So, my sister has avoided dentists for quite a few years, but finally reached the point that she needs one, so went in. Long story short, she needs a lot of work (she’s missing a lot of back teeth, among other problems).
My question is not the diagnosis, but the cost of treatment.
Her dentist has recommended (as far as I can tell) 5 crowns/implants (at about $2K per) plus one partial denture (at about $3K). Add in the work already done (examination, deep cleaning of the healthy teeth, and some consult fees) and the total is around $14K.
My first impulse is to tell her to go get a second, separate examination and estimate. We are in separate cities, so I can’t send her to my dentist or even ask him about this dentist. But if the estimate she’s been given is within the normal range for this kind of work, maybe it’s a waste to go for a second opinion.
My concern is motivated by the fact that she doesn’t have dental insurance, is retired, lives on a fixed income, and really does need to work for quality of life reasons. So, I’ll be covering the costs, whatever they are. I can afford it, so that’s not the issue.
Should I send her to a second dentist or just accept that this is what it is going to cost? I’m going to talk to her tonight, so it would help to have some ideas in the next 5-6 hours.
She should see several dentists to get different diagnoses and estimates. It will be expensive for implants. She might want to consider dentures it’s a lot less time and pain involved besides the cost. And depending on the extent of the work just 2 implants can be used to hold a complete upper or lower denture in place. It is very expensive to try to save teeth that are just going to cost more money and pain over time.
As a qualifier, I’m nearly finished about $30,000.00 dental investment so I know a little bit.
Absolutely get 2 or 3 estimates, but also look to see that the dental office has a good reputation. Like any trade, there’s good & not so good.
I selected a large place that had all specialties under the same roof and am glad I did. It saves trips to different offices. I required the implant specialist, a Prothsodontist and a Periodontist. There’s also the benefit of them being handy to one another for exchange of ideas. This alone saved me one procedure.
It sounds like most of your sister’s teeth are pretty much history. For that reason, I would suggest she look into an All-On-4 procedure (Google). It will be considerably cheaper than individual implants. Still expensive though. Dentists are like veterinarians when it comes to charging the earth.
Also; I had looked into going to Mexico. I found a place and had discussions with them and was quite impressed. I think for certain procedures it could be a good choice. It’s a lot cheaper. I’m glad I didn’t go. It turned out my work was more extensive and required far more visits than would have been logistically possible with trips to Mexico.
Good luck!
She should be able to get a treatment plan and estimate from a second dentist for quite a bit less cost than the first one because new X-rays, etc won’t have to done, the images can be forwarded to Dentist #2 from Dentist #1.
If your sister lives near a College of Dentistry, all the needed work could be done for much less. In my area the cost is 1/3 to 1/2 less. The student clinicians are very closely supervised and evaluated. That could also be a good source of a second opinion about the plan of treatment.
For myself I will do anything to die with all my teeth so I would do almost anything to retain them and avoid full dentures. Implants have gotten much more mainstream and can make sense, especially to stabilize a jaw or anchor something partial.
So, yes, I think a second consultation would be reassuring.
Having had to recently get a crown myself I think the cost to both me and insurance combined came to around $1400, but I did not need a root canal which would have bumped the cost closer to $2k. Just for a data point.
Having recently done some cosmetics on myself and some replacement dentures out-of-insurance-network for aged MIL, these seem like standard fully-uninsured a la carte retail prices for my mid-to-high cost of living area.
Can you get cheaper? Sure. Eaqsy to get shite work though. Best value for dollar is probably the dental college approach BBBoo suggested.
For damn sure Dear Sis could have avoided half this expense w decent maintenance all those years she was “economizing”. Just like my MIL.
As I understand it from your posts, my best bet is to move to Mexico, get some cheap dentures to change my facial contours, and change my name to Miguel Sanchez…
Or have her get a second opinion and see if it tracks to the diagnosis we have now.
Is there any way to get dental insurance that’d cover some/most of the work?
I know with a “cafeteria plan” at my work, I can set aside $XX pre-tax and then pay for health/dental work out of that. The catch is I have to guess how much I’ll need for the year.
