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I'd like to think that dentists (pediatric or general) would be more ethical than that. I specifically asked the pediatric dentist if she could have the cavities filled rather than getting a crown and he said it is because the cavities are between her teeth. But my dentist's opinion is that fillings are all that's needed. He's not specifically a pediatric dentist but he does have child patients and a child (and he's her dentist) and I've been going there for over 10 years and trust his judgment. He's gentle with his dental work recommendations, unlike another dentist I saw a couple of times who made me feel like my teeth were going to fall out any day now. I guess it just depends on the dentist sometimes, just like different doctors vary in their opinions.
Our family has had honest dentists and others that were not far from outright thieves.
One case I reviewed was a Medicaid mother who took her children to a child's dental clinic. The dentist wanted to fix 7 cavities. Turned out another dentist found no cavities. This thief wanted to drill 7 holes and fill them. Sounds like a felonious assault to me.
We personally had a phony dentist tell my wife she needed extensive periodontal work but would not submit a pre-estimate to the dental insurance. Over 20 years later, the work was never needed according to all the honest dentists we saw over the years.
Unless you have extensive experience with a dentist, get a second opinion on major work.
OF COURSE a dentist will push crowns. That's how they make money! Although their profession is a dentist they are still a small business owner. Do people really think small business owners provide a service because they need new friends? LOL. No! They do it to make money! If something doesn't sound right (like a 4yo needing a crown) then it probably isn't right.
I try not to respond to these threads because I'm not here to change public opinion about dentists. To the OP, that's great you found an office where you are comfortable. There are many, many great general dentists who have the capability to treat children competently.
What I am here is to call you out (underPSI) for making comments that show you have ZERO understanding of the topic at hand. 4 year-olds need crowns all of the time. I'm not here to explain why my 4 years of dental school, 2 of a pediatric residency in a major children's hospital, and almost a decade of patient care has taught me. But I am here to tell you that by making such ridiculous comments, you make things harder for parents trying to research on whether or not crowns are the proper choice. They read statements like yours and unfortunately think you have some credibility since you make such strong comments.
Below is a 4 year old with massive cavities that can only be repaired with crowns. Below that is a healthy dentition for comparison. Even with zero dental education I hope it's clear why crowns are sometimes necessary. We see this all day long. 2, 3, 4 year olds and up.
And just for the record- most pediatric dental offices make a majority of their profit off cleanings, fluoride, etc. In fact, our dream practice would be just doing cleanings all day. So no, the recommendation of a crown is not for profit. It's based on what is best for our patients. I know every pediatric dentist in Wake County personally and there's not a single one I wouldn't let treat one of my own.
What I am here is to call you out (underPSI) for making comments that show you have ZERO understanding of the topic at hand. 4 year-olds need crowns all of the time. I'm not here to explain why my 4 years of dental school, 2 of a pediatric residency in a major children's hospital, and almost a decade of patient care has taught me. But I am here to tell you that by making such ridiculous comments, you make things harder for parents trying to research on whether or not crowns are the proper choice. They read statements like yours and unfortunately think you have some credibility since you make such strong comments.
And just for the record- most pediatric dental offices make a majority of their profit off cleanings, fluoride, etc. In fact, our dream practice would be just doing cleanings all day. So no, the recommendation of a crown is not for profit. It's based on what is best for our patients. I know every pediatric dentist in Wake County personally and there's not a single one I wouldn't let treat one of my own.
You are exactly right. I am not a dentist so I do not have any understanding of the topic of crowns for a 4yo child as when they are needed and the application process.
BUT that doesn't mean I'm incorrect with my comment about getting a 2nd opinion when something doesn't sound right such as a 4yo needing crowns. There is no amount of convincing you even as a dentist can do to make me change my opinion that crowns for a 4yo is a normal occurrence. I understand there are times when it is needed but it is not normal. Any parent would be foolish to not get a second opinion.
My comments are not ridiculous at all. I merely made a suggestion to get a 2nd opinion. What's wrong with that? Are you against 2nd opinions? If a mechanic tells you your car with 20k miles on it needs a new engine because it won't start one time are you going to trust what he says simply because he repairs cars for a living? Come on, Doc. I'd like to think you are smarter than that.
I will wholehearted agree with anyone who may suggest doctors, especially doctors, should do what's ethically correct. The caveat is the word "should". Problem is I live in the real world and in the real world not everyone is honest and I understand this. And you, as a "Kids Dentist" should be ashamed and downright embarrassed for criticizing someone for simply making the suggestion of getting a 2nd opinion. Other posts in this thread have shown 2nd opinions are needed. Heck, even the o.p. posted back stating a 2nd opinion proved beneficial by learning a crown was not needed. But, based on your time and experience (or lack thereof) in the profession it's obvious you still have a lot to learn. If you don't support your customers (which is exactly what a patient is) by suggesting they get a 2nd opinion they will go somewhere else and won't come back.
