Dental Costs

[ferco]

Are there any "honest" retired or active dentists on the forum who can answer the question why dental procedures are so expensive? What about a root canal "costs" $500-1,000 or an implant $2,000-3000. Is it the materials, the labor? Or is it just what ever the market will bear.Can you give me the break-down on this. I think if consumers understood more of the economics they wouldn't be so pissed with forking over their hard earned $$.
I know it takes many years of schooling and the like....but geeze.
The same can be asked why it costs $2,000 to set up an estate plan with an attorney or why a surgeons fee for a bypass is/was $10,000(probably lower now with caps from the insurance carriers). I also would expand this to construction contractors and why there's such a mark up to build a house.

I think ultimately we'll outstrip the ability of the "average" consumer to afford anything....then these same services will have fewer clients and will attempt to cost shift to those left to be able to cover their costs of doing business(aka life style costs).

[Nords]

Quote:

Originally Posted by ferco Are there any "honest" retired or active dentists on the forum who can answer the question why dental procedures are so expensive? What about a root canal "costs" $500-1,000 or an implant $2,000-3000. Is it the materials, the labor? Or is it just what ever the market will bear.Can you give me the break-down on this. I think if consumers understood more of the economics they wouldn't be so pissed with forking over their hard earned $$. I know it takes many years of schooling and the like....but geeze. The same can be asked why it costs $2,000 to set up an estate plan with an attorney or why a surgeons fee for a bypass is/was $10,000(probably lower now with caps from the insurance carriers). I also would expand this to construction contractors and why there's such a mark up to build a house. I think ultimately we'll outstrip the ability of the "average" consumer to afford anything....then these same services will have fewer clients and will attempt to cost shift to those left to be able to cover their costs of doing business(aka life style costs).

It's the same reason that Exxon pays some of their pensioners $400M. It's not illegal and someone was willing to let someone else pay for it. Before long it'll be called "the market rate".

I also think it's the part where the professionals guarantee that you won't die of an infection or have your assets stripped via the probate process or have a house full of leaks & mold. Those are some of the reasons that I stopped doing my own appendectomies, too.

Another cheap way to achieve the same result as a root canal is to floss & brush frequently. But that probably costs more in dental floss & toothpaste than the expense of extractions and a full set of dentures. I guess there's just no accounting for fashion!

I could understand asking the question if you're trying to decide why one procedure is so much cheaper from one dentist (or professional) than another. But I don't understand questioning a cost solely on the basis of it being more than $9.95. By that logic, having a root canal in Laos or Vietnam is a better deal than having it done in Bangkok's Bumrungrad or your local dentist.

[lazygood4nothinbum]

don't know about the doc stuff though i generally go to the guy who seems most educated and spends money on the best equipment. i prefer doctors associated with teaching hospitals. my dentist is also a roving lecturer at local universities and even has computer xray. kewl.

i think general contractors get about 3% of construction cost (not sure if that is gross or net). if i remember right a good architect gets about 5-6% of building cost, out of which is paid the structural, mechanical & electrical engineers.

[cute fuzzy bunny]

My dad used to teach dentistry before he retired.

You've got an office to pay a mortgage or rent on, insurance, receptionists, hygenists, other qualified help, a technician or lab to pay that does the crown and bridges/etc.

Its not cheap to run an office. Not to mention they have a ton of last minute cancellations.

It is worth noting though that they behave pretty differently and charge less to cash customers than insurance customers. When I have dental insurance, the dentist wants me in there as many times a year as he can bill, and wants to do as many x-rays and other procedures as the insurance is willing to pay. When I was a cash customer for a few years, a whole lot less was ordered up, fewer visits were booked automatically, and the prices were lower.

