If my dentist tried to charge me $900 for a scaling ( he doesn’t call it deep-cleaning and I like it that he doesn’t dumb things down ) I’d be skeptical too.
I had one ONCE on his recommendation - I’ve been a patient of his for over 10 years. But it cost $400 and this is an office located in Midtown Manhattan.
He’s never recommended it since…even though I’ve asked if he thought I needed it done again. You’ll think I’m crazy but even though I hate going to the dentist I LOVE deep cleanings…it may hurt a little but it hurts in the same feel-good way that a good massage hurts…I call it the dental spa treatment.
This thread is very interesting to me and thanks for zombifying it.
I haven’t had insurance for around 6 years now, and haven’t been to a dentist because of it. I got a Groupon for a dentist who tells me I have 8 (I think it was 8…coulda been 9) cavities and gives me a “deal” to fix them for $22,000 or whatever stupid high number he gave me. Never did it cuz I never had the money, and since then I’m scared to go back.
Whenever hell freezes over and I get a job/insurance again I’m weargard(worried and eager) to go to a new dentist, not tell them my predicament, and see what their xrays say. This thread has given me a bit of piece of mind though.
We just recently changed dentists because my husband was very unhappy with the way they treated him. When I was looking for a new practice, I did a little research on line and came across this- very enlightening!! Everyone should read and heed!!
However, you can always ask if they’ll do that. If you explain the situation they might approve it. Or they might not.
In my particular case I was explicit I was looking for a second opinion. I waited sufficient time (fending off calls from the pushy dentist for months) until my insurance would pay for the visit.
You can always ask for a reduced price… they worst he’ll say is no, right? Then you have to decide if you’ll pay out of pocket or not.
But, to my mind, paying $100 to make sure $5k or $10k of treatment is really required is a good trade. YMMV.
Sweet Jebus, if that is the sealant they were working on back in the 70s at Eastman School in Rochester NY, fucking get it, do not stop, RUN! I was one of the test kids, and I have always had craptastic enamel even with the fluoride treatments and everything [I ended up with cavities no matter what] and the 2 years after I got them sealed I had absolutely no cavities or demineralization from acid at all.
Damn, I have never had it offered to me since … I need to see if I can get it!
I had almost this exact experience when I went to Aspen Dental for the first time. My regular dentist retired and I was dentist-less and I just needed a cleaning on a Saturday. Nope. No cleaning ever happened.
My experience was a little different because they did give me x-rays, a lot of x-rays. After what seemed like 18 or so I started to get nervous and tried to keep count. Anyway, they quickly declared that I needed scaling and furthermore that they absolutely could not give me a cleaning until months AFTER the scaling was completed, to prevent further infection or something. I was told a lot of scary numbers about my gums. Anyway, the thing that bothered me most was that 90% of my visit and dental planning was with the office manager. They trotted the dentist (clearly a recent grad in their 20s) out for about five minutes to declare that I needed scaling, but all the dental decisions were guided by the office manager.
I stuck around for one treatment (a hygienist scaled one quadrant and packed some sort of antibacterial powder under my gumline) and then found a local dentist practice. One with the actual dentist’s name on the door. Surprise, surprise, I haven’t heard another word about scaling and they actually give me a cleaning every six months. I really have serious misgivings about the ethical standards of national dental chains. There doesn’t seem to be any accountability besides to their shareholders. I also think that any dentist worth his or her salt wouldn’t work in a place where the actual dentists seem to have so little apparent authority or influence.
My husband was told he had periodontitis and needed to have this done.
Insurance declined the extra cost, saying they didn’t see evidence of enough perio disease. We tried fighting it but basically they ignored the appeal and we didn’t have the energy to push.
So since then, when he gets a perio cleaning (or some other perio treatment; he’s had gum and bone grafts) they decline THOSE because he has no history of perio disease.
The lack of history is, of course, because their records show they’ve never paid for such treatment in the past. Because they declined to pay for it that first time. Nice scam.
I was asked to weigh in on this via PM. I feel flattered. Sorry to take so long as I’ve been offline for a bit.
Deep Cleaning = Scaling and root planing = SCRP is a real thing needed by many people. It is used to treat gum disease/periodontitis. It is indicated for removal of tarter under the gum line. Subgingival tarter harbors bacteria which allows for further gum loss due to inflamation.
Does everyone need it, of course not, something like 10-25 percent or so. There is a bit of room for interpretation. To determine if you need it the dentist examines the x-rays for evidence of bone loss and takes measurements of the pocket depths. They use a periodontal probe and take 6 measurements around each tooth. Healthy pocket depths are 2-3mm. A few 4s or a couple of 5s is a bit of a worry 6s and up is usually a problem.
If you have questions ask about it they should be happy to explain. There are offices that over use it but a lot of offices also undercall it. This is why some people have been at one office for years without it being mentioned and then a new office makes the proper diagnosis. Most insurance covers it with limitations.
