Has going to the dentist changed?

In My Humble Opinion
1

I went to the dentist on Friday, after battling with a couple of cavities, and the need for the replacement of a couple of bad crowns. It has been over a year since my last visit to the dentist, so I figured my x-rays and cleaning would be performed, and any other work done later in a follow up appointment if it was more involved than just drilling a hole and filling the cavity.

I was there for over 2 and a half hours… I had two different hygenists look at me, as well as the dentist. All very nice, but none really doing anything other than taking xrays and poking at my gums with a gum pick.

They also took my insurance info and another person took that and compiled no less than three different scenarios from which I could chose, depending on what I wanted to do. The path the dentist advised, to no surprise, was the most expensive one. It also seemed to have a lot of risk associated with it, since he wanted to shave down a bone under my gum line. Apparently, I don’t have a lot of room between this bone and my sinus.

Anyway, I left with a handful of papers, with each approach outlined with costs and time. (the bone shaving option will take about 8-12 months to heal!), I didn’t even get a teeth cleaning, as they said that I required a DEEP cleaning, which cost more than a regular cleaning, and I’d have to come back for. the cleaning would take approximately 5 hours, and would be done in two sessions of 2.5 hours each! I would have invested 7.5 hrs. into this dental visit just for a cleaning, while my tooth ache and cavity are still untreated!

I am wondering if this is now SOP at the dentist, or this is a sign of the times.

I am guessing that dental insurance sucks for most people, and with the economy and unemployment the way it is, I’m guessing that dental procedures are ones that take a backseat to more pressing medical problems. So now, dentists have taken a garage approach, where a customer is given a number of options based on their ability to pay, kind of like going into a collision repair shop with your car and choosing a cheaper paint/clearcoat combo to fit my budget.

Has anyone else had this experience, or does this sound strange?

I am going to go to another dentist for a second opinion before anyone scrapes any bone out of my head. But I also want my cavities fixed and the pain in my head to go away. Do I have access to those xrays, or will I have to get a new set?

Thanks.

2

Sounds weird to me.

Now, the next to last time I had a cavity filled, I was given some opportunity to express opinions, but I think mostly I was told “come back in six months, and we’ll charge you $XXX”

(Most recent actual cavity was so small I was asked if I was willing to stick around for fifteen minutes, and try it without novacaine, and I did so, successfully. I guess it’s better to have very slight cavities on one’s front teeth, rather than the back molars).

But for the x-ray question, I’d call your dentist office and ask–my guess is that they can make them available to you (possibly for a nominal fee), but don’t routinely do so, and even if they give them to you, I’m not sure I’d assume the next dentist won’t want more or different views.

Of course, the whole bone scraping thing makes me think you have complicated teeth, which isn’t odd, except for the whole bit where you weren’t expecting to be told you have complicated teeth.

So, yes, I vote for second opinion, and try to get it without mentioning all the stuff that this dentist wanted to do to you first.

3

You went to a rich, dick-head dentist, they seem to be becoming more and more common.

They are more like cosmetic surgeons than real doctors. The main goal is to max out your insurance while making you feel bad enough about your teeth that you will continue to come back. They upsell you stuff you don’t need. The whole goal is to give you a movie star smile, when all you want is your teeth to work until you’re 75.

Run away fast. Find a decent family practice that will fix your teeth at a minimal cost.

4

do you have really bad gum disease? If so, I’d insist that a periodontist do the deep cleaning and bone scrape.

I waited a couple years one time for a dentist visit. The hygienist didn’t waste time with picks or scrapers. She used this water jet thing and power washed my teeth. Not a lot of fun. I’ve gone back to my six month cleanings ever since.

5

I think it’s safe to say that when a dentist views a mouth full of teeth, they see 36 times $3,000, or about a hundred grand in there.

6

I second the idea of a second opinion.

I’m guilty of not visiting the dentist as often as I should. Last year I was eating some Dots and pulled out an old crown. I went to the dentist the next day and he took the impression, then I went back a week or so later for the new crown (it wasn’t cheap, but I knew it wouldn’t be). He didn’t try to sell me anything else, not even a cleaning.

