the solution for these patients. there's no doubt about it. because, again, they're struggling to get through life, and so it does become an important part of the solution for them. >> oh, what a nightmare. >> o'brien: theresa ferritto, who's hearing-impaired, signed up for a credit card after going to aspen to get two teeth removed. >> mom's 87 years old, and she's in pretty good shape for her age. she's pretty sharp. and she comes rolling into aspen dental prepared to have these two teeth removed. but, much to her chagrin, she found out that they wanted to do a whole makeover of her mouth-- removal of many more teeth than the dentist had initially recommended, and then the creation of dentures, all at the tune to about $8,000. $8,000 is close to 50% of her annual income. >> when they presented that big... eight, seven thousand dollars, i says, "i can't afford that. i don't have that kind of income." well, they didn't care. they figure, well, i could put it on a credit. >> o'brien: mrs. ferritto

wound up with the g.e. credit card called carecredit. >> they never mentioned or explained about a lot of interest, high interest-- never. >> look at this-- look, look look. >> o'brien: carecredit began charging mrs. ferritto interest as soon as the credit card was issued, even before much of the work had begun. >> so as soon as she got approved for that credit, those charges and that interest started to accrue at that second, before she even left the dental office. and so we feel like she was really taken advantage of, just in that regard alone. the potential payment over five years would have been close to $12,000, and she initially came in for the excision of two teeth. >> o'brien: allan ferritto called the aspen dental office to try and get his mother off the hook. >> the girl at the office says, "well, you know, your mother came in here and she was very happy with our treatment plan, and she told us that she wanted a hollywood smile." >> i was confused, i was really confused. and then i realized, until i got

home i realized, oh, what i put myself into. this, this! i feel like... i wish i could hit them on the head with it. >> o'brien: in the case of an 87-year-old woman who can't hear very well, to get her to sign on the dotted line without perhaps somebody there advising her seems like it might be a little bit predatory, potentially. >> well, i don't think so and i certainly hope not. i hope that the team was clear about what she needed and that she completely understood what she was getting into, and hopefully, you know, she made the choices that she thought was right for her. >> o'brien: aspen patients have complained to regulators about being billed before their work was done and being charged credit card interest as high as 29.9% retroactively if they miss payments. >> so this is the consent decree between pennsylvania and aspen from 2010. >> o'brien: in response to such complaints, the pennsylvania

attorney general investigated aspen, and the company agreed to pay a $175,000 settlement. >> it's a conflict of interest. >> o'brien: and in new york, andrew cuomo, then attorney general, launched an ongoing investigation into the growing use of high-interest health care credit cards. >> and it is where health care providers become agents for financing, and the financing company is providing the money to the doctor all up front. >> o'brien: according to heather haynes, there's another controversial aspect to how aspen does business. the more work employees convince customers to do, the more money they make. >> they want us to sell the cadillac of all dentures, and that's how we would try and sell. we would sell the biggest, best product, and if that didn't work, then we'd downsell. >> o'brien: if you succeeded and did well, could you make a lot of money? >> you could. >> o'brien: bonuses?

>> yes. bonuses were given on a monthly basis. >> o'brien: so how do you incentivize your people and the dentists along the way here in order to keep the money flowing? >> well, the incentive for everybody is, let's do the right things for the patients. >> o'brien: but they have to meet certain goals in order to derive income. there's a bonus system, right? >> when you say "they," who's "they"? >> o'brien: well, office managers, for example. >> so the office managers are rewarded based on controlling expenses and making sure that they reach a certain patient satisfaction score. the doctors don't have any budget to reach. they're not rewarded based on hitting any level of production or any level of budget. >> o'brien: so doctors don't get bonuses, or their income is not linked to their production? >> i wouldn't describe them as bonuses. they get a percentage. you know, so in traditional practice, they get a hundred percent of the profits. in our practices, typically, they get a smaller percentage of those profits from that practice.

