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Dental/OOP cost
Just curious if anyone who works in the dental field thinks this is really necessary....yesterday I went for a cleaning.
Never had a cavity still don't.
I admit I don't go as often as I should.
I felt like the hygenist was really pushing me to pay for the gum disease preventive antibiotic....not covered by insurance...$45 per tooth.
Last time I was there hygenist said the same but was pushing more Invisalign for tooth straightening,
She made it sound like every tooth was gonna fall out of my head if I don't get this antibiotic preventive by the end of the year (I mentioned I didn't sign up for FSA at work yet because I'm tracking my spending this year and I wanted to see if it would be covered by that and maybe I will schedule come January).
She seemed to think January would be too late....
What's interesting is the dentist didn't mention anything and said my mouth looks great.....
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Posted 10/24/14 5:46 AM  |
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sunnyplus3
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Member since 11/05 8749 total posts
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Dental/OOP cost
I have been in the field over 25 years, I'm a clinician but I also teach dentists and dental professionals.
First let me say how awesome it is that you don't have any cavities!
Gum disease and tooth decay are totally different diseases and lots of people have one without the other.
As a profession we are very concerned about the oral-systemic connection. In years past we knew perio disease in a very localized area could cause tooth loss. Now we worry about much more serious things. I'm in a hotel and have to head out very soon so I don't have time to link to sources but the Candian Journal of medicine recently published findings of a 40 year study. People with periodontal disease that is not properly treated live shorter lives than people without perio disease or people that have it treated.
Perio is now directly linked to several terrible illnesses and conditions, Alzheimer's, diabetes, stroke, heart disease, low birth weight babies, oral cancer and the list goes on.
Perio disease or gum disease is absolutely painless so people are rarely aware. Many people are accustomed to seeing blood on their toothbrush or in their sink. I always ask, if your scalp bleed when you brushed your hair would you be concerned? Blood in your mouth regularly is never ok. Early perio may not bleed, that's good!
I personally suffered with severe perio disease in my late 20's, turns out I have genetic markers that make me prone( I had my salvia tested by the university of Pennsylvania ), my life was very stressful back then and it set it off. Luckily being in the field has allowed me to have excellent regular care including the medicine you describe but I must be diligent.
I would say $45 is a small amount to pay to possibly combat something so risky. As far as the timeline, studies show that the medicine is most effective at the time of the dental cleaning. Maybe that's what she meant, I'm not sure.
Message edited 10/24/2014 7:18:40 AM.
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| Posted 10/24/14 7:16 AM |
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sunnyplus3
:)
Member since 11/05 8749 total posts
Name:
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Dental/OOP cost
Crappy holt wifi, double post
Message edited 10/24/2014 7:17:21 AM.
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| Posted 10/24/14 7:16 AM |
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Kitten1929
LIF Adult
Member since 1/13 6040 total posts
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Re: Dental/OOP cost
Looking back, I wish I had done more dental work when I had better dental insurance.
My teeth are falling out of my head but - which I know is genetic and I have acidic saliva, but I do wish I had done more preventive care when I had the chance.
It can't hurt to look into it to see the pros/cons like KellyFG mentioned.
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| Posted 10/24/14 8:21 AM |
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sunnyflies
LIF Adult
Member since 9/09 1757 total posts
Name:
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Dental/OOP cost
" ... gum disease preventive antibiotic....not covered by insurance...$45 per tooth."
Did she say you actually HAD periodontal problems? Or is this simply for Preventative reasons? If so, I would say you do not need it. Extra and unnecessary antibiotics are never a good idea, and applying antibiotics to each healthy tooth is not logical.
I just paid about $5000 for my sister to get work on her mouth because she hadn't taken care of it. She had serious infections around several teeth that were treated, but not by having antibiotics painted on them. She was given several deep cleanings, had some root canal work and was given a course of oral antibiotics. She is fine now and knows she has to keep up with her cleanings, if she wants to keep her teeth.
You can indeed get very sick from infected teeth and gums. I know a woman who was hospitalized and almost died from a neglected infection that went up into her brain, but what you were offered sounds like a hustle to me.
