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Dentist - the solution is always a crown???/

OK, I'm 60 and have have filled cavities in my mouth for at least 50 years. Some of the metal fillings are chipping or falling out. Whenever I go to the dentist the solution always seems to be - 'you need a crown'.
Is it just me or have you experienced the same thing?
I just had my 1st crown, it wasn't that bad physically - cost $1,200. I don't have insurance.

I think the last filling I had, I paid $325.

I know I'm getting old when I complain about the cost of these things.

Back in the day my dentist did it all, schedule appointments, collect payment, but, no insurance submissions, and no medical assistant. That is what I think most of the $$$ is going to.
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Comments

  • Dentistry is a huge business now that every person must have super straight white teeth or their self esteem will be low. Look at the number of kids getting braces or other straightening methods. When I was young hardly anyone had braces. Now it's assumed it will happen somewhere along the line.

    I had to get a crown some years ago. Even with insurance I paid over $800. I have had a few faulty fillings just replaced with newer ones. I have a mouth full of mercury amalgam fillings. They seem to be holding up quite well.

  • @Dex, you might find this to be of interest to you.

    http://www.medicinenet.com/dental_crowns/page2.htm
  • rjb112 said:

    @Dex, you might find this to be of interest to you.

    http://www.medicinenet.com/dental_crowns/page2.htm

    I think that was written by a dentist!

    True story - I was a kid, teenager I forgot how old, I knew my family didn't have money so I had some cavities filled without Novocaine.
  • @Dex: Those prices are about what I pay, to a highly trained dentist.
    Teeth breaking down around old fillings, or old fillings breaking down or admitting decay beneath, are common reasons to need a crown. It's best to try to address these issues while there is still some tooth structure to anchor the crown. An implant is a LOT more money.
    Sometimes it's possible to add dental insurance to an existing health insurance program. In such cases, it is not unusual to have to wait 12 months after beginning the dental insurance before anything major is covered.
    I would have a detailed discussion with the dentist as to total oral picture, and be as informed as possible about present and future likely needs.
  • edited April 2015
    @Dex, I'm scheduled for 3 crowns for next week!
    @InformalEconomist: I've found that typically, dental insurance is not very good.....it often "caps" (pun intended) out at $1500 or less......and when you subtract the premiums....well, it's typically not that robust. Not to say it isn't worth it in some circumstances....it very well may be. I had it when it was offered by an employer, it was just quite limited.

    I'm sure we've all seen that dentists on every corner are advertising implants like crazy! Even though in years past, that was not the purview of the general dentist, but rather, an oral maxillofacial surgeon, a periodontist, etc.....they are trying to expand their piece of the pie. You've probably also noticed that dentistry is starting to go high tech.......sometimes with crowns available in 2 hours instead of 2 weeks (made in the dental office), dental CT scans, fancy devices to detect oral cancer, ad infinitum

    take care
  • Just my opinion, but dentists are becoming more and more like unethical stock brokers. They are churning their patients because that's where the money is, just as brokers churn their client's portfolios. Now I am not painting a broad brush here as some dentists and some brokers are good and ethical. But the stories keep coming out.

    Coincidently, a family I met while I was stateside had a daughter who was getting ready for braces. Her parents were discussing the in house financing the dentist offered them. Her teeth looked pretty good to me, but then again I'm not a dentist.
  • Last trip to the dentist I happen to miss. I received a $25 bill for missed appointment. After 25 years I thought this to be a little out of line for the loyalty I showed. Sent the money & still looking for a new dentist.
    Derf
  • Dental insurance seems to be basically prepaid service, not risk spreading. That is, it provides for basic maintenance (which one assumes most people take advantage of), and comes with a low payout cap.

    An alternative is to pay a third party to get negotiated rates - a "discount plan". You are limited as to the dentists who honor these rates (just as you are limited to dentists who take a given insurance plan). While I usually expect things like this to be scams, these programs seem pretty legitimate, and I have been using one for a few years.

    Of course you should make sure that your dentist works with the plan you choose. There's usually no more than one business day wait before a plan becomes active. That's because you're activating a rate schedule, not insurance coverage that might immediately pay out more than you paid in.

    As an example, these plans seem to represent $1100-$1200 as a typical rack rate for a crown, with $600-$750 being the negotiated rate, depending on plan and geographic region.

    For a filling, procedure D2394 (posterior, 4 or more surfaces), one plan shows $325 as the rack rate, with the negotiated rate being $175 or less.

    Generally, the higher the cost of the discount plan, the larger the list of participating dentists and/or the lower the negotiated rates.

  • "Just my opinion, but dentists are becoming more and more like unethical stock brokers. They are churning their patients because that's where the money is, just as brokers churn their client's portfolios"

    Hi John,

    Kind of like veterinarians, because as rjb112 posted, insurance is not very good. To compound matters, it's as difficult to get accepted to a veterinary school as a medical school, and we have come to take care of our pets better than our spouse or children!

