Maybe this has happened to you: You go to the dentist. They say you have a serious cavity in a tooth that has never really bothered you and suggest an expensive medical procedure to take care of it. You might start wondering: How serious is this? What would another dentist say?
If you’re feeling lukewarm about making a big dental decision, it might be time to get a second opinion.
“It makes sense to get a second opinion any time a patient feels uncomfortable about what is being recommended for treatment,” says John Da Silva, medical director of the Harvard Dental Center. “The patient is the best judge of what they need to increase their comfort levels.”
Getting a second opinion has become more and more common in various corners of healthcare. In the field of dentistry, where one dentist’s suggestions may differ drastically from the next, getting a second opinion could save you time, money and discomfort. One study found significant differences in the way dentists make clinical decisions, attributing them to factors including age, financial pressure and differences in dental curriculums across the world. Another 2019 study published in the Account and Financial Management Journal found a wide range in prices for dental services like teeth whitening or cleaning across the US.
All in all, sometimes you might just want another medical professional to weigh in. Here’s some advice.
There’s more than one solution to every dental problem
People most often seek second opinions for dental work because they don’t understand the treatment or they are balking at the cost, says Sally Cram, a periodontist in Washington, D.C. and spokesperson for the American Dental Association.
“The first thing to do is have a discussion with your dentist and try to understand what your problem is and what the possible solution may be,” she says. In many cases, there is not one clear treatment. “Some dentists practice conservatively, trying to minimize treatment as much as possible, while others are more aggressive.”
If you have a cavity, for example, one solution might involve filling in the tooth. But that can be risky; later on, the tooth could still break or require a root canal. Another option would be to skip the filling and add in a crown, which would protect the tooth from cracking. But when you have a crown on a tooth with a deep cavity, you may eventually need a root canal and further treatment, which could mean even more costs down the road.
So a dentist might conclude that removing the tooth and replacing it with a bridge or an implant is the best solution, even if it’s the most expensive option.
“There’s often two or three different ways to treat a particular problem,” Cram says. “The issue is to understand the pros and cons of choosing each of those treatments so you can make an informed decision.”
Make sure you’re communicating with your dentist
Before getting a second opinion, talking to your dentist about why they have recommended a particular treatment path could help avoid a communication breakdown.
“Have a discussion with your dentist and tell them if you have time constraints, money constraints, are fearful of the dentist, anything like that,” Cram says.
If a dentist proposes something out of your price range, ask if there’s an alternative or a way to stage the treatment over time to defray costs. If there’s no other option, Cram says it might be time to go find a second opinion.
Often, patients are reluctant to get a second opinion. One 2011 study in the Journal of Marketing Research found that patients are unlikely to challenge a dentist they’ve been seeing for a long time. But the American Dental Association recommends second opinions for patients who are unsure, as does the American Academy of Pediatric Dentistry and the American Association of Oral and Maxillofacial Surgeons. A good dentist will not discourage you from getting a second opinion; they might even suggest it.
Legally, per the ADA, you have the right to see, review and request copies of X-ray images of your teeth. Your dentist may charge you for copies of these images, but they have to give them to you. This could help you save money when seeking a second opinion, because it could help the second dentist avoid ordering another set of X-rays.
If you’re getting a second opinion, check in with the new dentist to see if they agree with the initial diagnosis and ask them what could happen if the problem isn’t treated. It’s also great to ask about the the difference in treatment costs and the long term risks and benefits of any suggested treatments.
Hot topics dentists disagree on:
Wisdom teeth removal
Dental experts have disagreed for years on whether wisdom teeth need to come out. Some of the latest research concluded that if your wisdom teeth aren’t bothering you, they’re fine to stay. If a dentist recommends pulling all your wisdom teeth, even if they aren’t bothering you, you might want to seek a second opinion.
Dentists also sometimes disagree on how to treat cavities. In one 2012 study published in Community Dental Health, researchers found that dentists tended to overestimate the presence of cavities. Some dentists might think a tiny fissure needs a filling, while others are content to leave it.
Another contentious issue is cosmetic dentistry, which is usually elective and not related to a disease or underlying problem. Cosmetic dentistry is expensive and can involve lots of visits, so Cram recommends trying a budget-friendly approach like teeth whitening before getting veneers or crowns to change the color of teeth.
“That’s probably the thing people get second opinions on the most,” she says. “It’s important to be really clear with the dentist about what you don’t like about your teeth, because there’s so many ways to treat cosmetic issues.”
Who pays the bill?
In many cases, a second opinion comes at a cost to the patient.
“Second opinion coverage depends on the insurance plan the patient is enrolled in,” Da Silva says. “Some cover it and others do not.”
Depending on your insurance plan and premium, a second opinion may have to come out of your own pocket. You may be able to use HSA funds to pay for a second opinion, depending on the specifics of your plan. While Da Silva usually leaves the decision to get a second opinion up to his patients, he encourages them to seek one if they seem hesitant to move forward with a treatment plan.
“The key thing is feeling comfortable,” Cram says. “If you don’t feel comfortable, and you feel like you’re not being listened to, it’s time for a second opinion.”