Denver dentists at PDS Health are selling gum disease, patients claim

When a dentist at Lakewood Modern Dentistry told Hailey Hernandez that she needed a deep cleaning, a root canal and a crown to treat extensive gum disease and other problems.

“I knew I was taking care of my teeth and there was no way I was going to get gum disease,” she said.

Her old dentist in Arizona said she was right when she went back for a second opinion, the Golden resident said. Her suspicions grew even more when two friends told her they also received gingivitis diagnoses from Lakewood Modern Dentistry and were told they would need a deep cleaning, root canals and crowns.

“There’s no way,” he said. “It just doesn’t sound right at all.”

One of those friends, Avery Hafer, said she, too, was surprised to hear she needed such extensive treatment, but she continued. When she returned about a year later, the Englewood resident learned she would need a deep cleaning every three months, as well as more root canals and crowns — on teeth that weren’t the ones that hurt.

Huffer said she decided not to undergo the additional treatment after talking to colleagues who told her they needed the same procedure.

“Is that just their basic diagnosis?” Hafer said she wondered.

Lakewood Modern Dentistry is one of more than 50 offices in the Denver area connected to PDS Healtha Nevada-based practice management company that works with dentists in 16 states. Although each practice is independently owned, they have nearly identical websites, with the same smiling woman on the home page and the same pitch for financing up to $75,000 in dental work, subject to credit approval.

The majority of practices also share the perception among some former patients that dentists and staff exaggerated their oral health problems and recommended unnecessarily invasive treatments. Of the 53 participating Denver-area practices, 40 had online reviews in the past three years that their dentists had told patients they needed extensive work, such as deep cleanings or root canals, when they thought a less invasive alternative would suffice.

The Denver Post spoke with six patients, including Hernandez and Huffer, who said PDS-related practices pushed them to pay out of pocket for deep cleanings and other invasive work they didn’t believe they needed. The five who sought a second opinion said they were told their mouths were largely healthy.

While patients who spoke to The Post believed their dentists were selling them more money, the lack of standardization in dentistry creates challenges in trying to parse why two providers might have dramatically different recommendations, experts said.

Without clear professional standards and limited push from insurers on unnecessary procedures, patients are largely on their own to figure out if a practice is selling them out, said Beth Mertz, a professor at University of California, San Francisco Dental School. They should get a second opinion if the diagnosis and treatment plan doesn’t seem to be a good one, he said.

“Dentistry is still the Wild West,” he said. “The whole system is not set up to serve the public particularly well.”

PDS Health spokeswoman Ellen Driscoll said the company provides non-clinical support services to independent dental practices, whose owners make treatment decisions based on the needs of their patients. Dentists have a long-standing debate about the best way to treat gum diseasewhich is common and underdiagnosed, he said.

Lakewood Modern Dentistry said it uses advanced technology to detect gum disease early, treating problems other dentists may miss.

“Periodontal disease is both widespread and often missed in its early stages,” the practice said in a statement. “Our team follows national clinical standards and is committed to preventive care.”

Dentists can have good-faith differences of opinion about how aggressively to manage common conditions like gum disease, which can cause inflammation that leads to other health problems, said Dr. Brett Kessler, its former president American Dental Association. Patients need to find a provider whose views match their own, he said.

“How the patient is treated depends on the patient’s goals and the provider’s philosophy and how they weigh together,” he said.

Differences in philosophy and training explain some of the gap in what dentists recommend, but the profit motive is also a factor, Mertz said. “Secret shopper” studies have shown that dentists give radically different recommendations if a person’s dress and demeanor signal they can afford expensive care, he said.

“Because dental insurance pays more based on what you do, providers are incentivized to do more,” he said.

Precise deep cleaning of the gums

Most dental insurance plans cover two routine cleanings each year, although plans vary in how much they contribute to deep cleanings and other treatments.

Michael Gitomer, of Denver, said the finance person at Edgewater Modern Dentistry and Orthodontics told him he would have to pay $1,000 to $1,500 out of pocket for a deep cleaning and a crown.

Deep cleaning of the gums, also known as scaling and root planingit involves removing plaque from below the gum line in the same way that dental hygienists scrape it from the visible part of the tooth during a routine cleaning. In some cases, dentists also give antibiotics to help eliminate the bacteria that cause gum disease.

Gitomer only expected a $30 copayment that day, so he requested a routine cleaning while he considered his options.

“They refused to do regular cleaning for me unless I paid for all this other stuff,” he said, although they relented after “giving them enough trouble.”

His previous dentist saw no need for invasive work, but recommended flossing more often.

Edgewater Modern Dentistry said it strives to earn patient trust through “clear communication and honest reviews.”

“Periodontal disease often progresses painlessly, which is why we focus on early recognition and informed care. Our clinicians are here to listen, explain and help patients make confident decisions about their oral health,” the practice said in a statement.

Duke Harten, of Denver, said he had a similar experience at City Park Dental Group and Orthodontics: His dentist told him he had severe gum disease and needed a deep cleaning every three months, which his insurance didn’t cover. He was suspicious because his previous dentist had never detected any problems, and he looked up reviews of the practice, which seemed to suggest a pattern.

A dentist he saw for a second opinion said his gums were healthy, Harten said, and even his records at City Park Dental seemed to contradict the idea that he needed extensive care, saying he had “good oral hygiene” and “no problems noted.”

City Park Dental said in a statement that it is committed to clear communication with patients and adheres to best treatment practices.

“When it comes to conditions like periodontal disease, time and technology can affect what a provider sees and how they choose to respond. While approaches to care may differ between dentists, our goal is always the same: to help patients stay ahead of disease and maintain their long-term health,” the practice’s statement said.

“They said I needed all this work”

said Samantha Nuyen, of Denver Highlands Dentists he found no problems with her mouth at her first two visits, but told her she had several cracked teeth at the third. The dentist he saw for a second opinion found no cracks or other major concerns, he said.

When she told her provider at Highlands Dentists about the second opinion, they offered no explanation for the discrepancy or defended their recommendation, Nuyen said.

“They said I needed all this work that I didn’t need,” she said.

Highlands dentists said oral health is deeply connected to the rest of the body’s wellness and is treated early to prevent bigger problems.