Going to the dentist can be stressful for many people, so it’s equally unnerving to find out your dentist is charging you for procedures you don’t need. The majority of dentists are ethical, but the Coalition Against Insurance Fraud says that although fraud only occurs in a small percentage of practices, there’s likely more of it out there than we realize.

Dentistry can be more vulnerable to fraud than other medical practices. Certain aspects of the profession make it easier for an unethical dentist to perform unnecessary procedures.

Diagnoses are more subjective

Since dental diagnosis can be subjective, whether or not you need a certain treatment can fall into a bit of a gray area. Two separate dentists might disagree on the same diagnosis. Whether or not they suggest a procedure depends on their own philosophies. Some dentists might want to wait before doing a procedure, whereas others might be more aggressive and want to work on it at once. This makes insurance fraud more difficult to detect because at times it’s hard to truly say whether a procedure was unnecessary. However, there are some dentists that will abuse this subjectivity.

Less oversight

Since dentistry has less oversight than other branches of medicine, unethical dentists can abuse diagnoses to squeeze more money from your insurance than necessary. Unlike other medical practices, a single dentist doesn’t really have anyone looking over their shoulder. This leaves the profession more open for dishonest dentists to take advantage of patients since they rarely get audited by the insurance companies.

The nature of dental insurance

The payout for dental insurance is generally capped at around $2,000 per year per person. So there’s less scrutiny over every charge. It’s easier to slip unnecessary procedures in to pad the amount that insurance will pay.

Also, insurance companies will sometimes have incentives for dentists agreeing to be in network. The insurance company will pay them by patient as opposed to how much treatment they give. The dentist then gets a steady stream of patients and a certain amount of money per head from the insurance company no matter what their costs are. An unethical dentist might try and reduce overhead costs to pocket more of the money. For example, they might encourage treatments that aren’t covered by insurance while putting off work that is covered.

So how do you know if your dentist is squeezing money out of you from unnecessary treatments? If your dentist is suddenly recommending a lot of expensive treatments and you’ve had little or no dental problems up until that point, you might be sitting in the chair of an unethical dentist. This is the most common form of insurance fraud in dentistry.

A second opinion is always a good thing if you’re being told you need extensive work done, especially if the dentist is pressuring you to get all of the work done immediately. Quarterly cleanings and excessive X-rays might not be necessary if you have no history of dental issues.

Also, watch out for dentists that advertise heavily with specials and deals. An unscrupulous dentist might get you in the door cheaply only to pressure you into expensive and unnecessary treatments. Choosing a dentist by word of mouth or real testimonials can help you to avoid the small but growing number of dentists who put financial gain above their patients.