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Sinus Lift+Bone Graft+Implant+Crown = $$$$
Old 04-16-2018, 03:11 AM   #1
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Sinus Lift+Bone Graft+Implant+Crown = $$$$

I think there have been several threads on this searching back, but trying to see if there are ways to reduce cost. I had a tooth extraction on #2 b/c there was an infection underneath it and they couldn't save the root canal. So now I have a gap there. The prognosis is that i need:

1) sinus lift
2) bone graft
3) implant
4) crown

So speaking to the dentist most of the sinus lift and bone graft will not be covered. I've already been quoted $3250 just for the lift.

Anyways, It *seems* my only option is to shop around and get the best price and bite the bullet? Or are there options to argue with the insurance that this is mandatory? Which seems like a fruitless venture. Thanks!
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Old 04-16-2018, 04:29 AM   #2
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There is another option - do nothing.

I had the same tooth pulled years ago. The tooth had cracked below the gum line and my endodontist said a root canal would likely fail. The oral surgeon who pulled the tooth said it was not an important chewing tooth and suggested I try going with a space for a while before deciding whether to try an implant. It's been 18 years and I haven't missed having a tooth in that space at all.
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Old 04-16-2018, 04:48 AM   #3
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There is another option - do nothing.

I had the same tooth pulled years ago. The tooth had cracked below the gum line and my endodontist said a root canal would likely fail. The oral surgeon who pulled the tooth said it was not an important chewing tooth and suggested I try going with a space for a while before deciding whether to try an implant. It's been 18 years and I haven't missed having a tooth in that space at all.


Very similar experience here. Not #2, but same tooth on the other side (forget the #). Had to have an extraction, and both oral surgeon and primary dentist indicated not critical to replace with an implant, and risk of complications (to sinus and nerve as I recall) - so, left the tooth out. Minimal effect on chewing, no effect on shape of the face, etc. Cheaper and less risk than a procedure to put in an implant.

Holding out for stem cell therapy which will allow for just growing new teeth to replace all the problematic old ones!
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Old 04-16-2018, 05:06 AM   #4
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Now that the tooth has been extracted, you have a little bit of time to see how much you miss it, and if it's worth the cost to replace it.

As far as trying to convince the INSCO that it's "mandatory", it doesn't matter. Dental insurance is all contract driven. The procedures and reimbursements are all clearly defined and dictate the premium. If it isn't in the contract, you won't get the reimbursement.

It wouldn't hurt to make sure though, by getting a pre-determination of benefits from the INSCO, though.

If it's an upper 2nd Molar (#2 in the most commonly used numbering system), lots of people do just fine without that tooth. Another question to ask yourself is whether or not you have a few other heavily restored teeth that could pose for you the same dilemma, and if so, what happens if you strap yourself trying to replace #2, and then down the road #5 needs the same action.
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Old 04-16-2018, 05:31 AM   #5
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Have you considered going outside of the US for major medical? I've had some elective surgeries done in Mexico. They weren't dental.
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Old 04-16-2018, 05:43 AM   #6
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I went through the sinus lift drill and it wasn't that bad. The entire process took about 8 months.

My dentist warned me that my bone loss was "on the edge" for an implant without a lift, but he elected to try anyway. The result was a punctured sinus. This added 60 days for the sinus to heal.

The lift went flawlessly and I used cadaver bone versus hip bone harvesting. Another two month healing process ensued.

The implant was performed with no complications and my regular dentist took care of the crown.

I suffered no pain during every stage and I would do it again. 10 years and no problems.

At the time, my insurance did not cover the implant or lift and the cost was $3500.00
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Old 04-16-2018, 06:09 AM   #7
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I am a retired Dentist and when I lost tooth #15 (the same tooth on the left side), I elected to do nothing to replace it. Yes - it's always good to have all of your teeth. However, this is the least important tooth and here's two reasons why: It occludes (when it bites down, the teeth it touches) with only 1/2 of the opposing lower tooth, not the full tooth, and unlike any teeth closer to the front with a tooth behind it, there is no tooth behind it (if you do not have your wisdom tooth) to drift forward and change your bite. The sinus lift, etc., is proper, as the root of #2 kept the sinus in its location and without #2, the sinus dropped and an implant needs to be placed in bone, certainly not sinus, so if you want to replace it, you have to go through all that. When I lost #15, my tongue missed it for a few months and that's it and that was over 6 years ago and nothing bad has happened. Just my opinion and personal choice. You might choose to do all the steps to replace it and that is good Dentistry.

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Old 04-16-2018, 08:29 AM   #8
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So speaking to the dentist most of the sinus lift and bone graft will not be covered. I've already been quoted $3250 just for the lift.

