What does a root canal cost a dentist?

Factual Questions
21

Well, that’s why bridges are a viable option. I’d never recommend a bridge to someone that could afford something better, though, but a bridge will keep your teeth from drifting.

I always feel sorry for my dentist. While he could be the “millionaire next door,” he drives a crappy car, doesn’t maintain his appearance, and works at a dirt cheap clinic. And when I don’t take his upsells, I feel like he’s never going to get ahead in life. He’s not a parter; just an employee. The company takes my insurance, and when you take insurance, you’re pretty much stuck to accepting lower payouts. It’s common knowledge that people without medical insurance (and dental, as is this case) pay the rack rate, unless you negotiate or do shopping ahead of time. I’m talking about my Michigan dentist.

Mine’s about the same for a routine cleaning/inspection. But we’ve gotten in upon request for emergent care, and treatment programs are always available (once diagnosed) in what I’d call a reasonable time.

Well, like I said, a root canal is less than $100 in materials costs. All other costs are highly dependent upon location (median rents and salaries) and the quality of capital equipment (old fashioned film, or modern digital radiographs?), and the cost of insurance. Another data point: my wife’s recent implant was done at cost (here, not in Michigan). It was $1200 USD, and it was charged in USD, because all of the materials come from the United States and are charged to the dentist in USD. That’s it for materials. When time to deal with the crown (acutally, two crowns), the cost was split between $900 MXN pesos (actual cost, the dentist owns his own lab), and $900 USD because a special solid gold adaptor something-or-other had to be ordered from the USA. Total cash price for the entire treatment: $1960 USD. The price quoted to me by my Michigan dentist (insurance only covers bridges) was “$4500 to $5000.” So, the $2500 markup would have to pay for about six hours of the dentists’ time, the assistants’ time, and a proportion of all of rent, utilities, association fees, promotional fees, donated opportunity cost, insurance, licensing, insurance processing, and other things you’d just call overhead. None of that’s cheap, but it doesn’t seem unreasonable.

Why are you outraged that McDonald’s sells you a cup of soda-pop with a materials cost of $0.12 for $1.09?

22

You are paying for his time. You are paying for the equipment that must be clean and safe. You are paying for his nurses helping him, you are paying for the nice lady who answered the phone, you are paying for the nice little fishtank in the waiting area. You are paying for rent, the lighting bill, the heat, the a/c, the list goes on and on and on.

Yes everyone loves money, me, you, doctors everyone. That dentist took out a shit load of loans to go to school and has to pay them back and might have a family, etc.

The fact that he has a skill many do not have means he can charge higher.

I am good with computers and do work on the side, i install windows xp, with office and adobe reader for a local bussiness everytime they get a new computer. I charge $75 a pop because i can and they are willing to pay that.

23

What does their expenses have anything to do with it? Their skill is worth whatever the market will bear. It’s the same of anyone in a skill-based profession. I pay a mechanic for their skill and time in fixing my car; people pay me for my photography. Why would you even think in terms of the dentist’s expenses for something like this?

Anyhow, the prices you quoted seem fair and reasonable to me. It sucks, but (at least in Chicago), that’s about right. I had a root canal and crown put in about three years ago, and it was $1200 for root canal and $600 for the crown, plus another $100-$150 in there. And my guy is quite cheap, as I live in an immigrant working class neighborhood where the market rates are lower than in nicer parts of the city. The time line was: initial visit at family dentist and referral to endodontist, procedure at endodontist, temporary crown at family dentist, permanent crown at family dentist. So a total of four visits from initial visit to permanent crown.

24

Many reduced cost dentistry plans like http://www.aviadental.com/ are legit and save those of us without dental insurance quite a bit of money. I needed a bunch of work done a few years ago (three crowns and some fillings) and saved a whole lot. I don’t recall the exact percentage, but it was all in the 30% and over range.

Do a search for your dentist on the site. My regular dentist was on there, as were a lot of local dentists whose name I recognized.

The one thing you have to be careful of with Avia is that if you don’t want to be automatically renewed for the following year, you have to follow their cancellation instructions exactly.

25

I agree that the sole reason the costs are high is that dentists are simply charging what the market will bear. If root canels always cost $15,000 to $20,000 instead of $1,500 to $2000 - how many people would be getting root canels?
There are also only so many dentists, and as noted they most likely don’t have trouble filling in their schedules with patients.

Having said that, part of the problem is due to regulations there are not many 2nd or 3rd tier options available. Due to these regulations - you can’t have some dental hygienist or failed out dental student open up a shop offering discount cleanings/fillings. Pretty much the only person you can hire to look at your teeth problems are highly skilled professionals whose limited number allow them to charge high to meet the demand.

So it is different than other services one might want to buy in a capitalistic society. Its like you want a car but the only one being legally sold is the cadillac. There might be the few dentists who charge less comparably, but they still must recover their pricy education and equipment costs.

Personally, I’d like to know the justification for not allowing for some 1 or 2 year tech program that graduates dental dudes who are qualified to do simple procedures like cleaning or filling cavities - presumably at lower rates.