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| Posted 10/24/14 10:55 AM |
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sunnyplus3
:)
Member since 11/05 8749 total posts
Name:
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Re: Dental/OOP cost
Posted by sunnyflies
" ... gum disease preventive antibiotic....not covered by insurance...$45 per tooth."
Did she say you actually HAD periodontal problems? Or is this simply for Preventative reasons? If so, I would say you do not need it. Extra and unnecessary antibiotics are never a good idea, and applying antibiotics to each healthy tooth is not logical.
I just paid about $5000 for my sister to get work on her mouth because she hadn't taken care of it. She had serious infections around several teeth that were treated, but not by having antibiotics painted on them. She was given several deep cleanings, had some root canal work and was given a course of oral antibiotics. She is fine now and knows she has to keep up with her cleanings, if she wants to keep her teeth.
In years past periodontal disease was treated with oral antibiotics, usually tetracycline based. Oral antibiotics create risk of superbugs, immuninity, etc. the type of localized antibiotic the OP was recommended are much safer, it does not contraindicate with any otger meds including birth control, also it does nothing to the teeth. It's placed in the sulcus which directly treats the gum and bone, that is where perio disease lives. This kind of medicine is not always recommended, it actually works better on localized areas than on people with moderate to severe, chronic periodontitis. The absolute best treatment for that is scaling and root planing with laser disinfection.
Sunny it sounds like your sister presented with an entirely different condition than the OP
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| Posted 10/24/14 8:12 PM |
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wakemeup
Member since 10/13 1397 total posts
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Re: Dental/OOP cost
Posted by KellyFG
I would say $45 is a small amount to pay to possibly combat something so risky. As far as the timeline, studies show that the medicine is most effective at the time of the dental cleaning. Maybe that's what she meant, I'm not sure.
That antibiotic (which DH needed, and had) is $45 PER TOOTH. Not a small amount.
I am not a dental expert but I think something as serious as an antibiotic needs some kind of evidence of actual necessity before you use it. Brushing and flossing and mouthwash are obviously working for you. I would not give it another thought. I had a hygienist tell me I should have teeth whitening because one front tooth is slightly darker than another, and when I pressed her for a reason she admitted it would be purely for aesthetic reasons AND it wasn't covered by insurance.
Message edited 10/24/2014 8:53:07 PM.
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| Posted 10/24/14 8:52 PM |
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sunnyplus3
:)
Member since 11/05 8749 total posts
Name:
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Dental/OOP cost
The medicine we are all discussing is only indicated for people with signs of periodontal disease, you must have a pocket depth of at least 4 millimeters and we measure several other components of a persons periodontal health before it should be recommended. It is not indicated as appropriate as a preventative measure. My thought although I was not there, is morning's condition is most due to lack of regular professional care, chances are the medication and a commitment to routine hyg visits and good home care could be the end of the story.
When patients choose to do nothing they should be informed of the potential risks to their overall health. There is not a toothbrush, piece of floss or waterpic on the planet that can completely remove the bacteria that causes periodontal disease to flourish in a pocket that is more than 4mm deep. That's a fact, you can find boatloads of reputable info online to support that. So the thought is the hygienist cleans the pocket and then Places the medicine while the inflammation in the pocket heals, the medicine wards off bateria and infection. Once it heals the pocket shrinks and hopefully the patient can keep it clean till the next visit. This is why perio patients are generally seen more frequently.
Let me explain what periodontal disease really is.
It is an INFECTION and a disease ( if moderate or severe it becomes chronic) in a persons head, next to their brain.
As for the $45, it's actually not per tooth, it's per site. Every tooth has SIX which certainly adds up but morning didn't say they tried to sell her on hundreds of dollars of treatment unless I misread her post.
None the less, if most people were told they had an infection in their eye and the treatment was $45 or a couple of hundred not covered by insurance most people that are able would pay to have it treated. In fact if most people were told they had an infection in their little toe( which we can all agree is mostly an optional aesthetic body part) and it would fall off if we didn't pay for a medicine for a few hundred dollars not covered by insurance most able people would buy the medicine.
If morning's hygienist did I crappy job describing her condition or validating the benefits of the medicine I can't do much about that.
