Dentist Did Unnecessary Work? How to Complain and Demand a Refund

You went in for a check-up. You left with a treatment plan for $4,800: six fillings, a crown and a “deep clean.” You paid for the first $2,100 of it. Then you got a second opinion, and the second dentist looked at the X-rays and said three of those teeth were fine.

That sick feeling is warranted. But you have more power here than you think.

Two sets of rules apply to dentists

1. Consumer law. Dental services are services under the Australian Consumer Law. They must be provided with due care and skill (section 60) and be fit for purpose (section 61). Recommending and charging for treatment that was not clinically needed may also be misleading or deceptive conduct (section 18).
2. Professional regulation. Dentists are registered under the Health Practitioner Regulation National Law and regulated by the Dental Board of Australia and AHPRA. Overservicing is professional misconduct. Complaints can also go to your state health complaints body (HCCC in New South Wales, Health Complaints Commissioner in Victoria, OHO in Queensland).

Use both. Dentists take AHPRA complaints extremely seriously, and the threat of one is often what gets the refund.

What you can claim

• Refund of the unnecessary treatment. If three of the six fillings were not needed at $280 each, that is $840.
• Cost of fixing any harm. An unnecessary filling weakens the tooth. If it later needs a crown or root canal because of it, that cost is foreseeable loss.
• Any health fund gap you paid for treatment that was not needed.

What you need

1. Your records. You have a right under privacy law to a copy of your full dental record, including X-rays and treatment notes. Ask in writing. They must provide them within 30 days.
2. The second opinion, in writing. Ask the second dentist to state which treatments were not clinically indicated on the X-rays. Many will do this for a consultation fee.
3. Your itemised invoices and health fund statements
4. The original treatment plan or quote

The Letter of Demand

Your letter should set out the treatment plan, the second opinion, the specific items you say were unnecessary, the amount, and the sections of the ACL. It should say that if the refund is not paid within 14 days you will lodge a complaint with AHPRA and the state health complaints body and file at the tribunal for the money.

Keep it factual and calm. Do not accuse them of fraud. “Not clinically indicated” is the phrase. It is enough.

Do this now

Do not go back to the first dentist for the rest of the plan. Do not sign anything. Request your records today, because the record request itself tells the practice you are serious, and it starts the clock.

What about the health fund?

If your fund paid benefits for treatment that was not needed, tell them. Funds investigate overservicing and can recover from the provider directly. It costs you nothing.

Claim Done drafts your Letter of Demand for $49. Done in about 5 minutes. You approve it before it is sent.