I think your dentist has some boat payments coming up.

7

Thanks, everyone for the sanity check. I was very pissed when I left, and I felt like I was being hustled. I’ve never felt that way in a doctor’s office or dental office in my life.

Not that I know of. I have skipped years between cleanings before, and have never dealt with anything for a cleaning but a standard scraping. With that said, I have no problem with doing a deep clean… my issue was I didn’t know that there WERE different levels of cleaning. And those were broken down into costs for my insurance and my own costs. If the teeth need to be cleaned and to do that they need to bring in crime scene cleanup crews in hazmat suits, fine by me. I’ll pay, as I don’t want my teeth falling out of my head. However, this approach was just weird stuff to me, and I wanted the sanity check.

This is the first time I’ve ever heard of bone scraping. Up until I broke a tooth in half (back molar, hurt like hell!), I really didn’t have many problems at all with my teeth. Just had to wear a retainer during high school.

And as many x-rays as I’ve had on my teeth, I’ve never heard that my sinus is too close to the upper bone. But then again, the reason this came up in the first place was because of the solution the dentist was calling for (an implant, not a crown).

The other thing that made me wary was that when the woman who handled the finances clearly could see I was uncomfortable with what I was seeing, she gave me an option to get half the work done now, half next year, since my insurance would again pick up most of the cost starting next year (they pay only so much / year, and once I hit that number, everything is out of pocket until the next calendar year).

If it is something I must have done or my health is going to be jeopardized, let’s do it now regardless of insurance costs or coverage. If you think I can wait until next year, it doesn’t sound too urgent to me.

8

You’ve encountered a business model for many new dental practices. The dentist will say that you need a complete examination by a hygenist, then a dentist, a full set of XRays, charting, history, and then a recommendation to do everything possible to your teeth and gums to fix anything real or imagined that could be called an imperfection in your teeth. Your insurance has to be checked for the available coverage. They’re really not interested in you as a patient unless you plan to spend a lot of money there. The dentists are often employees at these practices, and you may never see the same one twice. I recommend walking right by these places and finding a small private practice.

9

Have you thought about traveling outside of the USA for the dental work?

Depends on where you go of course, but here in Trinidad I can go to a private dentist that meets or exceeds reasonable standards and have a cavity filled for under $50 USD total cost(hell as low as $20 USD actually).

You won’t be hit with a bunch of bullshit and bill padding, you won’t be pressured into cosmetic procedures and all that crap.

10

I’d question the dentist’s math, then. Most people have 32 teeth at the maximum.

11

Most people? Does anyone have 36 teeth? If you’re super-wise do you get to have super-wisdom teeth (4th molars)? :stuck_out_tongue:

BTW: Bottle-nosed dolphins have 88 teeth, and they’re ALL canines!

12

Ooh, you need an implant or a crown? That changes things.

Although I’d still get a second opinion.

And I’m still not sold on the deep cleaning thing.

But I don’t think there’s anything weird or scammy about offering to do some of the work for a crown or implant now, and some later. My mother had something similar done a few years ago, over a somewhat extended amount of time.

13

This is the bottom line:

[QUOTE=StinkFishPot]
I was very pissed when I left, and I felt like I was being hustled. I’ve never felt that way in a doctor’s office or dental office in my life.
[/QUOTE]

It doesn’t matter if the dentist was on the level or not, if you feel this way about your doctor or dentist, you should find someone else. Trust is essential when people are charging you lots of money to stick sharp implements into your orifices and either glue stuff in or yank stuff out.

14

Years ago when I was growing up, dentists seemed almost like professionals in something resembling a recognized profession.

Now, they’re more like plumbers but without the high prestige and reputation.

After a few experiences like the OP’s, I trust car salesmen more than I trust dentists.

Does anyone know what happened?

15

I’ve always been suspicious of “deep cleaning” and “sealants” and I’ve always managed to find dentists who clean my teeth, do an annual xray, and fillings as required. He doesn’t even lecture me about flossing any more!

