Dentists sometimes recommend treatments that might not be needed. Large dental chains often require their dentists to meet a quota…today’s new dentists graduate from dental school with huge debt…and dental practices must purchase expensive equipment, all of which create pressure to maximize income. Be cautious if your dentist suggests…

Deep cleaning. Also called “scaling,” this typically costs $700 or more, often is not well-covered by dental insurance and is appropriate only for patients who have major periodontal problems—that is, problems with their gums or the bones that support their teeth.

Response: If your dentist recommends deep cleaning and you do not have a history of gum problems, ask to see your periodontal chart. If the number five or higher is listed for some of your teeth, you likely have experienced losses to the tissue and bone around those teeth and deep cleaning might be warranted. If not, seek a second opinion.

Drilling and filling a cavity identified only by laser. “Laser decay finders” have their place in dentistry, but if your dentist can’t see decay on your X-ray, there is no reason to treat the cavity, at least for now.

Response: If your dentist says you have a cavity that requires treatment, ask to see this cavity on your X-ray. There should be an obvious dark spot, likely triangular in shape. If you don’t see this, get a second opinion.

Extensive procedures during your first visit. It’s a red flag if you have never needed extensive dental work in the past…you go to a new dentist for just a cleaning or what seems to you like a relatively small problem…and your new dentist says you need extensive work.

Response: Get a second opinion.