26

Well, I can start making my best guess as to the rest of the budget of a hypothetical small dental practice. Once you include interest on the loans your cost of $500/day for initial fixed costs isn’t too far off. But that’s just the fixed costs, salaries and overhead is going to add a lot more to the daily costs of a dental clinic.

I’ll throw out some figures for the cost of all employees. Figure you’ve got one dentist who runs the practice and is getting $65/hour. There are also a couple dental assistants, each earning $13/hour, a hygienist earning $31/hour, and a receptionist earning $12/hour. Of course that’s just what each employee receives, and the practice pays maybe 30% more for payroll taxes and benefits. So the daily cost of wages is $1400. If the dentist only earns $40/hour, if you consider that more reasonable, that drops the daily cost of wages to $1140

For other overhead costs I don’t have much of a clue how to estimate those. Insurance for the practice certainly won’t be cheap. Somebody’s got to come clean the place. Utilities add up to a lot more than what an average household pays, especially with all of that energy-hungry equipment. And that expensive equipment has to be maintained, repaired, and periodically upgraded or replaced. You think it’s expensive to hire a plumber or repairman for your home? Now try to extrapolate how much it costs to hire the only repair technician in 200 miles that knows how to fix one particular bit of expensive and complicated equipment.

I’m sure there’s lots of other overhead costs that I haven’t even begun to think of.

I would be interested in seeing some accounting figures from an example practice (even vague and anonymized), if anyone might be willing to provide them in a public setting.

27

Well most visits are typically a cleaning and a checkup. The cleaning is done by a dental hygienist, and the dentist reviews your records and spends a few minutes looking over your mouth and teeth. I’ve paid around $80 for that sort of visit, and I’ve seen significantly cheaper prices advertised in lower-income areas. I’m not sure deregulation could reduce the price much for your ordinary cleaning/checkup. It might help with some of the simpler procedures which require an actual dentist, like the fillings you mention.

28

Less qualified “dental dudes” do perform cleanings. But you don’t want them filling cavities. You can die from a poorly filled cavity. There’s a reason dentists have medical degrees. Endocarditis from mouth bacteria invading tooth roots are a real danger.

29

A few years back a poor kid died when an infection moved from his tooth to his brain. He needed a root canal but did not get one due to lack of money.

30

Yet another reason that the free market and medical care don’t work well together. All it takes is a tacit agreement by the forcibly limited practitioners not to undersell each other, and you wind up with costs that are much higher than necessary.

And, as pointed out in this thread, quite a lot of people don’t see anything wrong with charging as much as you can get away with. Lots of people lack the morals to not live large while there are other people suffering. Getting more money is the ultimate goal, as they “can’t” live on less. And there is no mechanism in our society to punish that behavior.

31

I don’t have good dentist numbers off the top of my head, but I have quite a few clients in the medical field. Here’s some numbers that are probably good for a small dentist getting started:

$540,000 Net receipts (after insurance decides how much to not pay)
$60,000 cost of goods sold (surgical supplies, lab fees, etc.)
$120,000 Officer compensation (the doctor - including wages, benefits, dividends)
$120,000 Wages & Benefits (office manager, assistant and receptionist)
$60,000 Rent (this is the Seattle area we’re talking about)
$24,000 Insurance
$24,000 Taxes & Licenses
$20,000 Misc Tools & Supplies
$12,000 Interest (not including student loans)
$12,000 Depreciation
$12,000 Advertising
$6,000 Repairs and Maintenance (office and equipment)
$40,000 All other expenses

32

Umm… not sure how relevant this is, but a report from 2006 states the prices for a root canal on the private sector here in Finland were between 57e and 115e and I remember paying something in that vein when I had one done a few years back. That’s the base price without any healthcare fluff. I have hard time figuring out why the same procedure costs 10x as much in USA - is it just because our dentists accrue far less student loans?

33

Where’s the missing 30k go? Oh, wait, shhhhhh. I got it now.

34

Well this thread is depressing. I need work on my whole mouth; even with insurance, it seems I can’t afford even work on ONE tooth.

Guess I wait until infection puts me into the hospital. >.<

35

Another factor is when it comes to your health many people don’t want to go cheap. People assume higher cost is better but the reality is that is not true in all cases.

Sort of related: An old joke is "What do you call the guy who graduated at the bottom of the med school class? Doctor. "

36

Float, so you don’t go negative between the paycheck you gave your staff and the payment you get for your work.

37

I wonder if it would just be cheaper to combine a vacation in another country with extensive dental work rather than have it done here in the U.S. of A.?

38

Yes, dental tourism is common enough.

39

I had a root canal and crown put in here in Panama for less than $1000, so if you needed a couple it could be cheaper even if you add in the air fare and hotel.

40

We have a clinic near us that just does root canals. They have a long counter and the first receptionist asks for your health coverage information. The next one asks for medical info. The 3rd takes you into a room. The doctor comes in and makes an assessment. The nurse preps you and takes xrays. You are out of there in about an hour. It runs about 1500 bucks.
Most people call it McDentist.