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BlueMoon67 04-27-2012 01:56 PM

Conflicting Advice/Confused
 
I'm kind of confused. Although I have been with the same dentist for about a half dozen years, and do like his work, I am suspicious of the office manager, who has free reign when it comes to charging (and gets bonuses based on how much "business" she brings in).

So, I had the opportunity to get a cleaning, exam, and x-rays for $49 and took advantage of that. The dentist and the assistant were both very nice, knowledgable (or so it seemed), and very thorough. I was in there for over an hour.

Now, here's the part I'm unsure about. My previous dentist recommended a deep-cleaning, which I never had done. This dentist also said I need a deep-cleaning, but said I only needed one quadrant as opposed to the full mouth. (I never told him the other dentist already recommended it.) However, the new dentist would charge $274 for one quadrant, whereas my old dentist quoted me $475 for the full mouth (if memory serves me). It seems like a better deal, but should I get the one quadrant only and save money?

The part that I'm confused about is that this new dentist also recommended having four crowns replaced, and I do see his reasoning. They have a "margin" as they call it -- meaning a gap between the crown and the gum, and he says there is a bit of decay under one of them. (Can't this be seen on x-rays? I got the impression that the decay wouldn't full be known without taking the crown off.) He also recommended a few other minor things like replacing a few fillings, although they are not currently decaying. I have to admit the prices they quoted me seemed about average (I have no dental insurance), but the replacement for the veneer that chipped seemed high (about $1350 for one veneer).

Now, here's where it gets complicated. I am still undergoing treatment with Invisalign braces, and all of this work (assuming I got it all done at once) could only be done when I'm finished with the braces, but before they make the final retainer. Crowns, veneers, etc. will never be exact, and so the braces wouldn't fit (I know, because I already had some work done and it's not an exact fit anymore). So this gets tricky. My old dentist has treated me for all the work I've had done, including the Invisalign, so imagine the complications of getting work done elsewhere and trying to time this just right with the end of my Invisalign treatments, but before my retainer...

I'm now thinking it just isn't worth making the switch, although the new dentist does seem good in my opinion, but he's proposing work that would total about $3,500. My other dentist hasn't said anything about the crowns, or at least not that I can remember. I have had some fillings replaced, but not all, and he didn't say anything about replacing the others. However, I have often wondered myself what happens after I get the retainer and then need work done on my teeth. Do I need to get a new retainer every time? That would be a bummer because they are expensive. I never thought to ask that before, but I guess I should. Right now my trays are not fitting exactly because of an inlay my dentist did some time ago. (Yes, I know, I should have said something right away.)

If you have any advice or thoughts for me on this issue, I'd appreciate it. The only reason I even considered the switch is that I'm not good at confronting people about anything, and so I've just accepted whatever I got charged. Because I have no insurance, I'm sort of at the dental office's mercy. This seems to be a problem everywhere though, and has happened to me at other offices as well. (I used to have dental insurance, and was commonly told "the insurance doesn't cover it." Well, I just believed whatever they said, but looking back, I doubt they were truthful. I then gave up the insurance because it didn't seem worthwhile.)

KitKat880 04-29-2012 09:12 AM

Re: Conflicting Advice/Confused
 
A few years ago I moved from a rural to more metropolitan area after graduating from college and had to find a new dentist. My new dentist uses much more up-to-date technology, but this is not very cost effective, considering my dental insurance will not cover a lot of it. The new dentist also found a lot more wrong with my teeth than my old dentist had. Part of me thinks that the new office just wants to bring in more money

In any case, I just started Invisalign, and despite my suspicions about my new dentist's motives, I will not switch dentists until the Invisalign treatment is over. I would think going to two dentists for different treatments would make things really complicated. My advice would be to stick it out with your old dentist and discuss some of the issues you are concerned about with him.

Does Invisalign get less annoying as you adjust? Right now I hate these things and the idea of a year with them seems like cruel and unusual punishment! I'm only on day 4....

BlueMoon67 04-29-2012 05:00 PM

Re: Conflicting Advice/Confused
 
[QUOTE=KitKat880;4970216]

Does Invisalign get less annoying as you adjust? Right now I hate these things and the idea of a year with them seems like cruel and unusual punishment! I'm only on day 4....[/QUOTE]

Oh yes! The Invisalign gets much easier! Those first few days I thought I would go crazy and wondered if I could ever do this. Well, I can tell you with absolute certainty that it will become second nature to you shortly.

Thanks for advice. I agree that I should not switch dentists before ending the Invisalign. I do live in a major metropolitan area, and I know that prices here are higher and you probably have made a good observation about certain dentists simply pushing patients to have more work done.

ariot 05-05-2012 05:42 PM

Re: Conflicting Advice/Confused
 
[QUOTE=BlueMoon67;4969427]
The part that I'm confused about is that this new dentist also recommended having four crowns replaced, and I do see his reasoning. They have a "margin" as they call it -- meaning a gap between the crown and the gum, and he says there is a bit of decay under one of them. (Can't this be seen on x-rays? I got the impression that the decay wouldn't full be known without taking the crown off.) He also recommended a few other minor things like replacing a few fillings, although they are not currently decaying. I have to admit the prices they quoted me seemed about average (I have no dental insurance), but the replacement for the veneer that chipped seemed high (about $1350 for one veneer).
[/QUOTE]

It sounds to me like your dentist is drumming up unnecessary work. Every crown or filling will have a margin, its the interface between the tooth and the restoration and its best to keep it as small as possible, obviously, but its not a reason to replace a crown. I am not a dentist, but I am quite sure there is no way to see the decay until the filling/crown is removed, unless there is so much that it shows as a dark patch on an xray.

Why would the dentist suggest replacing fillings? Unless there is a problem with them I would leave well enough alone. I have some amalgam fillings that are 30 years old that are still functioning fine, and I'm sure the margins aren't perfect. There are risks with all dental procedures so unless you have a real problem that needs a solution, why expose yourself to unnecessary risk and expense?


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