One other problem is that patients ask to “just have a regular cleaning”. The problem here though is that if one has peridontal disease a regular cleaning is not an appropriate treatment. If the dental office only works on the tooth above the gumline while ignoring the subgingival tarter it is malpractice. Of course during the SCRP the supragingival tarter would also be removed and the teeth polished, the regular cleaning that folks want.
Thanks for weighing in, rsat3acr. It sounds like my treatment may actually have been correct, just poorly explained to me. You mention that the supragingival tartar can be removed at the same time as the scaling. Can you think why they might have told me that I’d have to wait months to get a regular cleaning to “avoid spreading bacteria”?
Also, if some dental practices don’t identify and treat cases needing scaling and planing, what happens to their patients long term? Do they get more cavities or lose teeth or what? Can you get a cavity below the gum line?
Well, my mom lost her teeth not to decay but to gum disease - the gums were so destroyed they simply could no longer hold her teeth in her jaw. So… I suppose that’s a possible end for the process.
scaling IS removing the tarter, root planing is scraping the root to make it smoother so tarter and bacteria have a harder time gaining a hold. In my mind a holdover from days past when they thought it made a difference. When viewed microscopically the planed root isn’t smooth. One would always remove supra and subgingival tarter at the same appointment if doing SCRP.
Why they said that about spreading bacteria I don’t know. Makes no sense to me. May be what they say when trying to hard sell treatment. Failure to diagnosis periodontal disease is one of the major reasons for dental malpractice suits.
Often it isn’t explained well. Patient confusion if the biggest problem I see when giving second opinions. In the long term untreated periodontal problems lead to tooth loss. It is the major reason for tooth loss in the U.S. Yes one can get cavities subgingivally but that usually isn’t as big a problem as loss of the bone that holds the teeth in.
I have to jump in with and ask for advice also, please.
Last year my office stated I needed a deep cleaning. It took about an hour and cost me $60. They said insurance doesn’t cover it. They said my pockets were 4 and 5’s, if I recall correctly. Anyway, over done with, right? No, they say I need to come every 4 months and pay out of pocket for deep cleanings every visit. My last one took about 30 minutes.
Is it normal to need deep cleanings 3 times a year and be told in advance?
I’d love to know how on earth HIPAA was supposed to do that!
Anyway, agree with everyone who points out that a “deep cleaning” is necessary for people with periodontal disease. BTW, the deep cleaning isn’t awful. I have comparatively minor perio (both of my parents have it, too, much worse). I had a deep cleaning two years ago and was fine last year when the hygienist checked my gums. I know at least one pocket seems to have resolved itself. We’ll see how it is at my cleaning this year.
Welcome aboard CLA1031
A lot of people need to come in three times a year, a lot of people don’t. 4-5 mm pockets are probably moderate perio at best. Very often these people, with good oral hygiene, can get by with regular cleanings.
Can’t say why yours was so cheap. That would be close to a usual amount for a regular cleaning.
Thirty minutes is pretty quick for a SCRP.
One possiblility is, and I am not making accusations, they billed the insurance for a regular cleaning as well as you for the SCRP. I’d check my EOB. Of course this may also just what they charge.
I am a dentist. I am honest. Most dentists are honest. Some are not. Same for every profession.
A “deep cleaning” is really a procedure called scaling and root planing, a dentist should recommend it if you have periodontitis (gum disease) and a regular cleaning if you have healthy gums or just gingivitis. The root planing part means the dentist or hygienist will numb you and go down under your gums and lift and scrape tartar off of the very roots of your tooth. This is different from a regular 40 minute 6 month cleaning. I understand the confusion that “deep cleaning” creates and personally do not use the term “deep cleaning” with my patients because it doesn’t really do justice to the procedure. It makes it sound like selecting a regular wash vs a silver wash at the car wash. My car looks the same after either.
Normally if you have gum pockets that measure 4mm or more you have periodontitis. If you have periodontitis, a regular preventative cleaning will not heal your gums and over time you will slowly lose your teeth due to gum disease. Doing a regular cleaning will not remove the tartar that is attached to the roots of your teeth. That’s the difference.
Many patients don’t like to hear about needing scaling and root planing (deep cleaning) for one reason, it means out of pocket cost. The secret is that dental insurance isn’t really insurance and only covers part of the cost of scaling and root planing or most procedures.
My inlaws picked a dishonest dentist, but they never went back. For years, they drove a couple of hours to their old city to see their old dentist, but the drive is a lot for a couple in their 80s, so they looked for someone in their town. They were immediately told they needed all sorts of procedures, including deep cleaning, totaling several thousand dollars, and they declined and made the gawd-awful drive again. Their old dentist told them they didn’t need deep cleaning or any of that stuff, and they’re at a loss as to how to find an honest practitioner in their town.
We’re really pleased with the practice we changed to - a husband and wife team and their cadre of hygienists - no pressure, no nonsense. They told me they could do some cosmetic stuff for me if I was interested, but I’m not and they dropped it.