A Wisconsin jury found Dr. Scott Charmoli guilty of deliberately injuring his patients’ teeth for profit. Was he drilling for buried treasure? In a manner of speaking, yes.  

Dr. Charmoli’s income jumped from one million dollars to over two million dollars in a year. Investigators attributed most of this surplus cash to a dramatic increase in the number of crowns he installed.  

He installed 434 crowns in 2014. In 2015, he installed more than 1,000. As the saying goes, if some is good, more is better. He carried (or, paying tribute to dental parlance – “caried”) on in this way until he sold his practice in 2019.  

Between 2016 and 2019, Dr. Charmoli billed patients and insurers more than 4 million dollars. It’s obvious Dr. Charmoli installed more crowns than the average dentist. How much did he buck the average? An insurance executive who testified against Dr. Charmoli stated that the average dentist installed fewer than six crowns per 100 patients in 2019.   

Dr. Charmoli treated 1,131 patients in 2019 and installed 881 crowns – about 78 crowns per 100 patients. Over 20 months, he installed over 1,600.  

How did he do it? Simple – he broke their teeth.   

The federal indictment describes his procedure…  

Charmoli advised patients that they needed crowns for teeth that had four intact cusps or were, in other words, not broken. To deceive patients into believing that they needed a crown, Charmoli would frequently take an intraoral photograph or x-ray of the tooth and show the patient a line or a spot that he would tell the patient was a fracture or decay that necessitated the crown. Patients, who believed that Charmoli was the expert, accepted his false representations and agreed to the crown procedure. Upon beginning the procedure, Charmoli used his dental hand piece (colloquially known as a drill) to break off a portion, most often a cusp, of the patient’s tooth.   

So much for “do no harm.”  

By breaking the patient’s tooth, Charmoli caused permanent disfigurement and serious bodily injury. After intentionally damaging the tooth by creating a break, Charmoli took, or instructed his dental assistant to take, an intraoral photograph or x-ray, or both, of the broken tooth. After documenting the damaged tooth, Charmoli completed the crown procedure and submitted, or caused to be submitted, a claim for coverage to the insurance company.   

Charmoli’s scheme did not go unnoticed by his staff. Baily Bayer, one of the dentist’s former assistants, testified during the hearing that she found it odd Charmoli took x-rays after he drilled the patients’ teeth. When questioned by his staff, Charmoli insisted that “insurance is going to want to see [the x-rays].” Believing their employer to be the expert, his staff kept quiet.   

His patients trusted his judgment as well.  

Todd Tedeschi is a former patient of Dr. Charmoli. During his testimony, Mr. Tedeschi describes when Charmoli convinced him he should “get two crowns to avoid having to repeat anesthesia, even though the teeth weren’t bothering him.”  

“It seemed excessive, but I didn’t know any better,” Tedeschi said. “He was the professional. I just trusted him.”  

So, his staff trusted him, and his patients were none the wiser, and the insurance companies never called him out. How did Dr. Charmoli get caught?   

He sold his practice.   

According to Dr. Paco Major, the dentist who purchased the practice, Charmoli treated patients through August 2019. When Dr. Major took full ownership a few weeks later, he inherited most of Dr. Charmoli’s patients – and their records. He uncovered the scam while reviewing the files of Dr. Charmoli’s former patients.   

“As medical professionals, we take an oath to ‘do no harm’ to our patients, which is why I felt the ethical obligation to report activity that I believed to be suspicious,” Major wrote in a blog post distancing himself from Dr. Charmoli.  

A federal grand jury indicted Dr. Charmoli in December 2020. They valued his assets at more than $6.8 million, including vacation properties in Wisconsin and Arizona.  

A jury found Charmoli guilty of five counts of health care fraud and two counts of making false statements related to health care matters. He faces a maximum of 10 years in prison for each count of health care fraud and a maximum of five years for each false statement conviction.  

To pile on, nearly 100 former patients sued him.  

Sometimes there is a light at the end of the tunnel; in this case, that light was a train.   

This is where we ask ourselves, “Well, what can we learn?”  

While it would be redundant (and unnecessary) to tell everyone “Don’t commit fraud” there are anecdotes related to patient interactions worth discussing. Many of Dr. Charmoli’s patients described feeling pressured into a procedure they (a) did not understand and (b) did not think they needed.   

Charmoli’s own staff, many of them young hires with limited experience in the dental industry, felt the same way. To borrow briefly from another source…  

A former assistant at Jackson Family Dentistry testified that the office went from busy to extremely busy after it moved to larger space and Charmoli consulted with marketing experts who urged the office to sell more services.  

Baily Bayer said she noticed significantly more procedures, tighter scheduling and a smaller staff-to-patients ratio.  

Bayer said it became uncomfortable and stressful and she finally left the office. Dentistry, she said, “shouldn’t be a sales pitch. It should be you either need it or you don’t.”  

When describing treatment options to a patient, make sure they understand the nature of the treatment plan. Give them the chance to ask questions. This is your final chance to determine if the patient truly is a good fit for your intended treatment – once you “cut” them, they are yours. You must take responsibility for the outcome, positive or negative.  

If your employees think you are pressuring patients, check yourself. 

What do you think? Let us know in the comments below.  

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.