For decades dental care was based on trust and loyalty of patients to dentists. The frequency of dentist visits creates a relationship as strong as the one patient has with their general health practitioner (GP). The difference is that you usually visit your GP when you are ill or have an ache, while you will probably regularly visit your dentist in precaution, but unaware of the state of your oral health. Even when your dentist examines you, there is no way you can double-check their opinion. Most of the time, patient won’t doubt the dentist's verdict and readily comply with the procedure which is often costly.
Sometimes these procedures are actually unnecessary, and sometimes some treatments which are actually necessary aren’t done. Some treatments are done poorly, causing more problems down the line. Dentists even have incentives for fraud - they earn money if they treat you. It doesn’t matter how necessary the treatment is. Due to the fact that there is lack of objective evidence and supervision in dental care, unnecessary costs are made for the benefit of the dentist.
To avoid unexpected financial risks of costly dental treatments, patients buy dental care insurance. But that same lack of transparency and verifiability causes the high levels of risk for insurance companies. This problem is solved by high premiums and low coverage, transferring of the risk onto patients (through partial coverage), initial checks, waiting periods, history of the patient with the particular insurance, and other. This means that patient decision, dentist decision and standard patient records are all seen as flawed by insurance companies.
Patient records are kept inconsistently, their usability is limited. This means your dentist will have to use their memory to remember what happened with your teeth before. Needless to say, this is a very unreliable way of storing such important information. On the other hand, a lot of patient records are held by third parties which provide storage systems for patient records. Exporting these records isn’t easy. If you wanted to change dentist, you probably wouldn’t reap much benefits from your current dental records. If you wanted to change dental care insurance, or get the one for the first time in your adulthood, the cost will be huge, even if you have perfectly healthy teeth and this is shown in your dental records. This is due to the fact that records can actually be mutable and trusted dentist checks might be flawed.
Obtaining evidence-based oral health information is not easy. Available patient based review systems are flawed. Patients are generally oblivious about the state of their oral health. Dental care fundamentally depends on doctor-patient trust. Dentists are able to exploit the trust of their patients. Dentists earn more by performing unnecessary procedures. Patients are able to exploit insurance companies. Unnecessary procedures increase costs of dental care and decrease oral health. Dental care insurance is expensive. Insurance companies additionally transfer the risk of fraud onto patients. Dental care insurance products are unpopular. Insurance companies leave billions USD on the table. Patients have bad oral health and spend more money.