Dentist Tips |11 min read

16 Red Flags That You Should Get a Dentist’s Second Opinion

Our dentist giving a patient a complimentary second opinion on dental work

In the June 2021 edition of Consumers’ Checkbook magazine and website, an article entitled “65 Things You Probably Shouldn’t Pay For… This text opens a new tab to the article…” stated the following:

“Be suspicious if a new dentist recommends far more treatment than your previous one—for instance, if suddenly many fillings need to be replaced, several teeth need to be crowned, or your gums need extensive surgery. This is an area where we receive frequent complaints in our surveys of patients.

 

To help you decide on a treatment, your dentist should fully describe the condition of your mouth and all treatment options, including those that might cost less. If a dentist recommends extensive treatment, get a second opinion.”

The following are suggestions to help you avoid excessive or undesired treatment.

Use these suggestions to help you get the highest quality dental care.

When to get a second opinion on dental work

1. The number one warning sign is when you sit in a dentist’s chair for the first time and are told you need procedures you have never needed before.

If you rarely have cavities and are told that you need quite a few fillings at your first appointment, I suggest you see it as a red flag.

2. A common pattern is dentists who use a deeply discounted dental hygiene appointment and checkup to get you in the door. Once you are in the chair, you may be hit with thousands of dollars of work that you did not anticipate. Ask a lot of questions.

3. If you’re diagnosed as needing to replace old fillings, ask for pictures and x-rays. Some dentists try to replace all of your fillings simply because they’re older fillings. This is not necessary if they’re not causing problems.

Certainly, there are old fillings that can crack or become surrounded by decay, necessitating a replacement. Still, a dentist should be able to present to you intra-oral pictures and x-rays, which show the need for replacing fillings.

Some people fear mercury in silver-colored fillings. The American Dental Association states on their popular informative guide to dental health, MouthHealthy… This text opens a new tab to the MouthHealthy website…:

“Although dental amalgam is a safe, commonly used dental material, you may wonder about its mercury content. It’s important to know that when combined with the other metals, it forms a safe, stable material. Be assured that credible scientific studies affirm the safety of dental amalgam. Study after study shows amalgam is safe and effective for filling cavities. The American Dental Association… This text opens a new tab to the ADA website…, U.S. Centers for Disease Control and Prevention and World Health Organization all agree that based on extensive scientific evidence, dental amalgam is a safe and effective cavity-filling material. The Alzheimer’s Association… This text opens a new tab to the Alzheimer’s Association website…, American Academy of Pediatrics, Autism Society of America and National Multiple Sclerosis Society… This text opens a new tab to the National Multiple Sclerosis Society website…—all science-based organizations like the ADA—also say that amalgam poses no health risk. As with any dental work, you’ll always want to talk with your dentist about your individual situation in order to make the most well-informed choice.”

4. Does your dentist clearly communicate with you about any treatment suggested and why it is necessary? Do you feel rushed or welcome to talk about findings?

5. Are you in a no-judgment office? Do not be intimidated if you have neglected to get dental care. You have the right to expect all dental team members to make you feel comfortable and be attentive and supportive.

What’s important is that you want your dental needs attended to now. Do not settle for any guilt, judgments, or intimidating remarks from any dental team member.

6. It’s a red flag if you are sitting in a waiting room for 45 minutes or longer and then taken to a treatment room and you wait another 45 minutes or longer.

I’d be concerned that the office is overbooking to maximize profit and not treating patients with respect due.

If this happens once or twice because of emergencies, it’s understandable. If it’s oftentimes, I wouldn’t want to go to a practice that overbooks consistently.

7. A dentist you can trust should be comfortable if you express that you want a second opinion. Your dentist should not hesitate to forward x-rays to another dentist.

We would always agree to do so at The Silberman Dental Group. It’s our standard of practice to give no-cost second opinions.

If we agree with the treatment plan presented to you when you come in for a second opinion, we’ll absolutely advise you to return to the practitioner you first went to. We have sent people back to see the first dentist who recommended treatment on numerous occasions.

Dr. Paul Silberman and Dr. Daniel Barakh have expressed they personally enjoy serving as a second opinion and then returning patients to their original dentist. Knowing the patient feels good because they are reassured that their treatment plan is needed feels gratifying to each of them.

In our office, we recommend you do one of two things if you want a second opinion. Either:

  • Come in with your treatment plan and directly ask our opinion.
  • Do not show us your treatment plan. Hang onto what was suggested at another office and compare it to what our treatment plan is. Then you decide once you have compared and asked questions.