Heck, even the o.p. posted back stating a 2nd opinion proved beneficial by learning a crown was not needed. But, based on your time and experience (or lack thereof) in the profession it's obvious you still have a lot to learn. If you don't support your customers (which is exactly what a patient is) by suggesting they get a 2nd opinion they will go somewhere else and won't come back.
Just to play devil's advocate, and I will say as an aside that I agree with you 100% on getting a second opinion for something like this, there is always the possibility that Doc 1 says the kid needs a crown and Doc 2 says the kid doesn't. Parent is happy and doesn't get crown, only to find out later that it was Doc 1 that was correct and Doc 2 was wrong.
If you get a 2nd opinion, and it aligns with what you want to believe (for whatever reason), that doesn't mean it's not wrong. Confirmation bias is very strong in the human brain and sadly we as non-professionals may not know which of the conflicting opinions is right and which is wrong. Same for doctors, mechanics, or any other advice we get in daily life.
This is a side note and general comment and not directed at you or anyone - just something to consider.
Again, I'm 100% in agreement that a second opinion is always (or almost always) wise for situations like this.
there is always the possibility that Doc 1 says the kid needs a crown and Doc 2 says the kid doesn't. Parent is happy and doesn't get crown, only to find out later that it was Doc 1 that was correct and Doc 2 was wrong.
If you get a 2nd opinion, and it aligns with what you want to believe (for whatever reason), that doesn't mean it's not wrong. Confirmation bias is very strong in the human brain and sadly we as non-professionals may not know which of the conflicting opinions is right and which is wrong. Same for doctors, mechanics, or any other advice we get in daily life.
The situation you stated is a possibility. I posted what I did because I was left with the impression from Kids Dentist that patients need to listen to the doctor because they are the one who went to medical school, not the parents. Just from a few of my previous experiences I have felt doctors need to listen to their patients more and lose this attitude that since they are the doctor the patient has no clue what they are talking about.
I feel it's especially important for pediatric doctors to listen to the parents of their patient. I'm sure anyone who is a parent will agree if they have a hunch of something not sounding right with their child they are probably correct.
Here's another example of why second opinions help.
Our son had a tooth that hadn't dropped into place at the normal time. Our trusted family dentist had him go to an orthodontist for a free consultation.
She wanted to pull the tooth down by cutting the gum open, attaching a clamp, and slowly tightening wires over several months to get the tooth down. Price over $3K for this and braces.
Our general dentist was shocked. He said he'd watch the X-rays every 6 months and see if this job was needed since the unerupted tooth was facing down as normal.
I guess you know the outcome. Tooth came into place by itself. Only thing sone needed quite a few years down the road was to have his wisdom teeth removed by an oral surgeon because they were not coming in correctly.
Here's another example of why second opinions help.
Our son had a tooth that hadn't dropped into place at the normal time. Our trusted family dentist had him go to an orthodontist for a free consultation.
She wanted to pull the tooth down by cutting the gum open, attaching a clamp, and slowly tightening wires over several months to get the tooth down. Price over $3K for this and braces.
Our general dentist was shocked. He said he'd watch the X-rays every 6 months and see if this job was needed since the unerupted tooth was facing down as normal.
I guess you know the outcome. Tooth came into place by itself. Only thing sone needed quite a few years down the road was to have his wisdom teeth removed by an oral surgeon because they were not coming in correctly.
Absolutely - I was in need of adult braces and got THREE referrals, and I went to see all of them.
Ortho 1 - your teeth are extremely crooked. I will need to pull at least 4 plus break your jaw and re-configure to get them even close to being straight and proper.
Ortho 2 - your teeth are extremely crooked. I will need to pull probably 2 of them, but we can probably leave your jaw alone.
Ortho 3 - your teeth are extremely crooked. We may need to pull 1 or maybe 2, but the others are crazy and we will not even think about touching anything else.
As a result, I wanted Ortho 3 and guess who now has a set of perfectly shaped teeth, with NONE missing except for the wisdoms that were extracted as a teen? This guy!
Sometimes you can go with the most conservative, even if you don't know for sure it's correct, and then later on go more extreme if necessary. Sometimes you can't.
My kid's dentist is awesome! I will shout the praises of Duke Pediatric Dentistry (Dr Keels and Dr Neal).
My oldest- hard enamel- never had a cavity- braces= Brackets for 6 months and head gear 2 years = perfect cavity free at 21 years old
My middle- twoish cavities, headgear 2 years -no braces *see footnote
My youngest - 10 cavities (between baby teeth) - fillings then later fixed retainer -no braces
*footnote- My middle boy's headgear did not move 1 tooth into a position they were happy with- they REFUNDED about 1700.00 in what we'd paid for treatment. Straight REFUND, no asking, weren't looking for, we were happy with the progress of his teeth.
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