Requesting Sanity Check on Estimated Dental Costs

In My Humble Opinion
1

I’m going to keep this approximate and somewhat generic, so as not to compromise anyone’s anonymity.

The person has been advised that they need to have their (remaining) upper teeth removed and a (permanent) bridge/denture put in. This person’s upper teeth have been bad for quite a while and are getting worse (they’ve already lost several). Oddly enough, their lower teeth are in great shape. I’ve been asked to provide a sanity check on the proposed cost. They have reasonable medical insurance, but no dental insurance. I don’t have any special dental knowledge, but this person trusts me, so I’d like to give them decent guidance.

The person, and their dentist, are in San Francisco.

They aren’t willing to risk this big a procedure on a dental school, so the only sanity check is against professional dentists.

Here’s the breakdown of the estimate (approximating the numbers and using lay language wherever I can, adding in the language from the estimate where needed).

Removal of 5 teeth at $500 per tooth, plus another $500 for “Surgical Guide” and about $350 for some additional pre and post surgical items (Itero Scan? and PRF Collect/Appl of Autolog?)

Total- ~$3,250

6 Implants (sxl plcmnt of imp: endo) at about $2,700 per implant, a bone graft at ~$1,000, and another graft (Ridge Pres - graft of mand/max) for about $2,000

Total- ~$19,250

Dentures (implant/abutment support fixed den and implant/abutment supported interim) at about ~$7,500 and ~$6,800 respectively.

Total- ~$14,500

Grand Total- ~$37,000

So, is this estimate crazy high for this magnitude of repair, or is it within the bounds of expected costs?

If it’s on the high side of expected costs, this person isn’t likely to go dentist shopping, and I wouldn’t advise them to, since they’ve already gone through a couple of dentists that they ended up having issues with. They like this one, so at least they’ll probably follow through on getting things taken care of.

I just don’t want to see them cheated on this. If the cost is within bounds, then that’s what it will be. They can afford it.

Thanks for any help, and I realize I’ll be getting opinions (hopefully based on factual experience), so I hope to get several in order to vector in on my advice.

2

Seems reasonable or a little low.

All of my remaining teeth were bad and needed to be pulled a couple of years ago. I had 20 teeth pulled in one day (surprisingly didn’t even hurt much) and a temporary set of dentures immediately put in place for a couple weeks. Then a more permanant set of removable dentures were installed. Cost right around $10,000.

The other option that I passed on was 4 upper implants, 4 lower implants, and the installation of a full set of more permanant teeth. Estimated cost for that was to be $57,000 US dollars.

3

I will leave it to experts here to weigh in on this. The one thing that I can say from personal experience, anecdotally, is that a former dentist (I liked him, and he stopped being my dentist only after he moved his practice to another city) once provided an estimate of all the things that needed to be done to bring me into top dental condition. The estimate was something well over $8,000, and this was probably well over 30 years ago, so over $16,000 today.

I didn’t get any of it done, and I’m fine today except for a few minor issues that are totally unrelated.

My point is, the dental estimates might be completely fair and reasonable, but a very important question that needs to be asked is how much of it is actually necessary?

4

The cheapest option is just to go with regular dentures for the top row. You can get that (including tooth removal) for less than $1000*. Implants and permanent dentures are indeed expensive–way more than they should be, IMHO.

*My insurance will literally pay for that option, so it would actually be free for me.

5

Several specific items seem high to me, and I would want to have an explanation of why they are higher than normal, if it were me.

However, online general dental sites (not dentists) estimate from $43K to $56K for a whole mouth. $37K seems high, on that basis, for half a mouth. Location might have something to do with it. What if they found a reliable dentist in Sacramento, for example, a 90-minute drive away, that could save $8K or 10K, would the extra trouble be worth it to them? Or generally, are they interested in getting a second quote from someone else, even locally? For $37K, I think I would.

6

IMHO, it depends on how old that person is.

7

Note that the dental school at UCSF is one of the best in the world, so if it’s possible to get the work done there and save money, you might not be risking much of anything.

8

My wife is in the final stage of having her two front upper teeth replaced with implants. Total cost will be right around $12,000.

