I refuse to pay for this dental service - how should I proceed? - Page 2

[mnnice]

Originally Posted by laohaire 

He didn't provide the service, though. I mean, he is obviously out some costs since he used the novocaine, he and an assistant spent 20 minutes, etc. But the procedure was not finished. We will need to go to another dentist to have the cavity drilled and filled, which could have happened yesterday but did not because of the dentist's (not our) choice. We will need to pay the full amount as if we never went yesterday. Since the tooth was opened, we also are running a risk of infection and who knows what.

And how is that different than my vasectomy example other than you knew right away that it didn't work?  If you had brought DD in and she refused to open her mouth period to me that would be different.  I think it would be unreasonable to charge in that situation.

[crunchy_mommy]

Originally Posted by mnnice 

And how is that different than my vasectomy example other than you knew right away that it didn't work?  If you had brought DD in and she refused to open her mouth period to me that would be different.  I think it would be unreasonable to charge in that situation.

But a known risk of vasectomies is that they may fail. You probably signed a paper to that effect before it was even done. This is more like if the doctor had stopped partway through the vasectomy.

[mnnice]

Originally Posted by crunchy_mommy 

Originally Posted by mnnice 

And how is that different than my vasectomy example other than you knew right away that it didn't work?  If you had brought DD in and she refused to open her mouth period to me that would be different.  I think it would be unreasonable to charge in that situation.

But a known risk of vasectomies is that they may fail. You probably signed a paper to that effect before it was even done. This is more like if the doctor had stopped partway through the vasectomy.

I didn't sign any waiver, but I am sure that DH signed something to that effect.  I guess a significant portion of men never bother with the post op testing.

Yea I do see you point about stopping before he had really finished. 

But most dental procedures have a risk of not working too (fillings, root canals, implants).  I know lots of people who have had root canals that have never healed well enough to put the crown on and have ended up paying for the root canal and then paying again to have the tooth extracted.

[laohaire]

Yeah the analogy would be that the doctor suffocated you during the vasectomy and then said he would not finish the procedure because you kept gasping for breath and trying to tell him you couldn't breathe. Or maybe that the numbing agent didn't work and he instead threw his tools down and walked out instead of dealing with it.

The better dental analogy to the vasectomy situation would be that the dentist filled the cavity but it later got reinfected and needed to be redone. And we have in fact willingly paid for something that might turn out to be just that: DD's first filled cavity (by another dentist) may have been too deep, but he stopped when he felt he was pushing the limits and refilled her up. He explained that we would need to monitor for any pain in that tooth. Therefore the procedure may have failed, but it was a best effort and we understand the risks.

Yesterday's fiasco was not a best effort at all. The procedure is NOT done and we are worse off than we were before, not due to bad luck but due to his incompetence. The procedure could have EASILY been completed to our satisfaction.

[lmonter]

What the hell is with pediatric dentists, I'd like to know?

Sounds like you got a bum one.  :(  Someone has to graduate at the bottom of their class, you know? 
The pediatric dentist I took my 2yo to last week was very gentle (as was the nurse/assistant/whatever) and they would just coax her to open her mouth by doing something funny, talking gently, telling her what they were going to do, etc.  With me sitting beside her on the exam table to help keep her still and reassure her.  He totally explained all we'd need to do next time (she had some cavities, how, I don't know), that I get to sit there with her in my lap, what they'd do, how they were going to do it, everything.  That said, my regular dentist is the one that recommended the ped one to us since my regular dentist doesn't see kids until 4+yo (when we first took in our older boys and they did great with the cleanings and everything).

Fwiw, dental insurance typically only pays out the cleanings, x-rays, and $1K/year of dental work.  So you're still paying for quite a bit out of pocket, and heaven help you if you need a root canal *and* a crown.  So while it's nice to have, it's not exactly good for anything catastrophic like playing hockey or something.  ;)
 

[ShwarmaQueen]

There are temporary fillings that you can get at any Wallyworld, target, etc. That might make it feel better if it's bothering her. Poor thing, im sorry she had to go through that.

DD uses a regular dentist who is truely kid-friendly. Maybe ask around at mom's groups for recommendation?

[KristyDi]

I agree with the PPs who've suggested sending the letter to the dentist and complaining to any dental or licensing boards you can find along with the BBB.

As to payment, would you be willing to pay for say, the nitrous, but not the temporary filling.  That might keep him from sending you to collections.

DD has had major issues with her teeth and we've had an awful experience with a peds dentist.  I couldn't believe that man chose to work with kids.  DD and I were both in tears by the time I grabbed DD and walked out on him.