8. You can research the dentist online. Read reviews and see how the dental practice responds to both praise and criticism.

A negative review does not mean the practice doesn’t have integrity because you don’t know the private details regarding a patient.

The Health Insurance Portability and Accountability Act of 1996, known as HIPPA, ensures confidentiality and greatly limits what can be said about a specific patient.

A dentist’s response to a negative review might convince you to see that dentist because of the general details given as well as the concern and poise shown in the response.

If you choose to look at reviews… This text opens The Silberman Dental Group Google Maps with reviews in a new tab …, consider the number of reviews. Is the dental practice ranked as five stars with only three reviews, or is it a dental practice with 4 or five stars with many reviews?

You can never make everyone happy, so I want to see a dentist with high rankings and quite a lot of reviews.

Are the patients giving details in the positive reviews letting the reader know why they feel comfortable in the practice?

9. Is your dentist giving you more than one option? There certainly are times when there is not an option. Ask for alternatives and why one treatment would be better than another.

There will be times when a dentist gives more than one option.

Perhaps an implant is the best option. However, if you cannot afford an implant, there is likely another option, such as a fixed bridge or a partial denture.

Remember that a root canal and the subsequent crown needed after a root canal is more lucrative and easy to pass by an insurance company if the dentist claims the patient was in pain, even if a filling would have done the job.

It may be well worth the time and effort you put into getting a second opinion to be sure you’re getting the appropriate dental treatment plan. Even a third opinion is sometimes a good idea.

10. When you leave a dental office, are you told that you’re welcome to call if there are questions? Are you clear about what needs to be done step by step?

At The Silberman Dental Group, we offer a no-cost follow-up after your consultation via a virtual visit with the dentist or a phone call from our dentists. We do this so that we can further explain whatever questions a patient might have. It’s no bother.

As Dr. Barakh explains,

“We’re thrilled you have taken an interest in your oral health and want to understand fully the options available to you!”

11. Insurance plans put incentives in place for in-network dentists. When dentists become part of these networks, they agree to extremely low reimbursements in exchange for a steady stream of patients.

Some dental practices, particularly large dental chains or franchise offices, use deals as a way to get patients in the door and then may give expensive treatment plans. Or the practice may heavily promote cosmetic work.

It can be more expensive to go to a dentist who participates with your insurance network because of additional work suggested than going to a dentist you know gives you an accurate diagnosis.

12. It may be a red flag if a patient in their late 70s or older goes to a dental practice that gives an extensive treatment plan, including Invisalign (orthodontic treatment).

If that person has not benefited from orthodontic work all these years, it’s doubtful that Invisalign should be proposed. We know many seniors who have much vitality and enjoy an active lifestyle and would think that pressure to get orthodontic work is just unnecessary and might be a red flag.

13. Our office no longer participates in network with a few insurance companies because Dr. Silberman and Dr. Barakh oftentimes felt the person making a decision about whether to pay for treatment was thinking only about profit for the insurance company and not about what was in the best interest of the patient. They will not be dictated to by people hired to make a profit for the insurance company.

Examples include a patient who wanted fixed bridge work. The insurance policy covered fixed bridge work. However, the insurance would only pay for a partial denture that comes in and out and is not as comfortable as a fixed bridge. Forcing the patient to have a partial denture instead of fixed bridgework would be much more profitable for the insurance though not best for our patient.

Another example is patients want white fillings, and some insurance companies will only pay for silver fillings on back teeth. They haven’t been teaching how to place a silver filling in dental schools for at least 20 years. Many newer offices don’t even have the silver in stock. It’s absurd that modern resin white fillings are not approved by the insurance company when it is considered the standard of care by The American Dental Association.

14. Modern technology makes dentistry more precise and comfortable than ever before. If you are experiencing a dentist who is rough or dental treatment that’s exceptionally painful, it may be a red flag.

15. Many offices that are open six to seven days a week hire young dentists who tend to leave after a short time. They’re likely fine dentists but don’t like working on quotas or may dislike the management style of large corporate and/or franchised dental practices.

If you are going to a dental practice that seems to have dentists and employees leave often, it may be a red flag.

16. How do you feel about the team working with the dentist you’re seeing? Does it seem as though the team works well together? Are team members smiling or looking like they cannot wait to finish their workday?

We know that our team chose a helping profession and respect them for doing so. They can make a huge difference in our patients’ lives, helping them have positive attitudes about dental treatment and positive outcomes.

