Do You Really Need That Treatment? What One Patient Discovered After a «Free» Cleaning
By Priscila Mendez, writer · Reviewed by Dr. Grace Ordóñez, dentist in Cuenca, Ecuador
| Short answer: an unexpected dental diagnosis doesn’t always mean you need treatment. Before agreeing to it, ask to see the problem on an image, ask what happens if you wait, and if something doesn’t add up, get a second opinion based on a clinical exam and, when needed, X-rays. You have the right to understand your diagnosis. |
Imagine going in for a free dental cleaning and walking out with this diagnosis: three cavities, leakage at the edge of one crown and another crown fractured. Now imagine that three months earlier, your regular dentist examined you, cleaned your teeth and told you everything looked fine. Who would you believe?
That’s what happened to one of Dr. Grace Ordóñez’s patients in Cuenca, Ecuador. Her story is for anyone who has ever left a dental appointment with more questions than answers.
What happened at the «free» cleaning?
The patient, an American woman living in Cuenca, and her husband have been seeing Dr. Grace for four years and come in regularly for check-ups. At her last visit, three months earlier, Dr. Grace examined her, cleaned her teeth and found nothing that needed treatment.
Like many foreigners living in Ecuador, she pays for private health insurance, which is required to get residency in the country. Her plan includes a free cleaning and X-ray, so she decided to use the benefit, even though she’d had her regular cleaning at Dr. Grace’s office just three months before.
At the other clinic, she was told she had three cavities, a leaking crown and another crown that was fractured. Her husband, who went with her, was told he had three cavities and a cracked crown. They both left worried and upset. After four years of trust, the doubt was unavoidable: how could their dentist not have told them anything? Had she done her job poorly?
Instead of accepting the new diagnosis or dismissing it outright, they did the sensible thing: they asked again.
How do you review a diagnosis without turning it into a fight?
When the couple arrived at Dr. Grace’s office, they were upset and full of questions. If she had examined them only three months earlier, how could they suddenly have so many problems? Why hadn’t anyone said anything?
Their worry was mixed with distrust. They wanted to know what was really going on and whether they actually needed all that treatment.
Dr. Grace listened carefully, without getting defensive or criticizing the other clinic. She simply said: «Let’s look at it together and see what we find.»
She sat the husband in the chair first and asked his wife to come closer so they could both see. Using an intraoral camera, she went through his teeth and showed them what she found. Then she did the same with the patient.
Seeing the images changed the conversation. Now they could see for themselves what had worried them so much. Dr. Grace explained, for example, that a stain at the edge of a crown doesn’t necessarily mean there’s a cavity underneath. It could be discoloration, wear on the material or something worth monitoring. When something needed to be confirmed beyond what the camera could show, X-rays were considered.
By the end of the exam, several of the problems they had been told about were not confirmed. The worry they arrived with gave way to relief. They no longer had to live with the doubt or agree to treatment without understanding why they needed it.
For Dr. Grace, this is a core part of caring for patients: listening to their concerns, showing them what she finds and explaining their options. When it comes to your health, being told what you need isn’t enough. You deserve to understand why and to feel at peace with your decision.
Why do two dentists give different diagnoses?
Dental diagnoses don’t always match, and it isn’t always a matter of bad intentions. The dentist’s experience, their threshold for «treat now» versus «watch and wait,» and whether there’s a previous record to compare against all play a role.
Dental Protection, an organization that advises dentists in the United Kingdom, notes that dentists tend to recommend more treatment for a patient they’re seeing for the first time than for a long-term patient with the same condition. That makes sense: without a history, everything looks new. Dr. Grace, on the other hand, had known this couple’s teeth for four years.
Some cases are less innocent. In a study by ETH Zurich, a young patient with a shallow cavity, which Swiss guidelines say should only be monitored, visited 180 dental offices. Fifty of them, or 28%, recommended fillings he didn’t need.
The useful question isn’t «who’s right?» but «what’s actually going on in my mouth?»
What should you ask before agreeing to dental treatment?
When a dentist recommends treatment, these questions help you figure out whether it’s necessary and urgent:
- Can you show me the problem on an image or X-ray?
- Does this need treatment now, or can we keep an eye on it?
- What happens if I wait a few months?
- Is there a more conservative option?
- How much will it cost, and what does my insurance cover?
- Can I get a copy of the images or X-rays?
A good dentist will answer these without getting uncomfortable. If you feel rushed or pressured, or the answers are vague, that’s a sign to pause and get another opinion.
When should you get a second opinion from a dentist in Cuenca, Ecuador?
Asking for a second opinion isn’t a sign of distrust, and it shouldn’t offend anyone. It’s how you make a good decision. Consider one especially when:
- You’re diagnosed with several problems at once, shortly after a check-up that found nothing.
- The treatment is expensive or irreversible: crowns, root canals, extractions or implants.
- No one showed you images or clearly explained why.
- You were seen at a new clinic, for example through an insurance benefit, without access to your dental history.
For expats in Cuenca, there’s an added factor: appointments in a language that isn’t your own. If you didn’t fully understand the explanation, asking questions matters even more. Dr. Grace sees patients in English and Spanish, without an interpreter.
A practical tip: bring any X-rays you’ve had taken. That way you avoid repeat exposure, and the second dentist can compare.
What Dr. Grace says
| «My job isn’t to prove another colleague wrong. It’s to help each patient see what I see, understand their options and make decisions with peace of mind. If I can’t show it to you, I won’t sell it to you.» — Dr. Grace Ordóñez, dentist, University of Cuenca (1995), over 30 years of experience with local and international patients. |
Frequently asked questions
Is it normal for two dentists to give different diagnoses?
Yes, it happens. The criteria for treating or monitoring vary from one dentist to another. What matters is that they explain why and show you evidence, such as images or X-rays.
Is a free cleaning through insurance lower quality?
Not necessarily. Many are done well. But if you’re offered several treatments afterward, it’s worth confirming the diagnosis before you commit.
What is an intraoral camera, and what is it for?
It’s a pen-sized camera that shows the inside of your mouth on a screen. It lets you see with your own eyes what the dentist sees, so the diagnosis is easier to understand.
Does Dr. Grace speak English?
Yes. She speaks fluent English and treats patients from the United States, Canada and other countries directly.
Key takeaways
- An unexpected diagnosis deserves a clear explanation, not a rushed decision.
- Ask to see the problem on an image, and ask whether it can be monitored instead of treated.
- A second opinion is a tool for better decisions, not an attack on anyone.
- Problems that aren’t confirmed don’t need treatment.
| Received a diagnosis you didn’t expect? Book a check-up or a second opinion with Dr. Grace Ordóñez in Cuenca, Ecuador. She’ll show you what she sees, explain your options in English or Spanish, and help you decide with peace of mind. [Button: Book an appointment / WhatsApp] |
Sources: Gottschalk, F. et al. (ETH Zurich), field study of 180 dentists on overtreatment recommendations; Dental Protection, «Overtreatment»; American Dental Association, Choosing Wisely recommendations. This article is for information only and does not replace a dental consultation.