However I will stand my ground in hoping that at least a few people learn about the true risks of perio disease and the value of proactive, reasonable treatment from this post!
Message edited 10/24/2014 9:34:04 PM.
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| Posted 10/24/14 9:30 PM |
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PhyllisNJoe
My Box Is Broken
Member since 6/11 9145 total posts
Name:
Phyllis
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Re: Dental/OOP cost
I don't know all the details to your case but my mom opted out of doing this same treatment bc of expense. She also has no cavities, never an issue. Thought they were BSing her for $. She wound up with full dentures in her 40's. Her teeth just started falling out and it was too late to go back.
I would really look into this before brushing it off
Message edited 10/24/2014 10:13:42 PM.
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| Posted 10/24/14 9:53 PM |
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luvmyReese
Hello Kitty
Member since 1/08 7542 total posts
Name:
Catt
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Dental/OOP cost
You'd figure ins would cover this treatment ..prevent more $$$ problems down the road.
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| Posted 10/24/14 10:39 PM |
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sunnyflies
LIF Adult
Member since 9/09 1757 total posts
Name:
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Dental/OOP cost
KellyFG - Thank you for your clear and thorough explanations. It makes sense to treat a pocket of infection directly. You sound wonderful. I wish I could have sent my sister to you. She had neglected her teeth but understands she cannot do that any more.
I just hadn't seen the OP mention having any infection or problem, just that the antibiotic treatment was preventative, so it sounded odd. I suffered for years with a fashionable dentist in NYC who did that sort of thing, running up huge bills I couldn't really afford. I trusted him as my DH's family had gone to him for years, until he went too far. I went to someone else for a second opinion who assured me I didn't need the thousands of dollars of the work the first guy was trying to get me to have done. Twenty years later I still don't need it. As a result of being taken in for many years, I have been suspicious of dentists ever since. I realize that most are not that way, but some are, unfortunately.
Message edited 10/24/2014 11:35:28 PM.
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| Posted 10/24/14 11:34 PM |
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Re: Dental/OOP cost
This again was coming from the hygenist who made it sound like it was a crisis situation that I get this work done.
When the dentist came in he said everything looked fine and good.
Isn't he the MD?
I am certainly going to keep up more on my cleanings now and will consider the treatment in the new year when I have FSA in place.
I also agree that something like this should probably be covered by insurance if it's "so necessary".
I'm sure a lot of people probably blow it off for similar reasons, thinking the practice is trying to sell them unnecessary work.
And also what about people who truly can't afford it. I know Medicaid doesn't cover much at all....
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| Posted 10/25/14 6:39 AM |
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Re: Dental/OOP cost
Posted by wakemeup
Posted by KellyFG
I would say $45 is a small amount to pay to possibly combat something so risky. As far as the timeline, studies show that the medicine is most effective at the time of the dental cleaning. Maybe that's what she meant, I'm not sure.
That antibiotic (which DH needed, and had) is $45 PER TOOTH. Not a small amount.
I am not a dental expert but I think something as serious as an antibiotic needs some kind of evidence of actual necessity before you use it. Brushing and flossing and mouthwash are obviously working for you. I would not give it another thought. I had a hygienist tell me I should have teeth whitening because one front tooth is slightly darker than another, and when I pressed her for a reason she admitted it would be purely for aesthetic reasons AND it wasn't covered by insurance.
Yeah, last time I was there they briefly mentioned the antibiotic, but it was all about the Invisalign. I would love to have the cosmetic work done but we simply can't afford that.
If it's truly something that I need to be concerned about because of health reasons, that's a different story.
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| Posted 10/25/14 6:43 AM |
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sunnyplus3
:)
Member since 11/05 8749 total posts
Name:
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Re: Dental/OOP cost
Posted by luvmyReese
You'd figure ins would cover this treatment ..prevent more $$$ problems down the road.
The dental "insurance" industry is far more twisted the the health insurance industry. I was at the American Dental Association meeting in Texas recently and things are getting worse, not better.
There are a handful of companies that cover it, but most do not. They will happily pay most of the cost for a patient to have all their teeth extracted and have a denture made rather than pay for something has is scientifically proven to save teeth and reduce the systemic risks of perio disease.
