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Old 05-19-2013, 07:58 PM   #1
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Intro and Cost of Phase 1 Treatment

Hi everyone,

I am new to the board and just wanted to introduce myself before posing my first question.
My name is Jen, and I have suffered from TMJ for about 15 years (I am currently 31). The first 15 years, I just had a clicking jaw, which never really bothered me, and didn't (at that time) see the need to seek treatment for. About 5 years ago, I began to experience muscle tension, which has now developed into full on pain in my facial muscles, as well as some small pain in the actual jaw joint. I failed to seek treatment due to being afraid of the cost and the time involved in treatment, but it has finally gotten to the point, where I HAVE to do something about it.
I found a neuromuscular dentist, and based on the treatment plan they have, I felt comfortable with going for it. I saw her this last week, and had severe sticker shock. Phase 1 with her is going to cost over 7K. She took what I believe were X-rays, which showed disc displacement on both sides, as well as wearing of my jaw bone, which I pretty much already knew was going on. She also said, that it was fairly severe, and another year or so without treatment would possibly require surgery.
I go in for a quick filling on Tues and will then get fitted for my orthotic splint, which she told me I will need to wear 24/7.
They spent a few hours trying to get my insurance comp to cover it, but that didn't work.
She did explain, that I will need to come in for therapy once a week for the first few months, and then down to bi weekly, as I get better. And I felt REALLY comfortable there, other than the cost of course.
However, I found some really negative reviews online about the practice, but none were with her TMJ treatment, just other patients who felt that the treatment she prescribed for other dental issues were unneeded and expensive. But seeing those reviews are making me uneasy.
But, she was trained at the Las Vegas Institute, and I like that it will be a one stop shop for everything... I work full time (shift work, weird hours), and have a toddler, so time is very hard to find. I really don't think I will be able to keep up with treatment, that involves various Drs, plus PT elsewhere, etc. I live in DC, and its so hard to get around, let alone with my crazy hours.
I felt comfortable knowing that I will be there so often, so if any issues come up, they will quickly be fixed.
One thing, that makes me uneasy though as well, is that they require the total amount up front for the treatment for phase 1. Is that normal for TMJ Phase 1 treatment? I was able to get 2 years of financing for a little more than half of it, but will have to pay around 2500 out of pocket.
Plus, we may be moving out of the area in 6-12 months, so I am nervous about committing (and paying for) a full year of treatment in case we move.
I plan on coming to her with my moving concerns on Tuesday and see if I can just pay half now and half in 6 months, but don't know if that is an option...
I guess I just wanted to see other people's experiences on cost, and how you paid i.e. all up front, how much, etc.
Also, if anyone has any recommendations for treatment in DC, or close to it in case I end up checking out others.
Thoughts?
Thanks in advance!

Last edited by jujubee455; 05-19-2013 at 08:02 PM.

 
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Old 05-19-2013, 08:13 PM   #2
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Re: Intro and Cost of Phase 1 Treatment

I would NOT pay all that up front. NO way. I would get a second opinion.
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Old 05-19-2013, 09:58 PM   #3
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Re: Intro and Cost of Phase 1 Treatment

I ended up paying about $2500-$3000 during the Phase I. That included diagnostic testing (2 specialists), splints treatment with the orthodontist, and supportive therapy by PT and chiropractic adjustments. Phase II was closer to $4500 overall.
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Old 05-20-2013, 05:23 AM   #4
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Re: Intro and Cost of Phase 1 Treatment

Not to complicate things for you, but I have written about these LVI dentists on this thread in the past. If you search LVI dentist on the web, you will find some interesting information about their treatment and billing tactics. In short, they pay lots for their training (which is not necessarily the best for everyone), and then they jack up their prices. This may not be the case for all of them, but it appears that this particular provider seems to be doing just that.

You will never know how much of anything you will need until you start your treatment. For example, you may be fine and not need much physical therapy. You may only need one adjustment per month, or one every 2 months. Most dentists charge by the visit. I am paying about $150 per visit and my splint cost me $1,500. I go to a separate physical therapist and pay her $140 per visit. All of this is covered by my medical insurance (except the splint was covered by dental).

I notice you are in the DC area. I know some good dentists (not LVI) that treat TMJ in the Bethesda area. They will not ask you for any up front payment like this. Think about it...you may start the splint therapy and find it is not working for you. Will they give you a refund?

Also, you will most likely need phase 2 treatment, which will really cause you sticker shock. Have they quoted you any ballparks for that? I have heard some very large numbers. Be very careful...it could cost upwards of $20K.

Just something to think about.