My dentist knows that, so she’ll often say “You’re going to need a crown on this bicuspid… either now or I can do it in December and bill you after the first of the year.”
No need to move to Mexico or change your name. Pre-COVID at least there was plenty of “dental tourism” going on. Clinics doing perfectly solid US quality work at Mexican or CentAm prices.
Not worth flying down for a cleaning. But I know several folks in my biz (airline) who got a full set of crowns done in Costa Rica for $300/tooth, not the $2000/tooth that seems to be US standard.
Fly down, get examined, hang out a few days for them to be made, have them installed, wait a couple days for any adverse problems, then fly back home. Meanwhile you get a 10-day vacation in an exotic tourist-friendly city to boot. The vacation more than pays for itself once you know you’re going to do the dental work anyhow.
During COVID I expect things are more difficult, but I also suspect the clinics are even more interested in incentivizing US visitors / patients to make the trip.
All of my remaining teeth needed to come out a few years ago. One option was 4 posts up and 4 posts down, where they put in 8 implants and a whole new set of teeth. It was only going to be $57,000!
I’d advise against this, based on the stories that my long term dentist told me about his experiences in dental college (at a very reputable school)… well let’s just say that you get what you pay for.
I went to undergrad and grad school at USC in Los Angeles. We had a brand name dental college. I didn’t avail myself personally of their services because I just didn’t need anything they did. I have yet to have my first cavity at age 62.
But other undergrads got perfectly decent results for fillings, extractions, wisdom teeth removals, etc.
I certainly don’t know how well that work aged over the subsequent decades, nor how much cruder it was than journeyman state of the art workmanship at the time.
I just had 50K put into my mouth ( 26 implants, full fixed arch top and bottom) It was expensive but I’ve worn dentures for 40 years. It was worth every penny. Dentistry is expensive but I can tell you first hand tooth loss is no joke. I would do whatever it took and spend the money now to save as much as you can. My two cents for whatever that’s worth. At least two cents I hope!
I suspect she’ll require a couple of CT Scans before the scope of the work required can properly be evaluated. Regular x-rays are fine but don’t show everything.
It’s possible in addition to implants there may be some bone graft required if sister has been missing teeth for an extended period (years).
In the meantime, maybe a ‘go fund me’ page could be in order. It seems that’s how people pay major expenses these days. Rather brilliant - get others to pay!
Definitely get a second opinion and price and, in her case, dental tourism or a teaching college is probably a solid option. Also beware of dentists who "prefer to be conservative. I had a tooth that I thought should be pulled. Please pull it, I asked. Oh no need to do anything that rash, I was told. A crown will take care of it. Well, two months after the crown was on I was still having problems so they broke through the crown and did a root canal. Three months after the root canal, they decided the tooth needed to be pulled.
I was charged every step of the way. They tried to sooth my extremely ruffled feathers but I had had it with them (I have three other crowns, all done by them and I’m sure that I needed two of them). So I had someone else install an implant that is working well for me and cost less than the original clinic wanted me to pay.
I am now very wary of big chain dental businesses.
We talked. She’s going to get a second opinion and we’ll go from there. I probably won’t go to extraordinary lengths to save money. I just want to make sure the recommended treatment is the right one and the cost is going to be reasonable for the standard of care.
You are good brother to enable her to get the dental care that will allow her to keep as many of her natural teeth as possible. As far as her quality of life goes, full dentures would be a distant second, so kudos to you.
FWIW, those prices would be only at the upper mid-range in my Midwestern university Capitol city, so I don’t think you are being ripped off.
Might your sister be willing to agree to twice yearly cleanings and check ups to keep things in good shape once her mouth is restored? In the long run not only is it cheaper but that would be easier on her. Dental prevention really is worth a pound of cure.
I have BC/BS dental insurance. It really only covers two cleanings/checks a year. After some benefit years a portion of restorations and root canals and crowns are increasingly covered but it is more of a forced savings plan than actual insurance in practice for those kind of things. The type I have you have to buy in concert with BC/BS Medicare supplemental but @John_T might know more about any possibility of dental insurance for her.
