How common is fraud in dentistry?

Updated: Mar 18, 2023

Dentistry, like any other field of medicine, is unfortunately not immune to fraud and billing mistakes. Fraud in dentistry can take many forms, including overbilling for services, performing unnecessary procedures, using substandard materials or equipment, and even insurance fraud. It is difficult to quantify the exact extent of fraud in dentistry, but it is believed to be a relatively rare occurrence.

One of the reasons that fraud in dentistry is relatively uncommon is that the vast majority of dentists are ethical and honest practitioners who have their patients' best interests at heart. Dentists take an oath to do no harm and to provide the best possible care for their patients, and most dentists take this responsibility very seriously.

However, there have been cases where dentists have been caught engaging in fraudulent practices.

For example, in 2018, a dentist in California was sentenced to eight years in prison for performing unnecessary procedures on patients and then submitting fraudulent insurance claims. In another case, a dentist in Florida was sentenced to four years in prison for submitting fraudulent claims to Medicaid.

The rise of dental insurance has made it easier for dentists to commit fraud, as they can bill for procedures that are not medically necessary or that were never performed. In some cases, dentists may collude with patients to submit false insurance claims in exchange for a kickback or other incentive.

To combat fraud in dentistry, there are a number of regulatory and oversight organizations that monitor and investigate complaints. The American Dental Association (ADA) has a code of ethics that all dentists are expected to follow, and dentists who violate this code can be subject to disciplinary action.

Patients can also protect themselves from dental fraud by being informed and vigilant. Patients should ask questions about the procedures they are being recommended and should seek second opinions if they are unsure. Patients should also carefully review their insurance statements and report any discrepancies to their insurance company.

In conclusion, while fraud in dentistry is a relatively rare occurrence, it can still happen. Dentists have a responsibility to provide honest and ethical care to their patients, and patients have a responsibility to be informed and vigilant about their dental care. By working together, we can help ensure that dental fraud remains an uncommon and isolated occurrence.