Dental insurance is not really insurance, it's a supplemental benefit designed to help patients with the cost of their dental needs. The average annual dental insurance maximum is $1500 per person. I have original policy documents that I found in old charts that were getting shredded. The policy documents are dated 1970, the annual maximum benefit was $1250.
$1250 in 1970 went a long way because crowns were $175, cleanings were $20
Today the average price of a crown on LI is $1000 and a cleaning is $115. That $1500 doesn't stretch very far even though the typically pay on percentages.
Message edited 10/25/2014 8:28:49 AM.
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| Posted 10/25/14 8:05 AM |
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sunnyplus3
:)
Member since 11/05 8749 total posts
Name:
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Re: Dental/OOP cost
Posted by sunnyflies
KellyFG - Thank you for your clear and thorough explanations. It makes sense to treat a pocket of infection directly. You sound wonderful. I wish I could have sent my sister to you. She had neglected her teeth but understands she cannot do that any more.
I just hadn't seen the OP mention having any infection or problem, just that the antibiotic treatment was preventative, so it sounded odd. I suffered for years with a fashionable dentist in NYC who did that sort of thing, running up huge bills I couldn't really afford. I trusted him as my DH's family had gone to him for years, until he went too far. I went to someone else for a second opinion who assured me I didn't need the thousands of dollars of the work the first guy was trying to get me to have done. Twenty years later I still don't need it. As a result of being taken in for many years, I have been suspicious of dentists ever since. I realize that most are not that way, but some are, unfortunately.
I'm sorry you had that experience. Dental diagnosis is subjective to a certain degree. It's healthcare but it's also elective services. Many dentists tell patients everything can do to improve their oral health and have better function as well as a perfect smile. Some of it is clinically necessary, some of it is optional. Also, because not every dentist will present this totally comprehensive approach " diagnosis" can vary from dentist to dentist.
Most dentists are terrible communicators ( communication is a major part of what I teach them) which leads patients to think they were tricking them.
I'm a big believer in telling patients everything we honestly see and what we would recommend to improve it, but I also believe we need to be concise about things that are optional vs not optional because of clinical need.
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| Posted 10/25/14 8:12 AM |
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sunnyplus3
:)
Member since 11/05 8749 total posts
Name:
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Re: Dental/OOP cost
Posted by MorningCuppaCoffee
This again was coming from the hygenist who made it sound like it was a crisis situation that I get this work done.
When the dentist came in he said everything looked fine and good.
Isn't he the MD?
I am certainly going to keep up more on my cleanings now and will consider the treatment in the new year when I have FSA in place.
I also agree that something like this should probably be covered by insurance if it's "so necessary".
I'm sure a lot of people probably blow it off for similar reasons, thinking the practice is trying to sell them unnecessary work.
And also what about people who truly can't afford it. I know Medicaid doesn't cover much at all....
The dentist is the one with the dental degree, however hygienists should have much more knowledge about periodontics. It's all they do, their entire degree is based on it and all of their continuing ed is based on it. It is not uncommon for dentists( unless they are periodontists) to not mention gum health, they usually completely trust their hygienist to make those findings and recommendations.
My business is teaching dentists and their teams to present treatment in a way people can understand and communicate better in general. It's a skill most of them desperately need to improve. They are not taught how to do it in dental school.
As for dental Medicaid, they are often entitled to more money per year than people with private dental insurance.
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| Posted 10/25/14 8:20 AM |
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Re: Dental/OOP cost
Thanks for your feedback!
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| Posted 10/25/14 8:35 AM |
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Mmm777
LIF Infant
Member since 2/13 330 total posts
Name:
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Dental/OOP cost
Not sure about this but how about consulting a periodontist ( I think that's the specialist for gums) and if he concurs maybe get it done ?
I need to deep clean , for my gums it's not covered by my hygienist and I will try and get it done next year ( new dentist as I moved to westchester ..oh well )
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| Posted 10/26/14 12:15 PM |
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Re: Dental/OOP cost
That's an idea.
The woman said usually they are not covered at all by insurance though....so we will see.
I'm planning to change to a better dental plan in the next open enrollment so hopefully I will have better options.
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| Posted 10/26/14 12:23 PM |
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