Toothache

I did not know there were scam dentists.

I went to the same family dentist in New Jersey for most of my life. Dr. R, Jr. Was a warm, kind, friendly man who ran his dental practice out of an office attached to his house. He hung replicas of large fish he caught on the waiting room walls, a signature hobby of his life outside the dental office.

He took care of my teeth, and also tended to my mother’s and my brother’s. He referred me to the best orthodontist all the kids in junior high and high school went to when my teeth needed straightening in those awkward teen years. He triumphed with me when a new cosmetic bonding procedure would cover up stains on my teeth from exposure to tetracycline as a toddler. He filled my cavities; his hygienist cleaned my teeth; and I always walked out of his office with some "at home care" essentials: a toothbrush, toothpaste, and dental floss in a zippered bag with a toothy smiley face.

When Dr. R., Jr. retired, his son Dr. R., III took over the practice, fresh out of dental school, and treated patients with the same gentle approach. Like father, like son. When the son relocated with his family to another state, Dr. R., Jr.'s daughter, Dr. Jan, picked up the practice and made it her own. The family sold the house, and Dr. Jan opened up an all-female dental practice a few towns away. The office felt cozy and inviting, they made everyone feel comfortable, especially children and adults who may have been apprehensive about visiting a dentist, or having a complicated procedure. The dentists, hygienists, assistants, and reception team were dedicated, caring women, empowered to provide excellent dental care. I trusted them implicitly with my teeth, and never felt any pressure to accept unnecessary services. They knew me, and my mother well; they'd ask about our lives; we shared stories about our pets; they were interested and engaged in their patients' wellbeing.

That all changed when I moved to California almost 6 years ago, after my mother died. I didn't have insurance when I arrived, and it would take another couple of years to get California's equivalent of government-funded Medicaid, Medi-Cal. A filling broke, along with part of the tooth, so I needed to find a dentist. I searched for a local dentist who accepted the insurance carrier. It took numerous phone calls, and rejections, until I found one, and I made an appointment at NuSmile Dentist.

The small office was in a strip mall, in between a taco shop and a Subway sandwich place – the location alone should have been a tipoff. The whole visit was half-ass backwards. Before anyone examined me, a woman came in to polish my teeth. Then someone else came in to clean them. The cleaning was so quick, I could tell they missed a lot of plaque, if they removed any at all, and I missed my New Jersey hygienist, who would have chatted with me about exercise and our mutual favorite singer. They took a panel of x-rays, free with my initial exam. Finally, the dentist, Dr. W., came in to examine my mouth and look at my broken tooth.

"You need a crown," he told me. "I thought so," I said. I didn't really need a dental degree to figure that out. He brought in a second dentist, Dr. N. to take a look. He agreed – I needed a crown. Dr. W. said, "I don't do crowns." Dr. N said, "I can do the crown, but I don't take insurance. That'll be $1,500."

The receptionist escorted me to the front desk. "You need to find a different dentist. We'll send you the x-rays."

I went back to the Medi-Cal dentist database to start my search again. I wanted to avoid dentists in bad areas of the city, where the dentists would only cater to Vietnamese-, Spanish-, and Chinese-speaking patients. Those sections of the city weren't safe either with a lot of gang activity. I’d already been cautioned about going to that area alone. One by one, I had to eliminate dental practices that would take my insurance, but only accepted children as new patients. Finally, I found an office that allowed in new adult patients, located in a family-friendly shopping plaza, not too far from where I was living. 

The practice also was small, but the team seemed nice. The dentist was female. They looked at the previous x-rays, took some new ones, and she examined my tooth. "You need a crown," she said.

They would submit the x-rays to Medi-Cal for review, and if approved, they could do the procedure. 3 weeks later, they told me Medi-Cal denied the claim, and would not cover it. But they could redo the x-rays, and re-submit better images. 

I came back for another round of x-rays and they sent them in. This time, the crown procedure was approved. They scheduled a first appointment, and a second one, since the whole crown process would be in two parts.

By February, nearly a year after my visit with the first California strip mall dentist, I actually had a crown on my broken tooth. The procedure was long. It involved multiple x-rays and photos, and it was painful. I was relieved when it was over, and didn't want any more dental treatment.

However, the tooth never felt comfortable. I tried to ignore it, not wanting to go back for yet more time in the dentist's chair. I sensed that something else was wrong with the tooth next to the crown: there was a gaping space with sharp edges that scraped my tongue (maybe the filling in that tooth had broken also); and it felt like a crater or a crag the size of the Grand Canyon.

Months went by, and the tooth continued to annoy me. Then, it was nearly February again, and I couldn't stand it any longer. I picked up the phone to make an appointment to have it looked at. My dear ole dentist in New Jersey would have sent me a reminder to come in for a checkup, but not this one. I called several times, and left messages, but no one called back.

I drove over to the shopping area on a day off, and stopped in to make the appointment in person. I never got your message," the receptionist said. "We're very short-handed." She looked up my patient file. "Oh, we no longer take Medi-Cal. We don't have enough help, so we've dropped some insurance carriers. "You'll have to find another dentist." She said they'd forward the x-rays by email.

I resumed my futile search for yet another California dentist, who'd meet my location preference, who would accept adults as new patients, and who would take my insurance to cover crowns, in case I needed another one – or something worse – like a root canal.