At The Silberman Dental Group, our team members know our dentists and office administrator respects them and wants the office to be an upbeat, positive environment. When we hire professionals and stress excellence, we’re helping to make dentistry a lot less scary.

Do you need a dentist’s second opinion?

Most dentists are honest and hardworking. Their values drive their decisions for their dental practice.

It’s not our intent to suggest that you’re being overdiagnosed; it’s only our desire to help you know when to seek a second opinion and when to trust your gut that there are some red flags for you to consider.

Dr. Silberman recently had a patient who went to another dental practice because we no longer were in network with his insurance company. The patient expressed feeling foolish for allowing the other dentist from a different practice to do some work.

Please, listen:

This is not about intellect. It’s about a betrayal of trust!

Dentistry is not scary! What is scary is having an unhealthy smile because the health of your mouth impacts your general health.

Book a complimentary second opinion today

Contact our dentists in Waldorf, MD!

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Our dentists are located in Waldorf, MD and see patients from across the state, including Charlotte Hall, White Plains, La Plata, Brandywine, Accokeek, and Mechanicsville.

18 comments on “16 Red Flags That You Should Get a Dentist’s Second Opinion”
  1. Dr. Deborah Hall-Greene

    These are very good dentistry tips to keep in mind Thanks for sharing your knowledge!

    Reply
  2. Harriet

    -What about when after the original assessment, more cavities are found? When asked, dentist replies that they were hidden. If they show up in pan xray, why not always give it? When responded that I would wait, as pain still existed on other side, was told that they would become root canal problems and then I would eventually lose the teeth.

    Reply
    1. Hello Harriet,

      It is possible that x-rays don’t show decay when it actually exists. New crowns (Zirconia), old porcelain fused to metal crowns, and old silver fillings are all metal which blocks the x-rays. They show up as white on a black and white x-ray. If there is decay on either side of the metal, it can’t be seen, unless viewed clinically. A panoramic x-ray is not very good for diagnosing decay. It’s not as clear as the regular checkup x-rays. It is good for seeing bone problems around the teeth and in the jaws and is an important diagnostic tool, but not for diagnosing tooth decay. When you have tooth pain, it usually means that your problem is advanced and should be treated. Most cavities in the early stages are not noticeable. If you have a cavity that is sensitive to sweets or cold, I agree that you should address the problem early or it will likely advance to where you need root canal treatment. Good luck. Dr. Silberman

      Reply
  3. juanita

    what is the name of an ethics DDS for a second opinion in Solano County?

    Reply
  4. Courtney

    I have about 22 left in my mouth. About 6 of them need fillings. All or most of my back teeth have been pulled. My dentist had a plan in place to fix the teeth with crowns but when I went today, he acted as if he didn’t feel like doing any of the work and instead would rather pull all of my teeth and give me full dentures. I am only 25 years old & my front teeth are good with 0 cavities & i can smile and not be embarrassed. He told me that since the appointments are so far apart that it would be pointless to do the plan in place because the decay would get worse over time while I wait for the appointments. I had 3 upcoming appointments all within a month to fix the big cavities in the back that needed to have root canals. Not even a month away and is now wanting instead to extract all 22 teeth I still have to replace them when most of them don’t need any work done at all.

    Reply
    1. Hi Courtney, I think you should consult with another dentist (or two). You can set up an appointment and ask your current dentist to email your x-rays to the second dentist. The second dentist cannot diagnose accurately without them. You are legally entitled to them and your current dentist should have no problem sending them out for you. In my office, we have a “No Fee Consultation”. This is not something that you may find in your part of the country. I just feel that it is the right thing to do for the general public. Even if you have to pay for the consultation, it sounds like it might be worth it to get a second opinion. It is most important that you have the best dental home care with brushing twice daily and flossing once daily. It sounds like you have a high cavity rate. Even if you get the best dental care, it will fail if your home care isn’t excellent. Good Luck, Dr. Silberman

      Reply
    2. K. Stahler

      Go to another dentist! Keep as many of your original teeth as possible, don’t get dentures, they suck! My denist said my front teeth were all decayed, and a denture was my only option. My front teeth also connected my partial plate that consisted of all my back teeth. Now I am stuck with a upper denture that is 2 times bigger then my partial plate that fit and looked great with my front teeth. This denture is killing my mouth, it’s to big! I am so sorry I didn’t get a second opinion. I’ve been going to this dental office for over 20 yrs. thought I could trust them, I don’t anymore! Run from that dentist while you still have your teeth!!