Anyways, It *seems* my only option is to shop around and get the best price and bite the bullet?
If you embrace the philosophy of the MBAs and MegaCorp, outsource it to Mexico!

AFFORDABLE Price list for Dentists in Tijuana Mexico | Dr. MEXICO, Tijuana dentist center for Affordable dentists in Mexico, dental implants in Mexico, and dental tourism reviews

Sinus Lift- $1000
Bone Graft $395 I just had this done 3 weeks ago. My insurance copay was $600.
Implant- $795
Porcelain crown for implant- $440.
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Old 04-16-2018, 09:14 AM   #9
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I have always felt that dealing with a solo- or small-practice dentist was like dealing with a commissioned salesperson who really believed in his product. More than once I have ignored a recommendation with no consequent ill effects.

The other problem with dentists is that not only can I not independently judge the need for work, when it is completed I cannot judge the quality.

I have recently found a really good solution to these concerns: our local university dental school's clinic. Their significantly discounted prices alone are attractive, but when I go there I am seen by a senior-level student, supervised by a professor. The professor first reviews the student's examination and assessment, then as work is done he reviews it at every step. Neither of them has the slightest interest in recommending unnecessary work. In fact at my last visit the student was suggesting filling a cavity but the professor looked at it and judged the work to be unnecessary. I also asked about some expensive work that a prior solo-practice dentist had recommended and I was told that it, too, was unnecessary.

So if you are lucky enough to have a good dental school nearby I'd suggest that you check it out. The only downside I have found is that appointments last longer because of the teaching and QC time.
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Old 04-16-2018, 09:48 AM   #10
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DW is replacing 4 teeth on that side....

Her first sinus lift was not good.... tore through... so had to wait for recovery.... second went OK..

First bone graft did not take, second did...

Still waiting to get implants...

We are paying through the nose (pun intended).... I think the final cost will be in the $12,000 range.... we are going to someone who is very good and respected... he charges more than others, but he also has not charged us for the problems we have had due to my wife's problems... such as the grafts not taking etc....
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Old 04-16-2018, 10:55 AM   #11
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I had a back molar pulled 20 years ago, with the promise of an implant. Somehow, after the tooth was pulled, it was found that my upper jaw was too thin to support an implant. I have a bridge (replaced once already) which I loathe. The space under the bridge gets bigger every year and is starting to whistle when I talk, which I also loathe! I would gladly pay 2X the price you mentioned, if I could get a implant.

Quote:
Originally Posted by refi View Post
I think there have been several threads on this searching back, but trying to see if there are ways to reduce cost. I had a tooth extraction on #2 b/c there was an infection underneath it and they couldn't save the root canal. So now I have a gap there. The prognosis is that i need:

1) sinus lift
2) bone graft
3) implant
4) crown

So speaking to the dentist most of the sinus lift and bone graft will not be covered. I've already been quoted $3250 just for the lift.

Anyways, It *seems* my only option is to shop around and get the best price and bite the bullet? Or are there options to argue with the insurance that this is mandatory? Which seems like a fruitless venture. Thanks!
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Old 04-16-2018, 11:20 AM   #12
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Timely post. My dentist is recommending replacing the massive filling on my #2 tooth with a crown ASAP. I switched to this dentist after my long time dentist retired. Funny my previous dentist didn't find any urgency in working on that tooth. After reading this post I'm inclined to leave it be and if/when the filling breaks have the tooth pulled. Sounds like I wouldn't miss it anyway.
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Old 04-16-2018, 06:02 PM   #13
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Quote:
Originally Posted by refi View Post
I think there have been several threads on this searching back, but trying to see if there are ways to reduce cost. I had a tooth extraction on #2 b/c there was an infection underneath it and they couldn't save the root canal. So now I have a gap there. The prognosis is that i need:

1) sinus lift
2) bone graft
3) implant
4) crown

So speaking to the dentist most of the sinus lift and bone graft will not be covered. I've already been quoted $3250 just for the lift.

Anyways, It *seems* my only option is to shop around and get the best price and bite the bullet? Or are there options to argue with the insurance that this is mandatory? Which seems like a fruitless venture. Thanks!
The procedure sounds right. I had the same a few years back for my implant. Total was over $4K. I reimbursed myself with my HSA to soften the sting as we've discussed in several threads that retirement and dental insurance isn't really an economical option.