Last edited by clencher1; 05-20-2013 at 05:31 AM. Reason: added more info

 
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Old 05-20-2013, 02:47 PM   #5
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Re: Intro and Cost of Phase 1 Treatment

Quote:
Originally Posted by clencher1 View Post
Not to complicate things for you, but I have written about these LVI dentists on this thread in the past. If you search LVI dentist on the web, you will find some interesting information about their treatment and billing tactics. In short, they pay lots for their training (which is not necessarily the best for everyone), and then they jack up their prices. This may not be the case for all of them, but it appears that this particular provider seems to be doing just that.

You will never know how much of anything you will need until you start your treatment. For example, you may be fine and not need much physical therapy. You may only need one adjustment per month, or one every 2 months. Most dentists charge by the visit. I am paying about $150 per visit and my splint cost me $1,500. I go to a separate physical therapist and pay her $140 per visit. All of this is covered by my medical insurance (except the splint was covered by dental).

I notice you are in the DC area. I know some good dentists (not LVI) that treat TMJ in the Bethesda area. They will not ask you for any up front payment like this. Think about it...you may start the splint therapy and find it is not working for you. Will they give you a refund?

Also, you will most likely need phase 2 treatment, which will really cause you sticker shock. Have they quoted you any ballparks for that? I have heard some very large numbers. Be very careful...it could cost upwards of $20K.

Just something to think about.
Thank you for this information... could you send me the information of the Dentists in Bethesda? I think I can swing traveling up there... and if it saves me a decent amount of money, I am willing to try anything. I am really worried about starting treatment and then having to move, and losing all that money.

 
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Old 05-20-2013, 03:48 PM   #6
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Re: Intro and Cost of Phase 1 Treatment

Dr. Sylvan Mintz (a very long wait for an appt, unfortunately)
Dr. Michael Singer (I think wait is not as bad as Mintz, but still a wait)
Dr. Sarit Kaplan (you will get in to see her more quickly and she is in same practice as Singer)

That is all I know in the Bethesda area. There is also a dentist at University of MD. Her name is Vanessa Benavent and her practice is dedicated to TMJ and facial pain. A bit of a haul for you I imagine.

I know there are others on this board in the DC area...maybe they can chime in.

Good luck and keep us posted.

 
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Old 05-20-2013, 05:34 PM   #7
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Re: Intro and Cost of Phase 1 Treatment

Thank you!!! I will definitely keep you posted.

 
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Old 05-20-2013, 06:15 PM   #8
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Re: Intro and Cost of Phase 1 Treatment

you guys are scaring me! i can't afford a CT scan! i just got a bill for 600 bucks for some routine blood work i had done and am trying to fight it, because apparently i went to the wrong lab. but they are denying that grievance i filed. i am so stressed out and of course this makes my TMJ worse. i work 10 hours a week and i have the summers off. my husband doesn't make much and i am freaking out now about seeing a specialist. the x rays cost 500 bucks. my mom has helped out but i cannot ask her to help out anymore. i have a feeling i am stuck with a limited opening forever and a soft diet forever.
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Old 05-20-2013, 06:23 PM   #9
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Re: Intro and Cost of Phase 1 Treatment

Quote:
Originally Posted by Mandolyn View Post
you guys are scaring me! i can't afford a CT scan! i just got a bill for 600 bucks for some routine blood work i had done and am trying to fight it, because apparently i went to the wrong lab. but they are denying that grievance i filed. i am so stressed out and of course this makes my TMJ worse. i work 10 hours a week and i have the summers off. my husband doesn't make much and i am freaking out now about seeing a specialist. the x rays cost 500 bucks. my mom has helped out but i cannot ask her to help out anymore. i have a feeling i am stuck with a limited opening forever and a soft diet forever.
I understand Mandolyn... the reason I have put treatment off for so long, is because I knew it would end up costing a lot. My dental won't cover any treatment, and my insurance won't cover "out of network" unless its emergency care. I did find one maxilofacial surgeon in my area that takes my insurance, so I may try going there, since then it would be covered, but no other TMJ specialists I have found take my insurance, so I may end up having to pay out of pocket.
My plan is to get over half of it financed, which I was approved for... so I will just pay it off interest free over two years. Have you looked into financing options?
I would check with your insurance to see if it covers TMJ treatment, and then look around for doctors who will take your insurance.
Also, remember that medical costs are tax deductible, so you will "get some of the money back", in a tax refund to some degree, since it brings your tax liability down.
Mandolyn, what kind of insurance do you have?

