My dentist bill

[Uncle Ted]

I wonder if some family members of ours had the same dentist? Two young daughters; the oldest with 7 fillings by age 7...fillings in a lot of teeth that were going to FALL OUT, too!!! I told our family member to never go back, yet sadly, she still does.

What?!? Doesn't your family members vaccinate their kids for cavities?

[Viking]

So, Viking, curious what you would do with a 7 year old that has teeth that will FALL OUT?!?

Would you take those teeth out?

If you did, would you then put a fixed retainer on that arch to prevent crowding and impaction of the permanent teeth that would follow due to space lost from removing those baby teeth?

Or would you just leave them until they become painful and infected?

A 7 year old has both permanent and baby teeth, BTW, so, keep in mind, some of those teeth might not be ones that will just fall out.

Also, of the baby teeth most likely still in a 7 year old, some of those baby teeth may not come out until the kid is 12 or 13. Seems to me that would be a helluva long time to leave a cavity in a tooth and not have it cause a problem for the child. Those same teeth also hold the space for the permanent bicuspids and canines.

Another possibility: The kids just have crappy teeth or really poor oral hygiene or both and the dentist is just taking care of the kid.

I know...inconceivable.

tisk tisk.

[Jeff Lebowski]

Jeff, feel free to make the gratuitous and predictable thin-skin comment.

Well at least you are self-aware. That's progress.

I would never claim that a majority of dentists do this. But I have encountered it so many times that I am convinced that one should be very cautious when a dentist proposes a massive amount of work. We aren't talking differences of opinion regarding conservative vs. aggressive care. This is basic fraud where perfectly good teeth are pulled or drilled. That's shameless.

[Portland Ute]

Well at least you are self-aware. That's progress.

It's a long road from here to walking on water like you, but it's a first step.

[Mormon Red Death]

This story sounds horrible, but there can be a lot of factors. For example, someone comes in with 10 teeth and there are only two cavities. Fix the cavities= $200. Fix the cavities and place 4 implants with restorations = $10,000.

I'm not saying that's your situation, but I've dealt with that kind of situation. Does someone want their mouth restored or do they want their teeth restored?



Is that price for the root canals alone? Or does that include build ups and crowns. I need to get out of Utah...



And, some older dentists will "watch" the small shadows grow and grown until a patient has pain and then instead of spending $200 on a filling they are looking at losing a tooth or spending upwards of $2000 for the root canal, build up and crown. Sometimes it's really cool when the patient leaves the old dentist and goes to a newer, maybe even younger dentist that gets to tell them the bad news. Then the patient thinks the new dentist is making stuff up because the old dentist said nothing was ever wrong and it had been years since they have a cavity. So, they don't do a thing. Until Saturday afternoon at 5:30 when they call, swollen and in pain.







Oh, bullshit. "Quite common." It's the uncommon exception as you state here...



There was one idiot and plenty of others that are competent and honest.


MRD, I hope you get taken care of and have a good experience. I'm sure, like most, your dentist is honest and does his very best work for every patient.

Differences in treatment plans are not uncommon between dentists. Some dentists see only fillings. They will cover an entire tooth with a silver filling. Others will see the need for a crown. In the long run, the crown is ultimately better for the tooth and the patient, but it will cost more money.

Dentistry is interesting from the standpoint that it's a reparative and preventative discipline, but it's also a cosmetic/elective option for many people. Some dentists are comfortable only doing fillings and extractions. They will routinely offer treatment plans that are very low cost. Others will inquire with patients if they are interested in changing the cosmetic aspects of their mouth and smiles using veneers, whitening, white fillings and crowns. They offer these services to patients and their plans will be significantly higher.

In some ways, it's like a woman that goes into a plastic surgeon and wants a little lipo but ends up coming away thinking she needs a tummy tuck and a boob job. Obviously, it's in the best interest of anyone to render more services. If I have a patient that comes in with a toothache but also complains that she hasn't ever like her smile, am I trying to rip her off by suggesting she whiten and even veneer her teeth and get an implant to replace a missing tooth?

It's a dumb dentist that unloads all the veneers, crowns, implants, whitening, and replacing old, ugly fillings with new white ones without discussing what he is proposing to the patient. But that doesn't make him immoral. It makes him a bad communicator.

In many ways, the $200 guy may be a worse dentist than the one that allegedly "overtreats."

For the record, I in no way excuse a dentist that would deceive a patient and drill or otherwise treat a tooth that is not decayed, broken or esthetically unpleasing to the patient. I am not defending such practice. That IS disgusting, but I do not believe in anyway that it is "not uncommon."

In the end, however, I can tell you that it is "uncommon" in my office...it doesn't happen. I hope and believe most of my colleagues are as honest and are also looking out for the best interest of their patients. As in anything, there are bad apples, but they are not common.


Jeff, feel free to make the gratuitous and predictable thin-skin comment.

