Dental Insurance Is Crappy

Thanks to fairly aggressive bruxism (I clench in my sleep - and have used nighttime bite guards for 7 years) and thanks to dentists not really telling me how bad it could become until I was in my 30’s, I’ve managed to wear my enamel so severely that I now need 3 crowns and 2 fillings (cavities because the enamel is so thin). I have dental insurance, so I figured “how bad could it be?” Ha. Annual payout maximum is $1,000. The estimate from my dentist is $6,000.

There goes my down payment for the condo I was hoping to buy. Having to choose between apartment living and a healthy mouth vs. a condo, I’ll have to go with the teeth.

I really like the dentist I’ve been seeing. And he’s the only who told me when I was 33 that the bruxism would cause these problems. We did the bite guard, but I clench during the day (and during naps - who goes and gets the bite guard before sitting down for a movie?), so it only does so much, plus I should have been using a guard since I was a teen, but no dentist told me until I was 33 that the wear was so bad. So thanks to my previous crappy dentists, and thanks to my current crappy insurance, I will be out $5,000 by February-March. Yippee!

I hope nobody expects anything for Christmas!

I know you like your dentist, but I would get one or two more opinions.

Yes it is. I hate selling it and only do so when the client specifically requests it. The premium to benefit ratio is just horrendous.

I know I live in a place where dental work is cheap – outside of certain Western-style hospitals, although even there it’s cheaper than in the West – but $6000 for three crowns and two fillings still seems excessive to me. I agree you should seek further opinions.

I paid about $1000 each for my crowns, and fillings should only be a couple of hundred. You don’t say that you need a root canal for the crowns; that would account for the remainder of the cost, if so, as they run $700-900. (In my experience.)

Get one of the crowns real quick this year, and more work done in January. That gives you two years worth of maximum payments. Have your dentist triage the work and see if maybe one of the others can be put off until 2012, maybe with the help of a (much cheaper) temporary crown.

Your dentist should be willing to work with you to help get as much out of insurance as you can.

I agree that the work is well worth doing, but there are potentially ways to work around making such a large outlay all at once. I’d look into them, if it were me. Keep in mind that the crowns will not last forever. Assuming an average lifespan for you, you’ll replace them at least twice. So don’t think that the cost is worth it to buy something that will last the rest of your days.

Part of if might be the cost of a “fancier” dentist - they only do composite fillings, for instance. They don’t do the grey fillings at all. So the fillings are $225 each. The crowns are porcelain/resin I think (the estimate’s at home so it’s not in front of me right now), but the crowns themselves are quoted around $1300 each, and the under work - the core build-up and any pins - is extra on top of that. I don’t remember how much that was - another 300 each, maybe?

I always loved having all natural-colored teeth where my fillings couldn’t be seen. I have no problem paying extra for that - but I may just have to shop around for the crowns. I have a referral from a coworker who really likes her dentist - I may have to see about consulting with them. Since I “own” my x-rays I can take them, and I have really nice digital pictures of the problem teeth, so another dentist should be able to make an accurate quote without needing to put me in the chair.

I have an appointment for the fillings and another deep-cleaning on the 23rd of December. We may go ahead with a crown on the one real problem molar then, too, so I can max out my calendar year and do the rest in Jan-Feb. But I think I’ll shop around in the next 2 weeks. One thing with the insurance, I can go to any dentist at least.

I’m just so disappointed that if it wasn’t for the bruxism, I wouldn’t need this done, and I’ll probably go through the crowns faster than normal, too. I kind of wonder if I should go with steel ones, anyway, maybe I won’t damage them as easily as porcelain/resin. I would rather have functioning teeth than perfect-looking ones if I really have to choose. And unless I win the lottery, I have to consider what I’ll be able to afford in the future, too. Though once I’m in my 60’s maybe I’ll care less and have no problem going the cheaper route then.

Jaysus! I just had a filling put in on Thursday. US$20. I don’t understand how people can afford most dental work over there anymore.

I’d look into dental tourism. Hunting through the website I see a clinic in Cancun, for example, that has prices for a fraction of yours - $400 - $550 per porcelain crown, depending on the number of porcelain layers. I’m sure there are plenty of good places in Mexico and Costa Rica where you can have all the work done and still come out ahead.

Indeed. The cost savings often pays for the trip itself and then some.

Our dirty little secret - our healthcare is universal here, but apparently your teeth aren’t part of your body. Dental insurance here is pretty crappy, too - even with my husband’s insurance through his job, I still end up paying $1000 - $1500 each year for dental work (crowns, root canals, etc.). Part of the problem that made me really annoyed was that the insurance has a schedule for what they pay that’s based on (if I recall correctly) decades old prices. Guess what? Dentists charge more than that now! I didn’t understand what was going on when I was getting charges for procedures that were “100% covered.”