That said, glad I had the implant taken care of, despite the long wait for completion and dental visits.
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Old 04-16-2018, 08:11 PM   #14
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... It *seems* my only option is to shop around and get the best price and bite the bullet?...
Given your situation, I would think that biting any bullet wouldn't be a viable option.
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Old 04-22-2018, 04:06 PM   #15
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I lost two back upper teeth due to deteriorating old dental work. Had the exact procedure you describe about 10 years ago with 2 implants. As I recall it was about $10,000 for the sinus lift, bone graft and both implants at that time (not a cheap oral surgeon but I wanted good work). Since I had lost two upper back teeth I had no opposing tooth on top for my lower bottom tooth and didn't want to lose that one. Results have been superb!
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Old 04-22-2018, 09:22 PM   #16
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Had a tooth extracted about 3 years ago, due to a crack in the root. Dentist has said that as long as it does not appear that the neighboring teeth are moving around, I can leave it be.


Think my total was going to be around 2800, but no sinus lift as its on the lower jaw. So far he is saying no reason to consider doing it.
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Old 04-23-2018, 05:54 AM   #17
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Timely post. My dentist is recommending replacing the massive filling on my #2 tooth with a crown ASAP. I switched to this dentist after my long time dentist retired. Funny my previous dentist didn't find any urgency in working on that tooth. After reading this post I'm inclined to leave it be and if/when the filling breaks have the tooth pulled. Sounds like I wouldn't miss it anyway.
Again, from the retired Dentist

If you have massive fillings on #2 that in time undermine the structural integrity of the tooth, I would recommend going ahead with the crown as a preventative restorative event. This is much different than deciding whether to replace a missing #2. At the least, those massive fillings will be replaced one day anyway, and not for a small fee, and not without risk.

That's my 2

Rich
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Old 04-23-2018, 06:48 AM   #18
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Just had the implant and new tooth for a pre-molar. All in was a tad less than $5k. The implant post was I believe $2800 (no bone work) and then $1700 for the tooth from the dentist. I thought it was outrageous for the implant (<45 minutes) and then when the dentist charged the 1700 I thought it was rather absurd. IIRC he'd charged 900 for crowns about 10 years ago, all he did was have assistant take an impression, send off to some place to fabricate, and thread it in.

If I had to do again I'd probably shop around, but he has been "our" dentist for over 20 years. In the time waiting for the post to take hold, I could easily have gone on w/o the replacement; no one would have noticed I'm sure and I could eat just fine. As it is, we can afford it no problem but it's just another case of wondering how people who make middle class wage can afford stuff (assuming this had been, say, a front top tooth).
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Old 04-23-2018, 06:58 AM   #19
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Just had the implant and new tooth for a pre-molar. All in was a tad less than $5k. The implant post was I believe $2800 (no bone work) and then $1700 for the tooth from the dentist. I thought it was outrageous for the implant (<45 minutes) and then when the dentist charged the 1700 I thought it was rather absurd. IIRC he'd charged 900 for crowns about 10 years ago, all he did was have assistant take an impression, send off to some place to fabricate, and thread it in.

<snip>As it is, we can afford it no problem but it's just another case of wondering how people who make middle class wage can afford stuff (assuming this had been, say, a front top tooth).
Old joke: a repairman submits a bill for $300 for just pushing a button to fix something. It's itemized as, "Pushing a button: $2. Knowing which button to push: $298."

You're paying for expertise and precision in work where angstroms matter. Well, maybe that's an exaggeration but my dentist said he was once faced with having to install the prosthetic tooth for a patient whose oral surgeon hadn't quite put the implant in at the proper angle so the tooth wasn't going to stand up at the proper angle, either. My dentist is a smart guy and a problem-solver so I bet he figured out something, but I don't want to be the one who shows up with that problem. And don't forget malpractice insurance, although it's not as expensive as for doctors, costs of the latest equipment and other overhead. My dentist has a little tiny torque wrench so he KNOWS how hard to screw in the tooth.

As for how people of modest means afford it- most can't. There are partial plates that are cosmetic but don't function very well. An Uncle had a one to replace a front tooth lost in HS football- he died in 1978 but an implant would be an option now.
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Old 04-23-2018, 07:23 AM   #20
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Again, from the retired Dentist

If you have massive fillings on #2 that in time undermine the structural integrity of the tooth, I would recommend going ahead with the crown as a preventative restorative event. This is much different than deciding whether to replace a missing #2. At the least, those massive fillings will be replaced one day anyway, and not for a small fee, and not without risk.

That's my 2

Rich
Had a crown placed over #18 for that very reason (large fillings, then tooth developed micro-fractures).

Over 25 years ago, so it might outlive me.

OTOH, had to have a root canal/crown on #4 last year (first root canal, told the kids I was now officially old)

From what I was told I expect to need an implant before too many years...
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