Total, with build up and crowns

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[Portland Ute]

Total, with build up and crowns

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Pretty reasonable, then.

[Uncle Ted]

Just make sure your dentist is not using paper clips for root canals...

A former dentist has pleaded guilty to Medicaid fraud for using sections of paper clips instead of stainless steel posts in root canals in an effort to save money.

[...]

Some of Clair's patients reported infections after he performed root canals on them, said Grant Woodman, a spokesman for state Attorney General Martha Coakley, whose office prosecuted Clair.

The following quote seems to imply that paper clips can be used in some cases, however...

James Kulild, a professor of endodontics at the University of Missouri-Kansas City School of Dentistry, said there are very limited circumstances under which a paper clip could be used during dental procedures. He said a paper clip should never be left in permanently.

PU, if you don't mind me asking, where did you go to dental school?

[Sullyute]

I have been to 4 dentists my whole life. I have gone every six months except for on my mission. I just had my second cavity ever filled last month (humble brag). My dentist have all been great, however I care more about the quality of the hygienist as they spend more time in my mouth than the dentist ever does.

[Portland Ute]

Just make sure your dentist is not using paper clips for root canals...



The following quote seems to imply that paper clips can be used in some cases, however...



PU, if you don't mind me asking, where did you go to dental school?

At the risk of divulging too much, Oregon Health and Sciences University.

I've seen this and I'm curious as to the details.

It may well be that Medicaid does not/did not cover posts or even the root canals and the dentist did this as a way to preserve the tooth rather than extracting it knowing he would not be compensated. The thinking would be that this would be a provisional fix and maybe down the line medicaid might start paying for posts and or the person would find a way to fix it definitively. Essentially, buying the patient and the tooth some time....holding out hope.

I'm also doubtful that the paper clips caused the infection. My guess is that the root canals failed (there can be several reasons for this...and, yes, poor technique could be one of them) and the paper clips were discovered upon examination. The root canal filling material (gutta percha and sealer) generally seal the tooth and would keep any weirdness from the paper clip from causing a problem. The main issue with the paper clip would be, I imagine, corrosion and failure of the restoration but not the direct cause of infection.

[myboynoah]

In some ways, it's like a woman that goes into a plastic surgeon and wants a little lipo but ends up coming away thinking she needs a tummy tuck and a boob job. Obviously, it's in the best interest of anyone to render more services. If I have a patient that comes in with a toothache but also complains that she hasn't ever like her smile, am I trying to rip her off by suggesting she whiten and even veneer her teeth and get an implant to replace a missing tooth?

Oh great, now GoatNapperer will jump in with his "Oh, oh, oh, boobs are in! Boobs are in! Boobs are in!"

As if someone needed to tell us that.

[Mrs. Funk]

Ugh. That sounds terrible. I avoided the dentist for six years until last week when I finally went in for a sore tooth that was evidently fine; small cavity in another tooth.

They told me that the silver filling I have in a bottom molar will eventually need to be removed and replaced with a composite filling, so I might as well do it then. The dentist who put in the silver filling scoffed when I asked about composite fillings, so I went with it. (This is the same dentist who acted as if getting a cavity was a moral failing on my part, especially when my kid brother didn't have one. He admonished me to take care of my teeth, "Like [my] brother," which admonition if I followed would involve sheer dumb luck and substantially less flossing and brushing than I do myself.)

Dentists and chiropractors are like locusts in the area we live. The sheer ubiquity makes it difficult to choose one.

[wuapinmon]

I went to Frandsen Family Dental once in Orem. He pounded on my teeth with the handle of his dental drill and then asked me, "Does that hurt?" He said he couldn't believe that two of my teeth didn't kill me.

He told me that I had "lesions" on my tongue where I had bitten it that I needed to see an ENT about (the ENT didn't even send anything for biopsy). And, Frandsen told me that I'd need a lot of work done.

I never went back.

[Moliere]

$14,555

Yowsers....

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My dentist is a friend that went through the accounting program with me. Anytime he suggests I have something done (like a small filling) I always ask if he's bought a new car or boat or other toy. He's a good guy and he even lives in the same ward as one of the Huntsmans.

[Katy Lied]

Portland Ute: This is a serious question for you.

My insurance, as well as most, pays for two checkups every year; one every 6 months. Would you recommend that my family go to one dentist for the one checkup, and then another for the second checkup? That way, we can seek for some sort of common recommendation? And be protected from unnecessary dentistry?

Even if we go to 2 different dentists, over time we would develop a relationship with each one. After all, once a year (for each dentist) is still a lot more than some people go.

[lambdacoug]

Well, I feel better now about my recent dental bill. A root canal, crown and some cavities. I haven't gone to the dentist for about 4 years, since the divorce. I expected things to be a lot worse, but will still be out about $1,500 by the time it's all said and done.

One thing's for certain, I'm never neglecting my dental visits again...