Why is dental coverage so unbelievably crappy?

He’s not your pal, buddy.

You’re better off self-insuring for dental problems. Put money away in your own account instead of paying premiums. Then when something happens, take the money out of your dental savings account to pay for it.

Rarely do you need to fix a dental problem right away. And even if you do, the costs will be (relatively) affordable. Something like a broken or impacted tooth can be handled for less than $1000. That’s a chunk of change, but it should be feasible for most people to pay that off over time.

Your boss getting $8k of dental work must have been for something cosmetic I would guess. He can just save up for that. Insurance is not going to cover things like veneers since that’s elective.

Dental insurance is typically not needed since the routine costs are relatively affordable and the major costs are rare or can be planned for well in advance, giving you time to save up for them.

The “catch”, of course, is that the premiums are more than the out of pocket cost for two annual cleanings…

1/3 whoosh.

Agreed. For anything other than fillings and cleanings it’s useless as there is no way I can come up with half of the cost of a crown or bridge.

Good luck finding a dentist that doesn’t want full payment up front.

Even if that’s the case, typically you’ll have time to scrounge money from whatever sources you have (hock, payday loan, friends, relatives, etc). And if you can’t scrounge $1000, then you probably couldn’t afford the dental insurance anyway. Your choices would be:

-Cheap insurance: Low premiums which only cover the most basic things like cleanings. Not worth it because the cost of the premiums are just about the same price as the treatments it covers.

-Expensive insurance: High premiums, but will cover things like tooth extraction, crowns, etc. Really only worth it if someone else (like your employer) is paying for it.

I’m not sure what low-cost dental options are available. I know dental schools have cheap options for treatment.

It probably boils down to the fact that it is extremely rare to need thousands of dollars worth of emergency dental care. Whereas a simple trip to the ER can easily be over $10000, dental emergencies will be much less and less urgent to fix. In just about every case you’d be better off putting your dental premium in a coffee can and pulling from that to pay for dental care.

Relevant poll:

How much dental work did you have done last year?

We also need to understand that the OP clearly has good insurance. I have a high deductible plan. The first $4000 of the year comes out of my pocket and then it switches over to co-pays. If I had major surgery and then spent 4 days in the hospital, I’d likely spend $4000 on just that, plus $60 copays on the follow up visits with doctors for after care.

The days of having ONLY a copay are going away very quickly.

Before I retired we had free checkup and cleaning with $1,500 allowance. Very often the dentist would charge more for a procedure than the insurance allowed and the patient would be responsible for the difference but in general it was pretty good.

I once had a dentist who explained this to me. Let me see if I can remember correctly.

As he explained, the main reason is because so much of dentistry is not mandatory but is optional. I hope that I used the correct words in that sentence.

I forget what the correct words are to describe this. Does anyone know what they are?

The idea is that when someone has a dental problem, they can choose to get either a minimal solution or a full solution with all the bells and whistles.

So, if you want to get a full solution to a dental problem, you will pay a lot of money and you will get a first class solution. But, if you only want to get a solution that includes the “bare minimum” of work, you will not need to pay a lot of money and you will not get a lot of service. You’ll just get the bare minimum.

But compare this to a medical problem. If you have a medical problem, there is not usually a wide range of solutions. There is usually only a very limited number of solutions. I’m not sure why this is the case.

I suppose I best withdraw from this thread and hope a dentist is around and that they will explain this (probably in a way much better than I could ever do).

I hope a dentist will pick up this thread and explain this concept now.


This sounds very familiar and it sounds a lot like what that dentist told me.

I’m guessing that you have always taken excellent care of your teeth. What does that mean?

It means that you brush your teeth thoroughly at least 2 or 3 times per day (after every meal). In addition you floss and massage your gums. You almost never eat sugar or sugar-based candies. Also, you make and keep regularly scheduled dental office visits. Perhaps every 6 months or 4 months for a checkup. Possibly even more often than that?

That is one of the most important aspects of good dental coverage. Do you do that? I bet you do!

It is important to note that there is an enormous difference between Government Health care and Government Dental care in Canada.

The government pays for most medical coverage. But is does not pay for hardly any dental coverage. Many employers pay the marjority of necessary dental costs for their employees. But only for the highest paid employees.

Employers could **never **afford to pay the majority of dental costs because so much of the costs of dentistry are optional and patients and dentists could easily agree to get top notch dental treatment that would result in huge bills - much, much larger than the ordinary dental bills. You can just forget about it!

