Dentists subject to consumer drilling

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An investigation by the Norwegian Consumer Council has exposed widespread irregularities among Norwegian dentists, who already have been under criticism for their high prices. Four test subjects visiting five dentists each received wildly different, and mostly incorrect, treatment options.

Many Norwegians complain about the cost of dental treatment. The Consumer Council's research suggests there should be question marks over the consistency and quality of treatment too. PHOTO: Erik Christensen

Going to the dentist is an expensive exercise in Norway, prompting many Norwegians to seek treatment outside the country. The quality of care in, for example, Sweden or Poland, is considered high and prices much lower.

Norway’s Consumer Council (Forbrukerrådet), working with the state health care regulators, decided to test dental practices at home. It randomly chose five different dental offices for its test subjects to visit within the Oslo area, having first sent the subjects for an examination with the vice-dean of the University of Oslo’s Faculty of Dentistry, Morten Rykke, who issued his own evaluation of what dental treatment would be needed.

In one case, a dentist proposed 15 fillings at a cost of NOK 12,700 (just under USD 2,300), while another told the same patient that no fillings were necessary. In another, the patient was told that they needed nine fillings and root canal work costing nearly NOK 23,000 (more than USD 4,000), but found a second dentist that suggested only one normal and one root filling.

Rykke evaluated all of the treatment options offered after the visits, and deemed only three of the 20 suggestions to be worthy, while six were seen as having given “bad treatment” and another three were described as “worthy of criticism.”

A press release from the Consumer Council attacked the “unnecessary and expensive” solutions offered by the dentists, who often “pressed hard in order to start comprehensive and costly treatment immediately.” The report was particularly critical of the quality of treatment for one of the test patients, who had many large cavities in his teeth, as well as fittings and crowns in need of attention, which were not discovered in their totality by any of the dentists visited.

These results led the Consumer Council’s Terje Kili to tell newspaper Aftenposten that “you simply cannot trust your dentist – unfortunately.”

‘Wild West’
Kili was clearly shocked by the findings, describing them as “like the Wild West.” He also was concerned the patients had not been afforded the level of advice and guidance supposedly made mandatory by Norwegian law, and for which the Consumer Council has already produced a guidance document aimed at dentists earlier this year. “Patients are entitled to be made aware of the doubts the dentist has about which treatment is needed,” Kili said. “This was only addressed by one or two of the dentists in the study.”

Responding to the fact that that the Consumer Council itself had found 98 percent of respondents asked in 2006 to be happy with their dentists, Geir Røed, who was responsible for the research, described this as a “paradox.” But he was quick to suggest that the levels of satisfaction might well be down to fact that most people do not get several opinions in the way that the test subjects did, stating that “the majority only go to one dentist and do not know what another would say.”

He added that “price, availability and good pain relief” were what most consumers looked for in a dentist, rather than quality.

‘Not a good picture of the process,’ say dentists
A spokesperson for the Norwegian Dental Association, Morten Harry Rolstad, told Aftenposten that he agreed that “this study says something about the importance of talking with dentists, asking and discussing which treatment alternatives are available.”

He suggested, though, that the report “does not give a very good picture of that process, because the majority of the patients in the test only had one consultation,” stressing that “dental treatment is a process” and that differences in treatment would even themselves out over time if patients remained with a dentist they liked “for a while.”

He also claimed that the dentists involved gave a different version of events than the one produced in the report, and a press release by the association later criticized the fact that “it is only the patients’ version of events that is heard.” Rolstad argued that Norwegians should trust their dentists, but “not be afraid to ask questions.”

Dental appointments on holiday in Thailand
The survey comes as greater numbers of Norwegians choose to travel to other countries in order to seek cheaper dental treatment. Sweden, Turkey, Estonia, Hungary, Poland and even Thailand are the main countries chosen by an estimated 100,000 Norwegians so far, and there are companies operating in Norway that help potential patients find suitable practices in foreign countries. Many plan dental appointments as part of their holidays.

Views and News from Norway/Aled-Dilwyn Fisher
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