    Mona
  • Maybe next time I will go to Mexico.
    http://www.riograndedental.com/
  • @Mona, You are right. People these days will spend thousands on surgeries, chemotherapy or whatever for their pets. My brother just spent $3300 for surgery on his dig to remove a tumor in his intestinal tract. We haven't heard the biopsy results yet.
  • edited April 2015
    Dex said:

    Maybe next time I will go to Mexico.
    http://www.riograndedental.com/

    @Dex: looks very good, except for one thing:
    Juarez, Mexico is very dangerous!! One of the most dangerous cities in the world.

    http://www.businessinsider.com/the-50-most-violent-cities-in-the-world-2015-1#27-jurez-mexico-had-3994-homicides-per-100000-residents-24
  • Dex said:

    Maybe next time I will go to Mexico.
    http://www.riograndedental.com/

    Dex,

    I am a resident of Panama and the prices can be great and quality of care top notch. I know a number of Panamanian dentists educated and trained at the best schools in the US, But as John surely knows, you need to do your due diligence.

    Mona

  • edited April 2015
    Exactly like financial advice, dentistry ranges and varies, and if you have a dentist you trust and has judgment (prudent), take his or her advice. Agree about most other points. My sil Alice in San Clemente is v good and honest as the day is long, if you need further resources. Pay cash always if no insurance, of course; these are small-businessmen.
  • . Pay cash always if not insurance, of course; these are small-businessmen.

    You bet!

  • Ok we got all the reasons for getting a crown ,But when is a crown not necessary, a regular filling will be sufficient? Had my share of crowns, Two went bad, now he wants to do implants or bridge work, for what? how many more years with new teeth?
    Hate the "being ripped off Feeling".... esp. from so-called medical people....
  • edited April 2015
    @davidrmoran, @Mona, Exactly. It is also interesting how much the price drops once cash is involved if you are dealing with a honest professional.
  • Speaking of dentists..... and I am sure after saying this I will need immediate dental attention next week...... My last visit to a dentist was June 1969. I have always had good teeth most likely because I chose my parents well. My 94 year old Mom still has all hers. Being a lifelong obsessive flosser probably hasn't hurt either.
  • Over here it is becoming popular for people fly to Budapest to see a dentist.
  • well, it drops only a little, 5% or so, in my experience. Still, on a $150 visit, enough for half toward your Prevident:)
  • @Junkster, Wow, and I thought I had the record for staying away from dentists at 22 years. I hope you didn't just jinx yourself. In 2007 I developed a bad toothache and I went in. Guess what? I needed a crown. My procedure was painful. Haven't been back to a dentist since.
  • Being a cynic by nature, I also question the honesty of dentists. Dentists know that most people know little about teeth. I last saw a dentist in Nov. and he said that the next time I come in (May) I would need to get a crown. This advice came up out of nowhere! I've never had a crown in my life and suddenly I'm in need of one? This dentist has also tried to suggestive sell my wife to get her teeth whitened. She doesn't smoke and has exceptionally white teeth to my uneducated eyes. Dentists = scam artists imho.
  • To add to the crown debate; most if not all crowns are made in dental labs. I suspect these things are very cheap to make. I would be curious to know the profit margins.
  • edited April 2015
    Hi everyone,

    Last year I paid out about $300.00 for dental insurance for about $3,000.00 in dental work completed before my full retirement on June 30, 2014. Did the same the year before but had to pay out about $600.00 for insurance. Now, that is a total of $900.00 for insurance and about $6,000.00 in benefits received. Currently, I am carrying Blue Cross Blue Shield's Senior Dental and pay a little back of $40.00 month for up to $1,500 in benefits. With the price of dental care I figure it is worth it to carry the insurance so I will receive the insurance write down for the cost of the procedure even if I exceed the benefit amount of coverage.

    Old_Skeet
  • I moved to WA State four years ago. There is a category of "dentist" here called denturist. I had never heard that term before so I invested their credentials. What I discovered was that denturists are restricted or barred from practicing in many states. I have this picture of going to a dentist that employees denturists and finding out that I need to pull all my teeth and replace them with prosthetics of some type since it is my impression that dentures is the true calling of denturists. Unfortunately many dental practices that accept my insurance are mainly comprised of denturists. Makes sense since they would migrate to states that allow them to practice. I really fear my husband's dentist hiring one and suddenly becoming a hotbed of pulled teeth. My husband would never question someone in a lab coat. Myself, I keep paying the insurance but haven't used it yet.
  • @Anna, it is similar with eye exam benefits. Many insurance companies list only optometrists that take the plan instead of ophthalmologists. Places like Lens Crafters get a lot of business that way.

    It is another way of reducing costs. The hospital I used to work at employed nurse practitioners in the emergency room. They would take the patients with sore throats, headaches and other simple maladies freeing up the doctors for the more severe cases.
  • Thought I would throw in the perfect response to all this talk about dentists:)
  • Just got a $1500 crown here in an expensive suburb of Houston. Dentist had a high tech setup whereby he scanned in an image and made the crown on a computerized lathe right in the office. The whole thing took less than 2 hours, no sending out to a lab and coming back for a second visit, etc.

    http://www.sirona.com/en/news-events/campaigns-and-promotions/cerec-packages/premium/
  • @Old _Skeet: It sounds like we have the same dentist. Mine tried telling me the same thing. Get your teeth crowned before your insurance runs out, retirement takes place & one loses benefits. Tried to line me up for three crowns ! Fortunate for me I still had dental insurance after retirement & my three teeth needing crowns still doing great.
    I felt like I was seeing a used car salesman every time I went for a cleaning, someone trying to sell me something !
    Derf
  • @MFO Members: I go to Dr. Tim DD/No S ! He pays me to practice in my mouth.
    Regards,
    Ted
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