Getting a Second Opinion on Dental Treatment: When and How

A second opinion is a normal part of health care, and dentistry is no exception. If you have been told you need a large or expensive treatment, or you simply don’t feel you understand why something is being recommended, asking another dentist to look is reasonable. A good dentist will not be offended. This guide explains when a second opinion is most useful, how to get your records so you don’t have to repeat every test, and how to compare what you hear.

When a second opinion makes sense

You don’t need one for a routine cleaning or a single small filling. It is most worth considering when:

• The plan is large or costly, such as several crowns, implants, full-mouth work, or a long orthodontic plan.
• The treatment is hard to undo, such as removing a tooth or reshaping healthy enamel for veneers.
• The diagnosis surprised you, for example many new cavities when you had none at your last visit, or a recommendation for gum surgery you didn’t expect.
• You were offered only one option and want to know whether alternatives exist. Our comparison of implants, bridges and dentures shows how different the choices for a single problem can be.
• You feel pressured to decide on the spot or to prepay for treatment you don’t understand.
• Your condition is complex and might benefit from a specialist’s view.

In an emergency with severe pain, swelling or fever, get care first and ask questions after. Our guide to dental emergencies explains what can’t wait.

Start by understanding the first plan

Before seeing someone else, make sure you understand what you were told. Ask the first dentist for a written treatment plan listing each tooth, each procedure and the estimated fee, plus the reason for each item. Our guide to reading a dental treatment plan walks through the codes and terms you’ll see. Useful questions include: What happens if I wait? Which items are urgent and which are optional? Are there less invasive alternatives?

Sometimes these questions resolve your doubts without a second visit. If not, you’ll arrive at the next office with a clear list of what to compare.

Bring your records

A second dentist can give a better opinion if they see the same X-rays and notes. Under HIPAA, you have a right to get a copy of your health information from providers covered by the law, including X-rays. The U.S. Department of Health and Human Services (HHS) explains that a provider normally has up to 30 days to provide the copy, may charge a reasonable fee, and cannot deny you a copy because of an unpaid bill (HHS: Right to access). Our step-by-step guide to requesting your dental records covers how to ask.

Sharing existing images may also help you avoid repeating X-rays. The ADA’s MouthHealthy site notes that your dentist reviews your history and examines your mouth to decide whether you need X-rays, and that a new dentist may ask for copies of existing X-rays instead of ordering new ones (MouthHealthy: X-rays) The second dentist may still want their own images, but bringing copies is a good start. Our dental X-rays guide explains the common types.

Choosing who gives the second opinion

Pick a dentist who has no stake in the first office’s plan. For specialized treatment, such as gum surgery, root canals, jaw surgery or orthodontics, a relevant specialist may be the right choice; our article on dental specialists explains who does what.

You can look up a provider’s National Provider Identifier and listed specialty in the CMS NPPES NPI Registry (NPPES NPI Registry), and check their license with your state dental board. Our guide on verifying a dentist’s license and NPI explains how.

When you book, say clearly that you want a second opinion on a specific plan. Some offices schedule this as a consultation or exam. Ask what it will cost and whether your insurance covers a separate exam.

How to compare two opinions

Differences don’t automatically mean one dentist is wrong. Dentistry often has more than one acceptable approach. MedlinePlus’s tooth disorders overview reflects how many different problems can affect teeth, from decay to cracks to infection (MedlinePlus: Tooth disorders), and judgment calls are common. Focus on:

• The diagnosis. Do both dentists agree on what is wrong? Agreement on the problem with different solutions is very different from disagreement about whether there is a problem at all.
• Urgency. Do they agree on what needs attention now versus what can be watched?
• Alternatives. Did either offer a more conservative option, and what are its trade-offs?
• Explanation. Did each dentist show you the X-rays or photos and explain in terms you understood?
• Cost. Compare like with like: same teeth, same procedures, same materials. Our guide to getting a fair price on dental work covers comparing estimates.

If the opinions conflict

Go back to each dentist with the other’s findings and ask them to explain the difference. A third opinion is reasonable for very large decisions. You can also ask whether watching a borderline area and re-checking at your next visit is a safe option.

Is it awkward to tell my dentist?

You aren’t required to tell your dentist that you are getting a second opinion, but you will need to request your records. Most dentists understand that patients want to feel confident about major treatment. If you decide to stay with your original dentist, you can share what you learned; if you switch, our checklist on how to choose a dentist may help.

Keeping notes

Write down what each dentist says, including the diagnosis, options, urgency and estimated costs, while it is fresh. A simple side-by-side table makes it easier to see where opinions agree and where they differ, and it gives you clear questions to bring back to either office.

Frequently asked questions

Does insurance pay for a second opinion?

It depends on your plan. Some plans cover a limited number of exams per year, so a second exam may or may not be covered. Ask your plan before booking.

Can my dentist refuse to give me my X-rays?

HHS says you have a right to a copy of your health information, including X-rays, and that a provider cannot deny you a copy because you have not paid a bill. A reasonable fee may apply.

Should I get a second opinion for every filling?

Usually not. Second opinions are most useful for large, costly or irreversible treatment, or when a diagnosis surprises you.

What if the second dentist finds nothing wrong?

Ask both dentists to explain their reasoning using the same images. Sometimes the difference is about whether to treat an early problem now or monitor it.

How do I find someone independent?

Choose an office not affiliated with the first, or a specialist for specialized treatment, and verify their license with your state board.

Sources

• HHS: Your right to access your health information
• CMS NPPES NPI Registry
• MedlinePlus: Tooth disorders
• MouthHealthy (ADA): Dental X-rays

By the Dentist Review Editorial Team.

This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.

Featured image: “Dental office of Clinic of KarRC 2011” by Igor Georgievskiy, via Wikimedia Commons, licensed CC BY-SA 4.0. Resized and compressed for the web.