After biting my tongue over the letters of outrage to the editor regarding the article on the fraudulent use of digital radiography ("Potential for Fraudulent Use of Digital Radiography," Dr. Andrew Tsang and colleagues, September JADA), I must offer additional fuel for the fire.
The last time I checked, the First Amendment to the U.S. Constitution was still in effect, and book burnings have not resumed. The censorship that some call for, even when well-intentioned, is neither necessary nor will it prevent fraud. In fact, one can achieve similar results the good old-fashioned (predigital) way.
Here’s the plan: Each time you see a tooth that definitely "needs" a crown, snap a good ol’ water-dipped radiograph. Make sure the tooth’s got enough decay or missing structure that no claims review clerk at the insurance company can possibly rule out the need for crowning. With the enthusiasm of a high-school entomology student working on his first insect collection, don’t stop until your album of all 28 or even 32 teeth is complete.
Make a small investment in a duplicating machine and produce copies of the film for submission with your claims p.r.n. Voila! No more denied claims! Only if you indiscreetly send the same duplicate too many times to the same insurance company and the same clerk reviews your claims will it be detected. The chance that undertrained employees at understaffed insurance companies will notice is virtually nil.
Digital or traditional, the possibility of fraud exists. Only individual honesty and integrity can prevent fraud—not censorship and government or industry regulation.
