In March 2015, a U.S. District Court ordered a Knox County dentist to return $500,000 to a patient. The Rockport dentist had prescribed the patient unnecessary procedures.

The lawsuit from Tennessee is not a one-off incident. It may be part of a worrying trend. “I believe I’ve noticed an increase in the skill of what I call ‘creative diagnosis’,” wrote Jeffrey Camm, DMD, on the American Dental Association (ADA) website in 2013. In dental circles, “creative diagnosis” is the euphemism for “unnecessary treatment.”

Acrophobia-inducing student loans, the rise of large dental chains, reduced reimbursements, and diminishing coverage for some procedures are prompting some dentists to partake in creative diagnosis. This is troubling.

If you brush and floss every day, you will most likely not need any dental work, other than two basic cleanings twice a year.

But dentists cannot increase their income through basic cleanings. So some practitioners try to sell you procedures that you do not need.

It can be difficult for you to know when your dentist is genuinely thinking about you and when profit is dictating his or her mind because, like most individuals, you may not know much about dentistry. But other dentists do.

One way to reduce your chances of being ripped off is to consult a second dentist when you notice any of these red flags:

Your dentist may be ripping you off

Red Flag 1: Your fillings need to be ripped out and replaced.

It is an old trick.

If you go to a new dentist, he or she may tell you that your mouth needs a ton of work. Frequently, it means replacing your existing fillings with new ones. Unless you are in pain and your fillings are decayed, it is unlikely that you will need them replaced all at once.

Red Flag 2: We offer free cleanings.

Some dental practices offer deals, such as a free cleaning or a free whitening. Often the intention behind such offers is to get you in the door.

Once inside, you are bombarded with expensive treatment plans that you may or may not need. Their marketing can be quite convincing.

In the long run, you will find it cheaper to pay for cleaning or whitening at a practice that does not offer over-the-top deals than rushing to cash in an attractive offer.

Red Flag 3: You need expensive fluoride toothpaste.

Fluoride toothpaste is unnecessary for most adults because drinking water and over-the-counter toothpaste contain enough fluoride to prevent cavities.

In most instances, it is unethical to sell costly fluoride toothpaste to a patient who does not have a ton of cavities.

Red Flag 4: You need veneers.

Selling veneers are lucrative. Many dentists try to push them to their patients.

Do not let yourself get talked into spending thousands of dollars for what is a purely cosmetic treatment.

If your teeth are in good shape, you will find that whitening is a less expensive option. Veneers are recommended only for patients whose teeth look awful.

Red Flag 5: You cannot see X-rays.

Your X-rays are your property. The law requires your dentist to turn them over to you so that you can see them or show them to another dentist.

Do not be lax if you are not comfortable with the treatment. Demand your X-rays and visit a second dentist. It can save you a ton of money.

Though the dental community in the U.S. is not in agreement over if the creative diagnosis is a becoming more prevalent, almost everyone accepts that unnecessary treatment is a real problem.

It is unrealistic to expect any positive changes any time soon. If you are a patient, you can consult Dr. Safarian, DMD, for a second opinion if you are uncomfortable with your dentist’s treatment.

Dr. Safarian is the Official Dentist of the San Diego Sockers, a member of the American Dental Association, a LVI Fellow, and a critic of creative diagnosis. He firmly believes that patients should only receive the treatment they need; nothing more, nothing less.

You can arrange your free consultation with Dr. Safarian by calling (858) 755-8993 for his San Diego office or (619) 656-6785 for his Chula Vista office.