,
11 tweets,
3 min read
Read on Twitter
1/ In 2012, a young dentist named Brendon Zeidler purchased a dental practice from John Roger Lund, who was retiring, and Zeidler assumed responsibility for Lund’s patients. It took only a few months for Zeidler to suspect something was very, very wrong. theatlantic.com/magazine/archi…
2/ While reviewing financial records, Zeidler saw a major discrepancy in the income he was making versus Lund’s reported earnings from the practice. Furthermore, Zeidler noticed that many of Lund’s patients had undergone extensive dental work.
3/ Zeidler would eventually allege in court that Lund had performed invasive, costly, and seemingly unnecessary procedures on scores of patients. A typical dentist might perform root canals on previously crowned teeth in 3 to 7 percent of cases; Lund performed them in 90 percent.
4/ More than 50 of Lund’s patients had ludicrously high numbers of root canals, and Lund also apparently billed patients for treatments he had never administered.
5/ How did this happen? A multitude of factors has conspired to create both the opportunity and motive for widespread overtreatment in dentistry.
6/ Because dentists’ income is entirely dependent on the number and type of procedures they perform, it’s easy to see how they would be tempted to buoy their income with frequent exams and proactive treatments. It’s even easier to see how that could quickly escalate.
7/ Furthermore, about 80 percent of the nation’s 200,000 dentists have individual practices, and they aren’t subjected to the same oversight as practicing doctors.
8/ A team of researchers at ETH Zurich, a Swiss university, found that 50 of the 180 dentists selected as part of a study suggested unnecessary treatment when visited by a volunteer patient.
9/ A @ReadersDigest investigation visited 50 dentists in 28 states and received prescriptions ranging from a single crown to a full-mouth reconstruction, with prices ranging from $500 to 60 times that at nearly $30,000.
10/ Finally, though there are dozens of journals and organizations devoted to evidence-based medicine, there are only a handful devoted to evidence-based dentistry.
11/11 That's perhaps the biggest problem: In many respects, dentistry remains an art as much as a science. There's no strong empirical basis for many of the decisions dentists must make. Read @ferrisjabr for more on the trouble with dentistry: theatlantic.com/magazine/archi…