When I was a kid, lo these many decades ago, our family dentist did everything - the cleanings, the exams, and the fillings. At what point did hygienists become standard?

16

November 2010 I had a deep cleaning, the hygienist used a sonic scaler to do the brunt of the work and was done in 30 minutes or so, not much longer than a regular cleaning - but it was pretty bloody and would have taken forever with a lot more pain if she had done it with a regular hand scaler.

I needed the deep cleaning because I hadn’t had a cleaning in 7 years prior (a little scared of the dentist, perhaps), and had moderate gingivitis, with red and swollen gums, and a lot of 4mm pockets (bad, bad about flossing I am. Hate flossing). The game plan was to do the deep clean that day, and to come back in three weeks for regular cleaning, because it took that time for the swelling and pockets to recede, and the hygienist would be able to get the last of the tartar at the second cleaning. Neither of them took crazy extra time to do. Two 2.5 hour sessions seems really excessive to me, especially for someone who was at the dentist a year ago.

They also took pictures of everything, and chart my teeth on the computer, so they can readily show me my xrays, pictures before and after, and my gum pockets (with improvement! The $100 electronic toothbrush really, really, made a difference!) progress over the last year and a half of visits. I’m also fairly certain that if I had any cavities or pain, they would fix that the day I was there and worry about the rest later. My dentist would not let me walk out of there still in pain!

My dentist isn’t cheap, but I trust him and that goes a long way. He does stuff like when he quoted me for crowns it was initially for porcelain, but when I asked him about gold instead, because my clenching/grinding is what led me to crowns in the first place, he said sure, those would be the least likely to need replacement. He just showed me the most cosmetically pleasing option first, because most clients want that these days. I don’t care about what my molars look like, as long as they work and I can forget about them for the next 20 years or so!

I think the OP is absolutely in need of another opinion, and please get that pain taken care of soon!

17

Around the time PA’s and NP’s became standard in medical practices and most vets really amped up their number of assistants/techs, and for the same reason. The doctor/dentist/vet is the limiting reagent in how many patients a practice can see in a day, which is a large part of determining not just how much money they make, but how long it takes to get an appointment. The more time they spend diagnosing sniffles/doing cleanings/scooping poop, the fewer patients they can see, and the longer it takes to get in to see them. If you bring another MD/DDS/DVM you can see more patients per day and get people in sooner, but you don’t really make much more money because although you’ve doubled your income, you’ve also doubled your expenses. But if you bring in a PA/hygienist/tech and let them deal with the sniffles/cleanings/poop while you focus on the more complex/serious stuff, you get the same increase in patient flow and income, without nearly the expense.

ETA agree with this whole 5 hour thing sounds crazy pants to me. I loved my dentist in NC–he would present me with a range of options for an issue, and usually recommended the cheaper option. I had a “deep” (periodontal) cleaning with them, and what they did was to do half of my mouth at one routine cleaning, and the other half at the next one. Actually, they recommended doing a quadrant at a time, because some people have pain afterward, but I went for the half and it was fine.

18

Definitely a second opinion, and find a dentist you like and trust. It may take a few tries.

I’ve found the best dentists in the lowest rent districts. Seriously. If the waiting room is a little shabby and there’s a 6 year old car packed out in back in the DENTIST spot, I know I’ve got an old school dentist who’s more interested in keeping people’s teeth healthy than in making money. Often, a doctor who still does most of the hands on work him/herself, and has enough experience that s/he’s developed a gentle touch, since most of his/her patients can’t afford the good drugs. I like that. You may like something else, but I like that. I look for a dentist who takes Medicaid, even though I don’t have Medicaid. It’s often a longer wait in a dingy waiting room, but the care has always been superior, and I feel like a patient, not a pocketbook.

19

A couple years ago I went looking for a new dentist, after not having gone to one for way too many years. I didn’t specifically know the things you guys were talking about, but some of the dentists on the insurer’s list, when I researched them, definitely gave off the vibe of being the kind of place you’re talking about. Fortunately, I found a small, one-dentist private practice that I have been really happy with.

20

What a great insight.