But now we've found a fabulous ped dentist who we both love.  She's friendly and so patient and hires staff that are similar.  So don't give up hope.  Great ped dentists do exist.

ETA, we don't have dental insurance either.  Our ped dentist gives us a 10% cash discount.

[goldenwillow]

Oh man.  I am sorry to hear this pedi was an ass to your child.  I personally (in my dental experience) have only met 1 pedi that was good with kids.  Sad really.  Most that I have met do not even have kids.  Was this the holistic pedi I think you were going to?  Or was that for you... sorry I forget. 

SO..  in my experience... 

I would, like others have said, write a letter (send certified) explaining the whole visit and how your daughter could not breathe and was telling the dr. that too.  That right there is huge.  I am sure the staff talked about it with the dr. in a morning huddle/meeting the next day (hopefully).  I also think that he was abusive in not allowing the novacaine take affect.  That is just horrible.  Hopefully the decay wasn't too deep and maybe that is why he went for it.  I would be careful in your writing about that piece of the visit.  Mainly because most dds' (not all) have this idea that they know everything and that would really be attacking his education and judgement.... even though we know he is a ass..... to get this bill off the record, I would dance around that lightly, stating that the novacaine takes a bit to set.  I know I would want to be on a soap box in front of his practice yelling how horrible he is/was. 

I personally would wait a little bit (billing cycle) to see if the bill is gets washed away though your letter...  then go ahead with the BBB/dental board/etc regardless of the outcome. 

Just my 2 cents. 

Oh... since the tooth is compromised right now, some oregano oil would help.  Be sure to keep it clean and hope you can get it fixed really soon.  Can also buy temp bond filling material usually at a pharmacy... again just be sure the tooth is completely clean as not to trap bacteria/food in there. 

Sending hugs to your family.  I am so sorry that the dentist has been such a hard experience for your family.  It can be good again.   

[laohaire]

Thanks for continued input. I am going to write the letter - in fact DH already wrote a draft but I wanted to tweak it. But for some reason I seem to be avoiding it, I'm still upset about it.

This was not the holistic dentist, Xantho. We saw the holistic dentist and he successfully filled one of DD's cavities (an urgent, deep one). The holistic dentist, who I still like and respect and may see again for ME, apparently does not that well with kids. We were honestly a little upset after we left, but that was nothing compared to this week's visit. The holistic dentist said some things that were really not cool at all, including telling DD she was being a "bad girl" at one point when she was crying (crying, but not preventing treatment). Yet he still treated her like a person, talked to her, at least tried to help her through the process, said mostly kind things, etc. We decided to take her to the pediatric dentist instead of returning to the holistic one given that it wasn't a great experience (though not an utter disaster, by comparison). The pedi dentist treated DD like an object, and specifically an object that was interfering with his day. He did that from the very beginning. Ah, here I go recounting it all again, sorry guys, I tend to do that.

I think we will do the letter and just go from there. While I'm not counting on it, I think there's a reasonable (though small) chance we just might never hear from them again and that will be that.

One thing that is on our side is that we were referred to this pedi dentist by a regular dentist. (Sorry, I know, we've seen so many). I called the regular dentist's office yesterday and explained the situation. The receptionist I talked to was upset to hear it, and when she called back she said the dentist was upset too. This dentist is extraordinary in his customer service skills, so this would actually and truly concern him. Not to be confusing, but he referred us to to a specific pedi dentist, who owns the practice. He said specifically that it had to be HER. I got the message, and made sure to communicate that. We got an initial visit with her, and she set up a treatment plan. Then we made the first treatment appointment, and I was surprised to see that we didn't get her (though her name is on the appointment card I have), we got what turned out to be her part time associate.

So I'm sure SHE is a good pedi dentist, and I think there is a really good chance our regular dentist will call her up and discuss it. I'm also sure that whatever is said will gloss things over (since neither dentist was there and she'll have the story from her associate's point of view) but at the same time, our regular dentist has an upset patient, and he's a colleague and major referrer of hers. Even if she believes her associate and thinks we're nutcases, there is a bit of pressure here for her to just back off, I think. Since the regular dentist was careful to say it had to be HER I am thinking there have been complaints in the past about the associate. And that's a big deal. Since the regular dentist is so huge on customer service, he may honestly have to think twice about referring anyone to the pedi dentist again, even if she is that terrific, since she apparently has a major liability on her staff.

[swd12422]

Can your dentist (the one who gave you the hopefully better referral) shed any light on how he thinks the pedi dentist should handle this? Just wondering from a dentist's perspective what he feels should be billed. Obviously, NOT the entire amount, b/c the work wasn't done.

