Dental Flaws

Open wide, please, should not include the wallet

As anyone knows who ever sat back waiting for the worst, a dentist's chair is not the place where a patient feels at his most masterful. "Whatever you say, Doc," is a customary attitude. But it also can be an invitation to painful larceny, both petit and grand, or so says a dentist named Melvin Denholtz.

Along with his wife Elaine, Denholtz, 50, who is chief of dental research at Newark Beth Israel Medical Center, is the author of a new consumer's guide titled How to Save Your Teeth and Your Money (Van Nostrand Reinhold; $8.95). He chides Americans for spending nearly $9 billion a year on dental care "without the foggiest notion" of what their dentists are doing for them, and estimates that some 6 million people lose perfectly salvageable teeth each year, many at "extraction mills." Writes Denholtz, quoting a Pennsylvania insurance department estimate: 15% of all dentists are "incompetent, dishonest or both." As an antidote to such outrages, the book urges consumers to drill their dentists on basic subjects like costs, procedures and alternatives before submitting to anything more drastic than a tooth cleaning or an X ray.

To avoid exorbitant fees, Denholtz suggests, try a little new-fashioned comparison shopping. According to the American Dental Association's 1975 fee survey, national U.S. averages are $10 for a silver filling on one tooth surface, $13 for a simple extraction, $14 for cleaning, $92 for root-canal therapy and $251 for full upper dentures. For the financially strapped patient, Denholtz recommends Government clinics and dental schools --often inconvenient, sometimes low on quality, but easy on the wallet. At all costs, do not fall prey to what Denholtz calls cut-rate "assembly line" dental sweatshops, where one man said he had all his teeth pulled in 35 seconds while the dentist boasted, "This is just like shelling corn."

Other tips: beware the dentist who keeps people waiting for hours, fails to ask for a complete medical-dental history during the first visit, works without assistants, does not take X rays, wants to extract without suggesting alternatives for saving a tooth, does not use disposable needles to administer local anesthetics, charges unusually high or low fees, never explains his fees or procedures. If a dentist commits several of these violations, Denholtz recommends that patients should consider going elsewhere.

What can be done afterward about a dentist who has overcharged or provided incompetent treatment? Denholtz advises taking the complaint up with the dentist first. If you do not get satisfaction, go to your dental society, insurance carrier or consumer-advocate agency. "If nothing else works," Denholtz concludes, "then consult your attorney." But he admits that the odds are stacked against the consumer: only a handful of dentists lose their licenses each year, and malpractice suits are rarely worth the cost or trouble.

It is doubtful Denholtz will do for dental consumers what Ralph Nader did for auto buyers a decade ago. But he appears to have brought consumerism to a profession in great need of a checkup.

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