[mathjak107]

insurance is brutal....the odds of a dentist giving novacaine to a child and that child having a reaction is enourmous...it used to be said its high enough to have it happen to every dentist at least once in their career......
im not defending dentists either as im paying 22,000 for dental implants right now...the surgeon got 13,500.00 for 3 hrs work putting 6 implants in the bone...the dentist now gets 8,000 for the actual teeth that go in....is that amazing ........thats more than my son the lawyer gets ha ha ha

[mathjak107]

your right about the 2,000 estate plan..i did it for free using willmaker but couldnt get a lawyer to review it and sign off on it here in new york...so i had to spend 2,000 bucks for a lawyer to do it and it looked likeand read like my free one with a few minor changes.....id say at best 500 bucks worth of work.....

[eyetri2]

I will try and answer the dental cost question because yes, I am a dentist. The unfortunate thing is I can't be too exact because I am a military dentist at the moment, but in 2 months I will be separating.

I just had a periodontist over my shoulder asking her what would be a reasonable fee for start to finish for 6 implants and I will assume 6 crowns (no bridges). She said at least 4,000 per unit, or 24,000 bucks. The implant alone costs $500 from the manufacturer and that's the mililtary price. Lab fees for the crowns, if it is a high end lab can be $200 bucks each. Throw in overhead of lights, chairs (5,000 each for just a chair), anaesthesia, impression material ($150 for the gun, and about 50 each on the low side for the putty), office staff, malpractice insurance, etc... and you start running into some hefty bills. And don't forget that most dentist graduating today come out with about $120K in loans - and that's just for dental school.

It's funny, though, I do agree on the lawyer thing. All they freakin' need is a desk and a lamp and can charge $250/hr plus. At least I need actual equipment to make some money.

[mathjak107]

does it cost more to have an appointment at tooth hurty? (2:30)
ha ha ha

[astromeria]

What is up with implants? Everyone seems to be getting them. I had a tooth pulled 30 years ago, and every dentist I've seen (I've moved a lot) wants to put an implant there. They say my teeth may move--I say Please let me know when they do, and I'll consider it. My teeth never moved. They seem to think it's normal to hold oneself to the highest standard of beauty and perfection--I say, Eh. I've been a happy camper with my empty tooth spot, and I saved myself hassle, money, and pain. It's not visible unless I open wide and you peer inside anyhow. Several times I have declined crowns, and it was alwasy the right decision--still have those teeth. I do have 3 crowns, at least one of which was almost certainly unnecessary. Plus it caused mysterious referred pain in the wrong location, which was only relieved when the tooth behind the crown finally cracked. Gee, thanks! Guess I'm dentally fotunate on the whole--mid-50s and no root canals or bridgework...so far.

[maddythebeagle]

Quote:

They say my teeth may move--I say Please let me know when they do, and I'll consider it. My teeth never moved. They seem to think it's normal to hold oneself to the highest standard of beauty and perfection--I say, Eh. I've been a happy camper with my empty tooth spot, and I saved myself hassle, money, and pain. It's not visible unless I open wide and you peer inside anyhow.

Interesting astro., someone in my family that is on a fixed income was questioning the same thing....and at least put it on hold for now for 1 tooth. For some folks (maybe many) 1-2k is a lot!

[Nords]

Quote:

Originally Posted by astromeria What is up with implants? Everyone seems to be getting them.

It's called "revenue enhancement".

You used to have to visit the dentist for tooth whitening, and now the home kits have killed that business. The dental industry figures that it'll be a lot harder for the home implant kits to take away their latest boat-payment stream. Unless, of course, you see Chuck Norris & Christie Brinkley telling viewers to "First apply the anaesthetic. Then insert Implanter's revolutionary 1/16" drill with its patented sanitized carbide-tipped bit into the orifice... it's that easy!"

I went to "my" dentist last month (follow-up to my Nov 2003 visit). He said "Your teeth are fine, but some of those fillings are wearing out and won't last much longer. I recommend that we replace them." I asked him how long the old & new fillings should last, and the answer was "10-12 years with old technology, 20 years if you get new ones."

I told him that my fillings had been inserted in 1981 or even earlier with "ancient" technology. Maybe they last longer because they're steadily leaching mercury & silver into my system.