After crossing off several who told me, "no," I found Western Dental Services and Orthodontics, with an office 10 minutes away – maybe the White Castle of dentists, with offices throughout California, Nevada, and Arizona. Who knew there were chains of dentists with franchise opportunities like 7-Eleven? In hindsight, I should have read the Yelp reviews first. But they had an appointment on a Wednesday when I was off from work, so I booked it. I drove to the office hopeful I would find some relief, and have my tooth taken care of.

The stand-alone building was at an intersection of two busy roads. Across the street was a McDonald's, and there were crummy strip malls at the other 3 corners. Not a neighborhood dental practice with a backyard and fishing trophies. It was pouring when I drove into their parking area, only to find it full. I parked around the corner, and walked back to the office, huddled under an umbrella.

Even though I'd already filled out and submitted new patient paperwork online, I had to fill it out again. The drab waiting area looked like the seating area of the DMV where you'd wait to get a replacement driver's license. This was some dental farm. I had an uneasy feeling sitting in the lobby, like I did when I discovered a shady chiropractor in New Jersey was actually a cult shilling “faith based’ chiropractic services. You can’t make this stuff up.

The paperwork said this first appointment would be for taking x-rays, photos, and an initial exam. The next appointment would be for a cleaning, and the follow-up appointments would be for any necessary treatment. The first appointment was covered by my insurance.

A technician brought me to a room for x-rays, and proceeded to take x-ray after x-ray until she was satisfied with the set of digital results that immediately popped up on the screen. I counted about 25 or 30 images. Thank goodness for the large lead vest covering my whole body, or I'd surely be radioactive. In another examining area, a second technician took digital photographs of my entire mouth with a panoramic camera wand. Clearly, this was the latest in fancy dental imaging technology. I was impressed with the detail of the imagery, and the speed with which dentists today can get all the information they need to see what's going on in my mouth. The technician also took my blood pressure, but didn’t tell me if it was normal or not, odd in itself, but also curious as to why they would take my pressure when they weren’t doing any procedures.

At last, the dentist, Dr. D., came in to see me. I couldn't really see his face, since he wore an N95 mask, and magnifying loops on top of his spectacles. What I could determine right away was that he was a gruff Asian man, who seemed indifferent to my dental circumstance. He never asked how I was doing, or even introduced himself. He looked quickly at the x-rays on his screen, and the photos on another. He looked inside my mouth and poked at the gum area of each tooth with a sharp tool, and called out some rating code to his assistant who recorded numbers from 1-5 by each tooth on a digital chart. It took about five minutes altogether. Time looking inside my mouth: 30 seconds.

He spoke: "the crown is fine. We can't do anything about it. You have to go back to your other dentist to have them look at it.” “Wait,” I said, “what about the tooth next to it that hurts me. Is the filling broken?” “There's nothing broken,” he said quickly. There's nothing we can do. You have some bone loss, and gum recession." 

He added, "You need a deep-cleaning," and he walked away.

The assistant said they'd have to submit my x-rays to Medi-Cal to get approval for coverage for the deep-cleaning. “Don’t you have a hygienist that does a regular cleaning” I asked. “No,” she said, “only the doctors do the deep cleaning.” She told me I'd also need to do some deep-cleaning preparation at home, and that's not covered by insurance.

"How much is that?" I asked. "$1,000," she said. I laughed. "Um, I don't think so! I'm not spending $1,000 out-of-pocket; I certainly don't have that kind of money!"

She showed me the kit they were up-selling: upper and lower plastic trays made from impressions that they'd need to do in the office, 10 tubes of some substance you were supposed to fill the trays with and keep them in your mouth for 15 minutes twice a day, an electric tooth brush, and more. She told me the insurance might not be approved if I didn't buy the home care package. 

Now, all I could do was smirk at her as I held onto my firm, “no.” She said they'd submit my x-rays anyway, and she made me another appointment for 3 weeks hence.

When I got back to my car around the block, I Googled “dental deep-cleaning" and learned that it's an invasive procedure where they have to numb your gums, go down under the gum line with some sadistic tool that actually separates the gum from the tooth to remove bacteria and plaque, and it can take 4-6 weeks to heal, leaving your gums raw, and your teeth feeling loose in the process, and they might not reattach.

Ah...no thanks.

Even if my insurance approved the deep-cleaning, I decided I'm NOT going back to Western Dental for any reason. I could smell a scam loud and clear. I looked up “Western Dental scams,” and there was an endless list of warnings, and terrible one-star Yelp reviews, where reviewers said to “run as fast as you can away from the place,” and called them conniving, rip-off con artists, and professional scammers who never actually do any dental work after dragging you in for four visits.

Three weeks later, as the "cleaning" appointment approached, I called up to cancel it. Western Dental didn't pick up the phone and the call bounced to a call service. I left a message with them to cancel the appointment. Someone didn't get the word, and now they began texting me reminders of my upcoming appointment.

I tried to call the local office number and it kept going to voicemail. I gave up. On the day of the appointment, I just didn't go. I thought that would be the end of it. But, no, it wasn't.

My insurance carrier, Medi-Cal, had actually approved covering the deep cleaning procedure, even though Western Dental never called to inform me. Now I started getting texts reprimanding me for not scheduling an appointment for my "recommended government-sanctioned cleaning procedure." They emailed and called every day, leaving me stern messages. The messages warned, "you need to schedule your appointment before the approval expires."

Ah, no, I will not. I won't be bullied by a scam artist who is attempting to leach money out of the government insurance company for an unnecessary dental procedure. 

I dodged a dental bullet today. I sure miss my wonderful dentist from back home. 

My search for a dentist continues.