I hear you about wishing you had got your night guard years ago - I have naturally bad teeth, but I might been able to hold off on some of the work if I’d been flossing and having a night guard since my permanent teeth came in.

Oh yeah, my uncle went to Mexico for dental tourism, too. He seemed to like it just fine (he had major work done - a mouthful of root canals and crowns or something like that).

You are lucky. A dentist once looked in my mouth and said “If you were a horse, we’d shoot you.”

A crown in Chicago goes for between $500 and $750, that’s the crown the work is extra. A filling is about $125 to $180 depenind on the tooth.

The thing to be aware of is the teeth opposite the crowns are going to wear down much quicker. So after you get them always have the dentist pay special attention to the teeth opposite so at the first sign of a crack you can get it fixed.

Last, do you like the color of your teeth? If the crown will show, that is the color it will be forever. I had a crown in 1995 and it’s much whiter than the rest of my mouth. So if I ever want to get my smile cosmetically altered, I’d need to pull that crown and replace it to match or try to whiten the rest of my mouth to match that single crown.

Dental is expensive I’m disappointed something couldn’t have been done with the upcoming health care bill to require more since dentistry can do so much with restoring and implants but the insurance will make you settle for partials and dentures as they are much cheaper.

Oh well the other alternative, as the British say is “Keep a stiff upper lip”

Costa Rica also has a good program, but I could never crunch the numbers because you still have to stay for a good length of time. A root canal will take you two or three weeks to complete so you’d have to vacation and a dentist can only do so much to your mouth at any one time. I guess if you’re retired or have a lot of time to spare.

I found the amount of time I’d miss from work would be more than paying for it up here.

That’s interesting; I have four crowns, and they are all opposite each other (middle molars on all four sides). I didn’t plan it that way; it’s just how the teeth broke down, but maybe that’s why (I got a crown, then the one opposite it got worn down).

ETA: My uncle is retired, so they did just go down to Mexico and hang out until all his work was done.

Same, but different wording:

“Go have them all yanked out, wait six months for healing, then come talk to us”.

About WHAT?! :smack:

Yikes! Are things better now? Tell us your mouths are OK!

My hygienist wants me to floss differently, and twice a day for the next month, and she recommended an Oral-B rechargeable toothbrush that’s not too expensive, and finally to use either Listerine or a salt water rinse after flossing/brushing. Once we get the 2nd deep-cleaning out of the way (because I hadn’t had a professional cleaning in a few years), I can go back to once a day flossing and forget the rinse.

So, I guess that’s lucky, there’s no periodontal disease or anything, just more gingivitis and pocketing than they’d like to see because I avoid my cleanings. Which is dumb, because those are covered twice a year! None of that would have changed the state of my enamel, however, and she said I’d still most likely have the cavities (they’re all on top, where the most wear is) and need the crowns thanks to the bruxism. She said keep the gums healthy and I’ll avoid root/bone problems, and hopefully just regular crowns are what I’ll have to worry about.

sigh It could be worse, but it’s still more cash than anybody would want to wave bye-bye to. I guess it’s better now than after buying a condo - then I wouldn’t have any money left at all for another couple of years!

Do some of it in December and some of it in January.

I’ve been pleased with Delta Dental. I get it through my employer. They even let you roll over unused deductions from the past years. I was impressed at how many dentists take Delta. I had no problems using my family dentist.

They are in all 50 states. YMMV depending on who (locally) administrators the plan.

I totally understand. Dental work is horrendously expensive. I have a daughter who needs a root canal because of a broken tooth. The fillings that patched the tooth took our new storage shed money already. No one will even see her without 50% cash up front and she’s already had an infection in the tooth.

No dental insurance at all here. :frowning:

Back when I worked with Payroll & Benefits for a large bank, the dental plan paid 80% of “normal and customary” charges for each procedure. So most of us after a dentist visit would pay our 20% of the bill, only to find out later that the insurance plan paid 80% of a smaller amount, so we still owed some additional amount.

But the way they decided those “normal and customary” rates had several features that resulted in them being lower than actual current charges:

  • They were based on the rates charged the previous year. And because of the timing, it was often charges from 2 years ago (for 2010, you selected your insurance plan in December of 2009, so rates were set based on 2008 charges).
  • charges for the whole state were averaged for this. So that charges from the big cities were averaged down by charges from small town, rural dentists, who were often much lower.
  • the charge from each dentist was entered only once in the average, regardless of how many such procedures that dentist did. So the charge from a small dental practice that did 5 root canals in a year had the same effect on the average rate as a busy dental practice that did 5 root canals every week. And the rates charged by small dental practices seemed to be cheaper than those of very busy dentists.
  • ‘referral’ dentists (specialists that the complicated cases are referred to) were not included in calculating the average charge. But an ‘average’ isn’t accurate if you exclude the high cases.