      Reply
      1. Hello K. Stahler, So sorry to hear that you had this experience. I wish I had seen you in my office. If you liked the way your teeth looked and your smile, we would have taken a digital image or impression of your existing teeth and had the lab duplicate them in a complete denture before removing your teeth. We would remove the teeth and insert the denture immediately so that hopefully, there would be little difference in appearance. Sometimes we have no choice but to go to a complete denture, though I do agree with you that the patient and the dentist should do everything possible to hold on to what you have. But it sounds like you have what we refer to as “an immediate upper denture”. This is a temporary denture. A permanent one will be made once you have fully healed from the extractions in around two months. Hopefully they will make something similar to what you had before. Bring your high school graduation picture with you to the dentist your original smile. They will be able to select the size, shape and color of your natural teeth from the photos. Good luck. Dr. Silberman

        Reply
  5. Debbie Koenig

    I have been going to my Dentist over 20 years faithfully every 6 months. He has done numerous crowns on me. Almost all my teeth. I went today for 6 months checkup and was told I had dry mouth from meds and possible covid which I had in between the 2 visits. he said I have 4 crowns that have decay and 2 cavities. I don’t understand how this could happen in 6 months. He prescribed prescription toothpaste and dry mouth spray. Do I need to get a second opium? I would not want to ask for my Xray’s due to my Dentist feeling like I don’t trust him after 20 years. Please help I don’t know what to do.

    Reply
    1. Hello Debbie, Sorry I didn’t get back to you sooner. It is very possible to get decay at the root/gum level of the tooth when you have dry mouth. Saliva is the first line of defense against tooth decay. If you combine dry mouth with frequent exposure to sugar, it is almost always a perfect storm for tooth decay. I have patients who thought they were doing themselves a favor to treat the dry mouth symptoms with hard candy, but it wasn’t sugar free. And the worst is dark chocolate. The sugar in the presence of dry mouth can cause decay to work its way up under the crown. It can’t hurt to get a second opinion. Google the dentists in your area and find one with good reviews that reflect honesty and integrity. I always offer a free second opinion and, if the patient is diagnosed correctly, I encourage them to go back to their dentist. I don’t know if there are other dentists with this policy. If the patient is not comfortable with bringing their x-rays, I may take a new set of x-rays and inform the patient that there may be a charge. Insurance often covers that cost. And the x-ray exposure is minimal so you don’t need to worry about that aspect either. Good luck. Dr. Silberman

      Reply
  6. Melissa M

    Rather than being overdiagnosed, I feel that I was ignored by my dentist. After a weekend when my bruxism hit an extreme, my whole mouth began to hurt. While some pain was bruising or wear sensitivity, there are teeth that have painful cracks and chips, as well as in areas that already turned black after the application of SDF. I live in a state with (lackluster) dental coverage included in the healthcare for low-income individuals, but the clinics that work with this insurance are limited and horribly overworked. I got in for a limited exam and the dentist took about 3 minutes to look at my teeth, disregarded my reacting when he hit painful spots with a probe, and said nothing was wrong. Most treatment beyond fillings or MAYBE basic bonding would not be covered by my state coverage, who would rather pay for extractions than for onlays, crowns, etc. — This means that I am eager to be seen as soon possible for a second opinion before I am beyond help for the problems that were not observed by my provider. If I pay out of pocket for a second opinion by a provider not in my state’s coverage network, can I take that opinion back to my regular dentist for treatment, if it is something that would call within the scope of my coverage? I’ve never had to get a second opinion before and am still confused on what comes after the appointment.

    Reply
    1. Hello Melissa, You commented about bruxing, state sponsored dental care, and getting a second opinion. Let me try to respond to each. As for the bruxing, you should be wearing a bite guard 24/7 during severe periods of attrition. You should always wear one at night as we have no control over our grinding habits while we sleep. There are very inexpensive ones that are over the counter at any pharmacy or sporting good store, but they are not comfortable unless you are in a boxing match. Your dentist can take impressions and make a comfortable relatively thin appliance that will help you with the grinding problem. Also, a prescription muscle relaxer can be taken to help stop the desire to clench and grind. As for the state sponsored dentist, it is difficult for a dentist in private practice to do dentistry when the rate of reimbursement is a “break even” proposition, at best. There may be dentists in your state what are on state salary so they don’t have to worry about staying in business. But the need is so great that it is difficult to spend as much time with each patient that each patient really needs. Like the over the counter bite guard, any dental help you can get would be to your advantage. As to getting a second opinion, if you aren’t able to pay for what is diagnosed, there probably isn’t any reason to get it. If you go back to your dentist who says that you have no current need with a treatment plan from another dentist, your dentist is likely to advise you to go back to the new dentist. You could go to the second dentist for another opinion and if they agree that no treatment is necessary, you can walk away with that piece of mind. Good Luck, Dr. Silberman