 
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Old 05-20-2013, 06:35 PM   #10
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Re: Intro and Cost of Phase 1 Treatment

Quote:
Originally Posted by clencher1 View Post
Dr. Sylvan Mintz (a very long wait for an appt, unfortunately)
Dr. Michael Singer (I think wait is not as bad as Mintz, but still a wait)
Dr. Sarit Kaplan (you will get in to see her more quickly and she is in same practice as Singer)

That is all I know in the Bethesda area. There is also a dentist at University of MD. Her name is Vanessa Benavent and her practice is dedicated to TMJ and facial pain. A bit of a haul for you I imagine.

I know there are others on this board in the DC area...maybe they can chime in.

Good luck and keep us posted.
Clencher:

Where do you go for PT? Did your Dr. recommend a certain one? Also, do you know of any massage therapists that specialize with facial pain in the area?
I am thinking at least in the mean time before committing to any treatment plan, I am at least going to get a massage or something... also going to force myself to commit to going to the acupuncturist once a week. My cheeks are just so tense, and I am now starting to have neck/shoulder pain. I could always handle the jaw pain/clicking, but the facial pain is getting to be too much. I need serious short term relief.

 
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Old 05-20-2013, 07:21 PM   #11
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Re: Intro and Cost of Phase 1 Treatment

It's Guardian. That's all I know. And I know they have changed our plan to routine x rays only ONCE every FIVE years. That is ridiculous! Other wise we pay out of pocket for x rays. This is routine x rays when you get a cleaning.
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Old 05-20-2013, 07:24 PM   #12
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Re: Intro and Cost of Phase 1 Treatment

Quote:
Originally Posted by clencher1 View Post
Dr. Sylvan Mintz (a very long wait for an appt, unfortunately)
Dr. Michael Singer (I think wait is not as bad as Mintz, but still a wait)
Dr. Sarit Kaplan (you will get in to see her more quickly and she is in same practice as Singer)

That is all I know in the Bethesda area. There is also a dentist at University of MD. Her name is Vanessa Benavent and her practice is dedicated to TMJ and facial pain. A bit of a haul for you I imagine.

I know there are others on this board in the DC area...maybe they can chime in.

Good luck and keep us posted.
Clencher:

Where do you go for PT? Did your Dr. recommend a certain one? Also, do you know of any massage therapists that specialize with facial pain in the area?
I am thinking at least in the mean time before committing to any treatment plan, I am at least going to get a massage or something... also going to force myself to commit to going to the acupuncturist once a week. My cheeks are just so tense, and I am now starting to have neck/shoulder pain. I could always handle the jaw pain/clicking, but the facial pain is getting to be too much. I need serious short term relief.

 
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Old 05-20-2013, 07:47 PM   #13
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Re: Intro and Cost of Phase 1 Treatment

juju- are you taking ibuprofen? I am taking 600 mg 3x a day, regardless if i feel pain or n not. The oral surgeon told me to continue taking it. Not sure how long i am suppose to though. sometimes i still feel some pain and my cheeks are super tight too. when i rub them it makes it worse.
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Old 05-20-2013, 08:04 PM   #14
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Re: Intro and Cost of Phase 1 Treatment

Quote:
Originally Posted by Mandolyn View Post
juju- are you taking ibuprofen? I am taking 600 mg 3x a day, regardless if i feel pain or n not. The oral surgeon told me to continue taking it. Not sure how long i am suppose to though. sometimes i still feel some pain and my cheeks are super tight too. when i rub them it makes it worse.
I have been taking ibuprofen the last week or so, since it has gotten so bad. Probably around 800 mg twice a day. It definitely helps some, but not completely. Everything I try seems to be very temporary.
I often rub my cheeks as well, and it helps but only for a minute or so. I am really hoping a massage will at least give me a day or two of some relief.
I, like you, feel fine when I wake up in the morning. My pain develops throughout the day and by the evening, it is the worst.

 
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Old 05-20-2013, 08:29 PM   #15
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Re: Intro and Cost of Phase 1 Treatment

Yes, that is how I am. What is your diet like? I found that when I thought I could eat something like pancakes or muffins or even mac n cheese it got worse. So for 2 days I ate straight yogurt, oatmeal, smoothies, applesauce ... stuff like that. Today I had some cooked julienne potatoes (like scalloped potatoes) and I hope it didn't aggravate it. It required very little chewing, but I also had rice pudding and thought maybe I shouldn't have. The rice was cooked but I noticed I had to chew more than I thought.
I think that is what is aggravating it as the day goes on- talking too. And I probably bring my teeth together more than I think. My dentist told me to wear my guard 24/7 but I just can't wear it much in the day. I wear it only a few hours in the day and all night. It's hard to talk with it and drink. I also lick my teeth too much!!!
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