in your mouth, what if she had spotted a cancerous lesion?. Some dentists including myself will not do a scale & polish as a stand alone treatment for a new patient without an exam first as the diagnosis of pathology should come before the removal of pathological material from the mouth.

That makes sense and I agree with what you've said so why can't that simply be part of any treatment or shouldn't it be a mandatory treatment?

ivorystraws

AnonDentist wrote: »

So you got a diagnosis and a verbal treatment plan? Is that not what was listed?
I personally give any patient requiring further treatment a written treatment plan but I know many that just give verbal ones.

Btw If you thought you were entitled to the S&P for free due to your PRSI how come the examination wasn't covered?

Yes, on previous Dentists to other Dentists I would have received documentation on the Dentists proposed treatment plan for me and their diagnosis and that's handy for review to help plan further appointments and understand what the overall treatment will cost. Maybe it's just the way each Dentist carries out their respective treatment but it's difficult for the majority of people to remember and understand the Dentists diagnosis and what treatment plan they recommended.

The front office admin gave me the form to complete to check if I could reclaim the treatment (exam) on PRSI which I subsequently found out I was.

Oral Surgeon

ivorystraws wrote: »

great dentists are always more expensive and that price and quality ALWAYS go hand in hand. Don't you think this is a very general statement from you about every other Dentist and the quality and pricing of their work

Nice cars are expensive
Nice houses are expensive
You want the best lawyer, you'll pay more
You want the best accountant €€€
You want a five star hotel, big €€€€
and on and on....

Why does it surprise you that a good dentist providing a good service is more expensive??

btkm8unsl0w5r4

ivorystraws wrote: »

No I haven't found out anything!?

Yeah I am getting that. :rolleyes:

AnonDentist

ivorystraws wrote: »

[

The front office admin gave me the form to complete to check if I could reclaim the treatment (exam) on PRSI which I subsequently found out I was.

Did the dentist give you back the money charged for the exam?

I agree that verbal treatment plans not being worth the paper they are written on.
One practice I work in don't give printed treatment plans (still use paper charts etc) but I give ever patient a written plan with the cost of each treatment listed. As you said it can be difficult to remember everything especially if lingo is use.