And we’re in the Midwest!

9

Thanks for the replies. Keep them coming!

I don’t think another dentist is in the cards unless this one is way out of line. This person has been to a couple of dentists and finally “went back” to a dentist they trusted and liked. I’ll need a strong case to get them off this dentist.

And yes, the upper teeth are that bad. I’ve seen the pictures. Horrorshow.

10

Another vote that getting work done at a dental college is less than risky. Every move that student dentist makes will have been laboriously planned, practiced and defended to several professors, at least one of whom will be literally supervising the student dentist very closely. That student is highly motivated to get it right and to have good chairside interpersonal skills because they will be getting graded on it. A community dentist is not getting supervised nor are they getting a review or grade on their work.

A dental school has to cover expenses with their fees but they do not have the same profit motive that a community dentist has-the more the community dentist does and the faster, the more profit.

It is very likely that the student dentist doing the work will be in a post graduate specialist program, so they will have already graduated from dental school and passed their boards. They will be full-fledged dentists. They are still closely monitored and supervised by professors in their post graduate program. Mediocre clinicians do not get into or survive in post graduate programs-mediocre clinicians do practice out in the community. No one is giving them a grade or looking over their shoulder.

The only drawback to having something major done at a dental school I have experienced is that, because of the intensity of supervision, a course of treatment can take slightly longer than out in the community at large-plus they are not hurrying through as many procedures as possible to maximize profits. For instance, a root canal and crown I had done at my state dental college (on the recommendation of my dentist to save me a thousand dollars) took 3 sessions instead of the 2 sessions it would have been elsewhere. Since I live ten minutes away, that was not an issue.

Your friend could always take the treatment plan he has and ask for a second opinion from the nearest dental college. The savings can indeed be significant and it is not at all risky.

11

That estimate is not at all out of line. Also, based on what I’ve seen living with someone who has full dentures, I respectfully disagree with @BigT . If you don’t have some solid molars to anchor a partial, dentures can be really annoying, limiting, and sometimes painful. If we had it to do over again, I’d urge my loved one to go with the implants.

12

I never said what was better. I just pointed out that regular dentures are a lot cheaper, and that it is the permanent nature that is making the cost so much higher.

What my dentist told me is the complete upper dentures tend to work well (especially with denture adhesive), but that lower dentures are much more of a problem. They’re the ones that tend to slip out.

I personally think that people should consider all options. If she’s already considered and rejected regular dentures, fine. But that dentist better have at least given the option–while explaining the downsides.

13

Often you don’t need all individual implants (6 noted above) - you can a get several attached on 1 or 2 posts.

14

What about going to Mexico for the work? That seems to be all the rage amongst my cohort.

15

Won’t work unless you’re really close. Several visits will be required so multiple plane fares & accommodation will wipe out any saving.

16

I’d see how long of a time period the work can be spread out over. Dentists can often prioritize stages of the work and work on them over several years. In the mean time I’d suggest this person get dental insurance that offers the most annual coverage and max it out each year.

17

More possibly useful anecdote on costs …

I live in Miami. Not as generally expensive as SF, but up near there.

About 4 years ago I had my 10 upper front-most teeth veneered. Which is a cosmetic procedure to grind off a bit of each tooth then glue a porcelain front face on each tooth so they all appear straight and uniform. Each veneer actually wraps partly around the sides of the tooth, so grinding each tooth slightly narrower to make room for the side of the veneer is part of the job. The actual grinding work on all 10 took just a few minutes, so not very extensive.

As part of the same process I did Invisalign on my rather scraggly lower teeth. We did the upper veneer installation just as the Invisalign process came to its slow-motion conclusion.

Total bill was ~$22K. For something vastly less invasive than the OP’s friend is looking at. And for something that was purely cosmetic with negligible functional improvement to a set of teeth that were already fully functional and fully healthy. FWIW, I’m very happy with the outcome. And not feeling ripped off about the price although as always, less expensive would have been nicer.

This being a purely cosmetic procedure my dental insurance paid zero. As expected, and legitimately so IMO.