So, it is extremely misleading to imply that the Canadian government pays for the majority of dental care for the average citizen. That is just absolutely not true and it is an extreme falsehood to imply the truth is anything close to that. It is not!

The truth is that perhaps about ten percent of all employees in top notch companies get dental coverage that covers anywhere close to full coverage. In most cases, only the basic dental costs are covered and it’s a dirty lie to imply to people that the Canadian government would ever pay for anything more for its citizens. The truth is very, very different from that and it’s a shame for anyone to imply that the Canadian government pays for most of the costs of dental care. That is ridiculous! No government could ever afford that. Except perhaps for oil-rich governments like Kuwait or others.

Yeah, I understand. My wife just broke a tooth and even though she has dental insurance the out of pocket cost is still around $600. It will take us a few months to save up for that. Like someone else said we might as well just put the premium money aside and pray we never have a dental emergency.

Ignoring snark…

Mine is still a valid point. Benefits are probably 1/3 to 1/2 the cost of salary when we’re discussing larger corporations. In Canada, this covers typically dental, prescription and retirement benefits. In the USA, a substantial percent of this number is eaten up by basic medical coverage, leaving much less for other benefits.

(And of course, cutting benefits is easier than cutting salaries when the boss is not making a big enough bonus).

I found that when I started hitting my 50’s I needed a few root canals. Before that, I would need a filling maybe once a year. I guess the point with employer benefits or similar “insurance” is that it spreads the load. Instead of being hit with big bills at certain times - when the kids are old enough for braces, when you are getting on in age - it “spreads the load” among all employees. True, anyone with a strong will and a good savings plan could do the same themselves, but generally people cannot plan that well - which is why this would be a “benefit”.

Yes, Canada has problems - our murder rate in Toronto, for example, is closing in on one tenth of Detroit’s. A lot of handgun crimes happen thanks to guns smuggled into the city from the USA where controls are far more lax. A typical well-to-do wage earner may pay up to 25% of their income in income tax, leaving them only 75% to spend on themselves. Employers who want to get rid of an employee for no reason must pay fairly high separation pay, they can’t fall back on “right to work” laws to deprive an employee of their right to work. Forcing employees or welfare recipients to take drug tests is generally considered a gross invasion of privacy. Even felons in prison can vote. Our doctors don’t pay exorbitant malpractice insurance rates because they don’t get sued as often. Frivolous lawsuits are discouraged because quite often the losing party must pay the winner’s legal bills. Our public schools are pretty good. Our students typically don’t graduate saddled with massive student loan debt they cannot get rid of.

And oh, yeah, our Olympic TV coverage doesn’t suck, and mentions and shows athletes from countries other than our own…

If I sit here and think, I’m sure I can come up with several other problems that Canada has.

What a hellhole.

My take is that though dental costs is expensive it is several orders of magnitude cheaper then other medical expenses. All in all $8000 max (stated thus far here) is actually affordable for most people - yes a stretch for many but doable even if paid over time. OTOH other medical expenses are way beyond this, actually this is the price for the trip to the hospital alone for many - once the person actually enters the door the real charges begin.

So the answer is big price discrepancy justified or not, and that dental expenses are actually affordable to some degree while medical is not.

You’re using American prices. Canadian aspirin tablets and tongue depressors don’t cost $100.

Whereas, if a lot of Americans pay their own dental costs (like plenty of Canadians do) then nobody is going to go to a dentist to pay out of their own pocket if the price did not bear some resemblance to reality and affordability. The cost of my semi-annual cleaning is not a much different than if I had a plumber or appliance repair guy come in and do work at my house for half a hour. A filling, IIRC, was in the $150-$200 range. (I’ll have to look it up one day). The training and equipment required to become a dentist are not cheap, that’s not an unusual cost for that kind of business and one I could bear every year or so.

The real question is “why are medical prices so high in the USA?” which is a completely separate GD topic.

Of course, doctors could easily kill you with a mistake. Dentists, much less likely - they can just make you wish you were dead.

The fee schedules for common interventions I have seen (discounted after insurance discounts) are roughly as follows

$50 for a filling
$900 for a root canal & crown
$100~ for a cleaning and exam

Those are not major expenses, especially considering that most people can go years without getting fillings.

Dental insurance usually doesn’t cover orthodontia, or major reconstructive work as far as I know. They have a $1000 annual cap also, which is stupid. I’ve done the calculations, I come out slightly ahead buying a dental discount plan and paying out of pocket vs getting insurance (with their monthly premiums and 1k a year cap). But my employer offers insurance so I take that.