I'm thinking that 2008 will be time for a new dentist.

[Martha]

Quote:

Originally Posted by eyetri2 It's funny, though, I do agree on the lawyer thing. All they freakin' need is a desk and a lamp and can charge $250/hr plus. At least I need actual equipment to make some money.

[AltaRed]

Quote:

Originally Posted by astromeria What is up with implants? Everyone seems to be getting them. I had a tooth pulled 30 years ago, and every dentist I've seen (I've moved a lot) wants to put an implant there.

Interestingly, I had an extraction in my teen years and yes, my teeth moved a bit to partially fill the gap. Never had a dentist suggest an implant yet and I am in late 50's. Course maybe once the teeth move, implants are no longer viable anyway.

Nords: I do believe that old filling materials (dark colored stuff) do become weak and porous over time. I had to have most of those replaced with newer style (white) fillings as a result of decay starting again underneath those old ones. Wise to consider replacement, because if too much new decay starts, then you have to start looking at crowns to avoid weak/broken teeth... or worse, a root canal because the decay has gotten too close to the nerve.

I have been a dentist's best dream. 8 crowns and 2 root canals so far. Knock on wood that I am good for 10 more years now.

[Nords]

Quote:

Originally Posted by AltaRed I had to have most of those replaced with newer style (white) fillings as a result of decay starting again underneath those old ones.* Wise to consider replacement, because if too much new decay starts, then you have to start looking at crowns to avoid weak/broken teeth... or worse, a root canal because the decay has gotten too close to the nerve.

Fillings come in white now? How can you count your cavities?!?

I think that my tooth-decay problems stopped the day I learned how to floss correctly. X-rays every couple years have made sure that I'm not getting cavities under the fillings. I've also been told that tooth decay dramatically declines in your 40s, although perhaps that's just a self-fulfilling prophecy.

I'm not inclined to mess with the fillings unless they start popping out...

[cute fuzzy bunny]

I have some 30 year old "old style" fillings. Only had a problem with one on the 'face' of a molar that over time became a 'wedge' and cracked the tooth. I wouldnt fiddle with them unless you had a problem with one, like leakage, infection, etc.

Fillings do in fact come in a variety of whitish colors to match your teeth.

Lawyers need lamps?

[grumpy]

About 10 years ago I was having alot of weird and disturbing health problems. I had nearly every diagnostic test known to medical science (all negative). At that point I read some stuff about the possible effects of mercury leaching out of old composite fillings. I had a lot of those so I decided to have them all replaced with modern materials. Shortly after that the symptoms subsided. Fortunately my wife had opted for the excellent dental coverage from her employer that covers essentially 100% of the costs. I have had several gold crowns since then and have only had to pay the deductible.

Grumpy

[cute fuzzy bunny]

http://en.wikipedia.org/wiki/Dental_amalgam_controversy

[haha]

Quote:

Originally Posted by Nords I went to "my" dentist last month (follow-up to my Nov 2003 visit).* He said "Your teeth are fine, but some of those fillings are wearing out and won't last much longer.* I recommend that we replace them."* I asked him how long the old & new fillings should last, and the answer was "10-12 years with old technology, 20 years if you get new ones."

I have been getting this BS for more years than many of you have been alive. Almost all my fillings were done in the 50s, all amalgam A few have cracked- for these I get gold crowns. The” gold standard' in wear, and hey, I am a gold bug anyway so what's not to like? If a front tooth ever goes, I am going to get gold with a diamond star inlay. Or maybe cubic zirconium? Or one of those nice synthetic emeralds to match my green eyes.

For the rest, I say I'll call you when they crack, if they crack.

Ha

[AltaRed]

To each his/her own. My goal was to have good dental health while on a reasonable company group plan before I retired. Can't say I was happy going through the process, but can say I am happy I now have all new composite fillings and crowns on all molars. Now I should have nothing but good checkups for years and years.