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Can be hard to get credit these days, but that may not be the case when it comes to a loan for getting your teeth fixed. Across the country, dental credit cards are becoming more popular, especially among patients who are poor and have no insurance. A growing number of critics warn these types of loans might be risky for consumers.

Kelly Weiss of Capitol Public Radio reports from California.

KELLY WEISS: Joseph Lopez is 75 years old and lives in a Sacramento trailer park. Last year, his wife needed a bridge for her teeth. It had a $3,000 price tag, and Lopez didn't have dental insurance. So, he says, he got a special kind of loan.

Mr. JOSEPH LOPEZ: The reason I took their way of financing the work was because they told me that I would not have any interest for two years.

WEISS: But Lopez says when the bill came, the treatment wasn't even completed, and it was for $5,000 - $2,000 more than he agreed to. He claims he never got an official application outlining the terms and conditions. So he says it wasn't clear to him whether he was agreeing to a payment plan with his dentist or getting a credit card.

In fact, he was enrolled with CareCredit, a card that's designed to pay for medical costs. He says the company threatened to sue him if he didn't pay.

Mr. LOPEZ: Psychologically, it is very disarming because you figure they're going to take me to court, and my house, and my car, my bank account, you know.

WEISS: Lopez got help from a lawyer, and eventually CareCredit backed off. His lawyer then shared his story with California lawmakers. She testified before a Senate committee in support of a bill to regulate dental credit cards.

Lopez's story is becoming an all-too-familiar one, according to Elizabeth Landsberg. She's an attorney with the Western Center on Law and Poverty.

Ms. ELIZABETH LANDSBERG (Western Center on Law and Poverty): It's a new trend that we're seeing. We didn't have any of these cases in 2006. We saw some in 2007, and we saw a lot more in 2008.

WEISS: Landsberg says states are just starting to pay attention to this problem, and California is ahead of the curve. That state is now tracking complaints, and this year saw nearly three dozen, she says. Most of these were from the poor, the elderly, and non-English speakers.

Landsberg accuses CareCredit of predatory lending practices. She says people can get broadsided by an up to 30 percent, retroactive interest rate for a late payment.

Ms. LANDSBERG: Both with the foreclosures and with these dental credit cards, people are being convinced to take on more credit than they can afford. We have people who are living on a fixed income of $1,000 a month who are being signed up for $6,000 in credit. There's no way they can make those payments.

WEISS: CareCredit declined to do an interview on tape, but spokeswoman Cristy Williams says the company is not involved in predatory lending practices. And, she says, the majority of their customers are happy. Right now, Williams says, CareCredit has an all-time high of 100,000 providers nationwide offering the card. About half are in dental care, but plastic surgeons and veterinarians use the card, too.

Unidentified Woman: Thank you for calling Dr. Lott's office.

WEISS: At Dental Care by Design in Sacramento, there is a sticker by the door that says, We Offer CareCredit Low Monthly Payment Plans. Douglas Lott says CareCredit gives his patients choices.

Dr. DOUGLAS LOTT (Dentist): Well, I don't like credit cards in general, but I don't know if there's a better option.

WEISS: That was the case for one of Lott's patients, Angie Gerritsen. She says she needed extensive work, $20,000 worth.

Ms. ANGIE GERRITSEN (Patient): I was having a lot of pain and a lot of infection, and I probably would have ended up losing a lot of my teeth if it wasn't because of CareCredit.

WEISS: The credit cards can help the dentist, too. Lott says he gets the money for procedures up front and in full. And if a patient defaults on payment, CareCredit deals with collection.

The California Dental Association, or CDA, endorses the card and so does the American Dental Association, though it is worth noting both get paid for those endorsements.

Mark Rukavina is with the health-care advocacy group the Access Project. He says using credit to pay for medical care is bad. But he says the undisclosed endorsements, that's even worse.

Mr. MARK RUKAVINA (The Access Project): The blurring of medical provider and financial services provider is problematic. But when you have a financial stake in the marketing of these cards to patients, it's even more perilous.

Ms. CATHY MUDGE (California Dental Association): If we do endorse a product, we believe that we've done the research and analysis to assure that it's an excellent product for both the dentist and the patient.

WEISS: That's Cathy Mudge, CDA's chief administrative officer. She says, yes, the association does not publicly disclose the payments, and they shouldn't have to. But here's the bottom line, according to Rukavina.

Mr. RUKAVINA: Unless they're at risk of losing life or limb, we would advise people not to put medical expenses on their credit cards.

WEISS: Rukavina says setting up a payment plan directly with the dentist is a better option. As for the bigger picture, last year, Governor Arnold Schwarzenegger vetoed that California bill to regulate dental credit cards. But advocates are sponsoring similar legislation again this session.

For NPR News, I'm Kelly Weiss in Sacramento.

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