>> with aspen, you'll share financial rewards and benefits... >> o'brien: this video that aspen uses to recruit dentists tells a another story. >> compensation for associate dentists includes an annual salary plus bonus opportunity that increases as key target leve >> o'brien: lili reitz, executive director of the ohio dental board, which regulates dentists, worries about bonus opportunities at corporate dental chains. >> in some of these kinds of practices, there are quotas and goals that the dentists are expected to meet that work there. and when you're offering bonuses for services, there's going to... there's incentive for that person to want to do more of that, obviously, to set themselves up better financially. but that jeopardizes the standard of care. that puts the standard of care at risk. >> o'brien: but ms. reitz, who prides herself on being a no-nonsense regulator, is virtually powerless to do anything about it, because she

doesn't have the authority to discipline corporations. >> the dental practice act just gives the board the authority to issue a license, regulate that license and take action against the license when necessary. >> o'brien: when you say a licensee, you are regulating dentists. >> dentists, dental hygienists and other auxiliary. >> o'brien: who regulates the corporations in this case? >> i don't know that anyone regulates a corporate dental practice per se. >> o'brien: so, in a way, you can only attack the problem indirectly. >> correct. i'm not going to argue with you that that's not frustrating, but that's... that is what we're responsible for addressing. >> o'brien: with little oversight of its corporate practices and intense demand from americans in need of dental care, aspen is expanding rapidly across the country. >> o'brien: tell me what the plans are. you're right now at 350 offices. where are you headed? global domination, right? >> no, i wouldn't say global domination, but we have... we do believe that there are

communities across the country that are still, like warsaw, we know there are people, good, hardworking people trying to make ends meet in those markets, that need our care and need our services. we're in 22 states, and we have half a country to go. >> o'brien: of course, if there were other options for americans without dental insurance, maybe people like vanessa nations wouldn't find themselves charging dental work they can't afford on credit cards they can't pay off. >> hey. >> o'brien: but as vanessa knows, the only other place for most to turn is to charity. >> hello, vanessa. >> hey. >> how are you doing? >> o'brien: today, dr. joshua swanson, one of the volunteers at grundy, is going to give vanessa her new teeth. >> it is the big day. >> yes. >> let's try this top one in. put it in, you're going to give

it a good push. up there nice and tight. let's try the bottom in. bite together for me. let me give you a mirror here, okay? have a smile. see what you look like with some teeth in. big smile. >> i feel so blessed. i can't express how blessed i feel. i mean, it's a miracle, is what i feel. >> o'brien: as for the millions of other adults in our country that charities can't treat, there is to date no solution for them. >> next timfrontline, the epic story of the global financial crisis spreads.

>> these banks transfer risk across the atlantic. >> investment banks such as goldman sachs were eager to lend to risky places such as greece. >> even convents were being sold derivatives. >> they came down here like sharks to raw meat in the water. >> "have i got a deal for you." >> "money, power and wall street,"frontline investigation. >> frontline continues online. learn more about our broken dental system. >> you've got to have good dental health. >> read stories from our partner, the center for public integrity. >> it's just not a simple matter. >> more about why it's so difficult to get quality dental care. >> about 30 minutes later, the crown falls out again. >> removal of many more teeth than the dentist had initially recommended. >> plus, watch the full progrm again online and follow frontline on facebook and twter, or share your reaction at pbs.org/frontline. >> frontline is made possible

by contributions to your pbs station from viewers like you. thank you. and by the corporation for public broadcasting. major funding is provided by the john d. and catherine t. macarthur foundation, committed to building a more just, verdant, and peaceful world. and by reva and david logan, committed to investigative journalism as the guardian of the public interest. additional funding is provided by the park foundation, dedicated to heightening public awareness of critil issues. and by tfrontline journalism fund, supporting investigative reporting and enterprise journalism. captioned by media access group at wgbh access.wgbh.org

>> for more on this and other frontline programs, visit our website at pbs.org/frontline. frontline"dollars and dentists" is available on dvd. to order, visit shoppbs.org or call 1-800-play-pbs. frontline is also available for download on itunes.

"now you told me there was an interesting story- where did you find this?" "my mother had a cousin..." "...grandpa..." "...husband's parents ..." "...great uncle..." "...mom's 3rd cousin... "...governor of vermont..." ..that i'd found laying on a trash pile..." "...flea market..." "...dealer..." "...in the dirt..." "...she paid 45..." "...25 dollars..." "...never seen one quite like this..." "...rare..." "...fabulous..." "...fantastic..." "...25,000 dollars..." "...250,000 dollars...' " "...300,000 dollars..." "...oh my god!" every treasure tells a story. antiques roadshow only on pbs.