I would wait til you get a bill. Then ask for a detailed itemized bill. When you look at it, you can see what was actually done and what wasn't. If you don't want to ruin your credit by refusing to pay at all, maybe you can agree to pay some of it, like for the office visit, since you were seen, and the novocaine. MAYBE the temp filling. But nothing more. Then send your letter explaining that this payment is the full amount you intend to pay for the services rendered, and that the remainder represents services that were NOT rendered due to the dentist stopping in the middle of the procedure and announcing his refusal to finish. It was HIS choice not to finish, not yours, so he shouldn't be paid. (And yeah, actually, just the fact that he didn't finish means he doesn't get paid in full, but make it clear in the letter that that was his choice, not yours.) And furthermore, since you'll now have to pay another dentist to finish, you'd like him to pay for all the other stuff the new dentist will have to do that you are paying for from this visit. The bill will follow by mail as soon as it is available. Thankyouandhaveaniceday. Something like that, anyway. I hope it works out for you.

[goldenwillow]

Urgh...  sorry to hear that the holistic one said those words to your DD.  Just because they are holistic, doesn't mean they are this or that...  so frustrating.

Good work on contacting the original referrer.  That also is a huge move on your part.  No DDS likes to piss off the original referrer.  That is a main bread and butter.  My hope is that will resolve the issue before you have to go to battle, sort of speak. 

My heart aches for your little girl and for you and your husband.  I used to hear so many horror stories from adults about dds' back in the day.  You would think with all the knowledge today, these things wouldn't happen anymore. 

The mouth is such a private, personal orifice. So many dds' don't get that. 

[Ellien C]

sorry about DD and you've already been given good advice. 

I just had to chime in "What is the deal with Dental dams?!" I had one ONCE and I had the feeling like I was suffocating. I talked to the nurse or something and she was like - refuse it next time. I never went back to that dentist and none has used it before or since on me or my kid. Someone told me it's like a dental school kind of thing and experienced dentists shouldn't use it. This was years ago, though. 

[goldenwillow]

They are a just a precautionary measure so no toxins, dental clamps, too much water, metals, etc...  are swallowed.  I do think most procedures do not warrant a dam.  Especially for a child, however, a lot of dds use bite blocks with kids to keep their mouths open and they do not want to risk the kiddo choking.  Dams are usually used by rookies, by the book or not great/lack of finesse dds.  On the other hand, I have seen dds that have great skill use them because an amalgam filling or the tooth was severely fractured and they didn't want to risk the air hand piece not being able to suck it out effectively.  Just depends.  I feel they are widely overused.  Dentistry is an art.  Not all seem to be artists.   

[spedteacher30]

A co-worker of mine had a previous bad dentist pay for her work to be redone by a dentist who was capable of not destroying her mouth. She did it through the dental licensing board and professional accreditation group for the state. I believe she paid the first dentist in full to protect her credit score and then filed official complaints. Her bill that was covered by the first guy's insurance was well over $10K.

[spedteacher30]

A co-worker of mine had a previous bad dentist pay for her work to be redone by a dentist who was capable of not destroying her mouth. She did it through the dental licensing board and professional accreditation group for the state. I believe she paid the first dentist in full to protect her credit score and then filed official complaints. Her bill that was covered by the first guy's insurance was well over $10K.

[GoBecGo]

I'm shocked by this thread!

I'm in the UK (with our terrible teeth, right?) and i have NEVER had such an experience with a dentist!  We've had 2 dentists (since i had the kids, i've had about 6 in my life) and are seeing our 3rd for the first time next Monday (our previous dentist has gone travelling so we had to either wait for a random replacement or move to a new practice and our old place was far to travel so we decided to move).  Until DD1 was 3 she never even sat in the chair, the dentist asked ME to pull her lips back and she looked at the teeth with no tools at all.  Now DD is older she jumps in the chair and has the mirror and pick in there, and has her teeth counted and so on.  She *touching wood* has never needed any treatment, but in 16 extractions (for orthodontic reasons, not decay, don't ask!), 5 fillings and a whole bunch of cleanings i have NEVER encountered a dental dam except in sex ed at school!  Here in the UK we don't have pedi dentists - just dentists.  I would DEFINITELY complain to the dental board and whoever licensed this man if i had this experience.

Also, FWIW my friend, terrified of dentists, got a "temporary filling" done when she was 9, because she panicked midway through and the dentist said she'd place a temp and then finish the procedure in a few weeks, and that filling stayed in EIGHT YEARS before she finally went and got it replaced.  The dentist HAD drilled all the decay out before (though wasn't sure of having done so) placing the temporary and i'm not advocating leaving it so long, i just thought i'd mention it because it might mean you don't worry too much about rushing to get it replaced, and can take your time finding a better dentist this time.