      Reply
  7. EileenF

    A most informative article. I am a senior with longstanding periodontal disease. I could never afford expensive gum treatments with lifelong maintenance appointments required. At this time, I am really in need of Dentures. Dentist offices are making me feel terrible for my situation. One dentist even told me to “move back home with family” if I can’t afford a periodontist. I no longer have any “family.” Dentists in Lehigh Valley, PA won’t accept me as a new patient that can only afford Dentures. A depressing situation.

    Reply
    1. Hello Eileen, Sorry to hear that you are going through this. I suggest you check with clergy as some churches have connections with dentists who treat the underserved. In my area the connection is through an organization called Donated Dental Services. Also contact your local dental society to see if they can help. And your state congressperson may be able to offer guidance as each state is unique with some offering help for those in need. Most states with heavily Democratic rather than Republican legislatures tend to have programs for those in need. Good luck. Dr. Silberman

      Reply
  8. RJay

    I’ve had the same dentist for over 40 years, and regular appts every 3-4 months. This time I had found my doctor has retired and new people are in the practice. With my last appiontment, I was having some trouble with an old root canal. The Dr. “lasered” it, but I still found it painful only when I chew on that side (bottom right molar). I mentioned this to my new Dr., and she said it was somewhat loose, sensed an infection, and set up an extraction/then bone graph, eventually an implant. I also received a Rx of antibiotics. I was stunned as I had never experienced a treatment like this, and never lost a tooth. As this is a new dentist, I’m considering a second opinion and possibly a new dentist. Can the root canal not be replaced with a new one?
    She also saw a cavity that may need a crown as part of the filling is missing also. Then she oddly reminded me to “be aware” I still have my wisdom teeth (??..and??… I didn’t ask her why that mattered) I know doing nothing is not an option I’d choose, but clearly don’t feel the trust I need to go through with this from a new dentist. Is there an option other than extraction that is viable, and is a second opinion a good idea?

    Reply
    1. Hello RJay, I’m not sure what “lasering” does for an old root canal. If there is mobility in the tooth, it is likely that the root canal has failed causing some bone loss making the tooth somewhat “loose”. If this is the case, I agree that extraction/bone graft/implant is the correct treatment plan. A second opinion is always a good idea though. Select a dentist who will see you for that second opinion and ask your old dentist to forward the x-ray to the new dentist in time for your second opinion appointment. You might also ask for a second opinion for the tooth that the new dentist says needs a crown. Have that x-ray forwarded as well. As for wisdom teeth, I usually inform patients if they still have them but usually render no treatment. At your age, we usually x-ray them every five years if they are asymptomatic (panoramic x-ray). We need to confirm that there is no cyst formation around them. I hope that helps. Good luck, Dr. Silberman

      Reply
  9. Mike Fiero

    I went to a dentist 9 days ago for the first time in a few years. I was having pain on a upper back tooth. They took X-rays and did a intake assessment and before I knew what was going on they pulled the one that was hurting me up top and 10 of my bottom teeth!! My teeth may not be the prettiest or healthiest but far from needing to pull all of them.
    I went back 2 days ago and asked them what happened why you pull all my teeth and what’s the plan to fix it.
    The dentist who did the work was not there but another one was and looked in the computer. Asks was just like I don’t know you have to on talk to her.
    One of the 3 teeth I have left in my lower jaw is causing wxtream pain because it hits my upper teeth or the roof of my mouth when I talk. Eating is almost impossible. We’re do I turn? Hospital , another dentist, lawyer? Or is this normal. I still don’t know why they pulled them all.

    Reply
    1. Hello Mike, Did the dentist have you sign a consent form before extracting your teeth. It is customary for the patient to sign a form stating that they understand what treatment is about to be rendered and that the patient understands what alternative treatments might be available. If not, you might consult a lawyer. But to take care of your immediate dental needs, you should go back to this dentist or find another one who can help you. When we extract teeth in the “smile zone”, we usually make a denture that replaces the teeth to be extracted. As soon as the teeth come out, the denture goes in, so that you never lose your smile. It certainly sounds like that wasn’t the case here. I doubt that a hospital can help you unless they have a dentist on staff. Good luck, Dr. Silberman

      Reply
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