[Agatha_Ann]

I agree with most of what is being said about writing a letter and contacting the BBB. I do think you should pay for the work that was done, but that is just my personal opinion. I think a problem might be that you consented to the dental dam. Even though you said "try" it was still ok'd by you and your DH. I would see a much bigger case for a full dismissal if you flat out refused and it was used anyway or if you had no experience with it and then your DD had a hard time. I worry that since it was discussed that you know how she reacts and still agreed might make the complaint hold less water.

We have the most amazing ped dentist ever. I wish I could go to him! My oldest and my third have both needed fillings and my DD had to have some other spacing work done. This man is so gentle and soothing, none of them even know that they have ever had shots in their mouth. They all countdown the days in between visits! So don't give up. There are great ones out there. I'm so sorry your DD had to go through such a negative experience. I remember what it was like when I was little and I still have the hardest time making appts for myself.

Oh and like a pp mentioned about temp fillings...I've had one in my mouth for 11 years! I know thats awful, whenever I get to the dentist, they always want to do something else first and then I'm pregnant all the time, and I forget about it, anyway don't let it go forever, but you have a little time to find the right dentist.

[SundayCrepes]

I agree about the letters and online reviews.

Our pedi dentist is great. We don't have dental insurance because the 2 pedi dentists the insurance covers don't allow parents in for procedures. I can't imagine doing that. So we pay full cash to our dentist. When my son wanted purple gloves while the dentist was putting on blue gloves, the dentist changed to purple. Lots of behaviors like that.

I wanted to comment about the blood draws. If your kids need blood draws or any sort of shots, get the doctor to write a prescription for Emla cream. It is a topical anesthetic. You put it on the area to be stuck about an hour before the procedure then cover it with a tattoo type bandaid, saran wrap taped around the four edges, etc. My one year old calmly watched  while the phlebotomist stuck her. No pain, no screaming. It's insane that this isn't offered to every child. I've received shots with the stuff on and you don't feel the shot. Some people don't like it for lab draws because it can make the vein constrict, but I just googled it and it says that if you leave it on longer than an hour that's not so much of a problem. I haven't had much problem with that even with it on less than an hour. Google also says another product, Ametop Gel, works just as well but doesn't cause vasoconstriction.

Also, I am an RN, I've had to do a lot of venipunctures. I'm good. I can start an IV on a 1 pound baby. More impressive, I can start an IV on a fat 10 pound baby. But every now and then I miss. It sucks when you have to dig for the vein, but sometimes that happens. Don't blame the phlebotomist. Most likely they're good at what they do and it's just a bad stick. It's awful when it happens to an adult. When you do it to a child it's even worse. I know I break out it cold sweats when that happens to an adult and when it's a kid I just want to die.

[crunchy_mommy]

Originally Posted by SundayCrepes 

I wanted to comment about the blood draws. If your kids need blood draws or any sort of shots, get the doctor to write a prescription for Emla cream. It is a topical anesthetic. You put it on the area to be stuck about an hour before the procedure then cover it with a tattoo type bandaid, saran wrap taped around the four edges, etc. My one year old calmly watched  while the phlebotomist stuck her. No pain, no screaming. It's insane that this isn't offered to every child. I've received shots with the stuff on and you don't feel the shot. Some people don't like it for lab draws because it can make the vein constrict, but I just googled it and it says that if you leave it on longer than an hour that's not so much of a problem. I haven't had much problem with that even with it on less than an hour. Google also says another product, Ametop Gel, works just as well but doesn't cause vasoconstriction.

Also, I am an RN, I've had to do a lot of venipunctures. I'm good. I can start an IV on a 1 pound baby. More impressive, I can start an IV on a fat 10 pound baby. But every now and then I miss. It sucks when you have to dig for the vein, but sometimes that happens. Don't blame the phlebotomist. Most likely they're good at what they do and it's just a bad stick. It's awful when it happens to an adult. When you do it to a child it's even worse. I know I break out it cold sweats when that happens to an adult and when it's a kid I just want to die.

I didn't know about ELMA cream until too late.... My DS doesn't like other people touching him -- so he was upset more about that than the pain (he barely notices pain), and then when the digging started he just lost it. I wouldn't blame the phlebotomist if she missed once or twice, but what happened with us was way worse... she was just not good at what she was doing and she refused to remove the needle while we switched from me holding DS to DH holding him (she insisted on the switch ), then kept digging around etc. again after we told her to stop the blood draw... his arm was all purple & bruised afterward...