How to Have Healthy Teeth and Avoid Crazy Dental Fees


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You can keep your teeth and your wallet intact with good personal practices and knowing the tricks of the dental industry.

Keeping your teeth and gums healthy isn’t just a question of vanity. Sure, fresh breath and a sexy smile are great social assets. But oral health also has a lot to do with overall wellness.

According to the Mayo Clinic, dental disease may be linked to such health issues as premature birth and low birth weight, cardiovascular disease, diabetes, endocarditis (infection of the inner lining of the heart), osteoporosis and even Alzheimer’s disease.

A twice-annual cleaning and exam can help you stay healthy — and that ounce of prevention will help save you far more costly work — but even a cleaning can run up a bill of several hundred dollars.

So, the question is, how to stay on top of it without breaking the bank?

Dentists often advertise some super deals through social buying sites such as Groupon and LivingSocial, local “shopper” newspapers and even the ubiquitous blue envelope from Valpak. Let me bear witness to deals that do exist: While living in Seattle, I should tell you that I redeemed a Valpak coupon: $29 for cleaning, X-rays and a free teeth-whitening kit custom-made for me in the office.

Read such deals carefully, and take note of expiration dates. If a voucher expires, you can still redeem it for the amount paid but you won’t get the same price on the deal. Suppose you spent $29 on a Groupon deal for cleaning and X-rays but forgot to book the appointment in time. You can still apply the $29 toward those services, but it’ll cost a lot more than $29.

Remember, too, that deep discounts, whether through social buying networks or a coupon in a local paper, are generally for new customers. You won’t get nearly as good a price on future visits.

Also keep in mind that the office on the coupon might not be the most cost-effective game in town for later work. If the exam turns up a problem, write down the specific treatment recommended and the total cos, then say you’ll get back to them regarding future appointments.

Next, use a list of average dental costs compiled by Consumer Reports to see if the charges seem reasonable. If not, ask friends and co-workers which dentists they use and call to compare fees for the same service.

Beware costly extra procedures

Teeth whitening is just one of the unnecessary treatments offered at many offices. Nancy Metcalf of Consumer Reports says, “Many dentists are trained to push for procedures, both cosmetic and non-cosmetic, that will boost their bottom line.”

“We were struck by the finding that nearly a half of [readers surveyed] who had a cosmetic procedure had been prompted to do so by their dentist,” Metcalf says.

In-office whitening will cost, on average, about $650, according to the Consumer Guide to Dentistry. If you’re concerned about stains on your teeth, you can instead purchase whitening strips or bleaching kits over-the-counter for a fraction of the cost.

Among the procedures that could be unnecessary are teeth whitening, amalgam filling replacement, X-rays (more on those in a minute), precautionary removal of wisdom teeth and temporomandibular joint (TMJ) disorder surgery.

Regarding X-rays: Most adults don’t need them at every dentist visit. According to WebMD.com, you might need them only every two to three years depending on your age and the current state of your mouth. If your dentist wants X-rays at every visit, ask why.

Consider a second opinion

Suppose the dentist says you need deep treatment for serious gum disease plus a crown to fix serious upper-molar decay. You’ll probably reject the idea, wondering just how your teeth could have gotten that bad even though it’s been a year since your last checkup.

It could be you’re rationalizing. But it could also be that you need a second opinion.

My daughter got that “Serious gum disease! Ghastly cavity!” diagnosis last year. The second dentist she visited said, “Nope, you just need a good cleaning and to learn to stay on top of the flossing.” Not a word about gum scaling or even a decayed tooth.

Although most dentists aren’t out to rob you, consider a second opinion if things just don’t feel right. Doing so saved my daughter $1,000 out-of-pocket and a whole lot of unnecessary work.

And if you do need additional care? Prioritize the procedures, i.e., take care of pain and/or infection immediately lest things get worse. Schedule any other work to be done over a period of months or even a couple of years, so you won’t go over the maximum annual allowance on your dental insurance.

Don’t have dental insurance? Spacing out the treatment might mean you can pay as you go versus charging it. Here’s a tip that could help: Use a site like FairHealthConsumer.org or Healthcare Blue Book to learn the insurance reimbursement rates offered in your region. Ask whether a dental practice will accept that rate, paid in cash, each time you go in for treatment. If you need a lot of work done, maybe you can negotiate an additional price break.

Or look for discount dental plans such as New Dental Choice and Dental Plans. An annual membership fee of $80 to $150 qualifies you for discounts of up to 60 percent from a group of dentists who have agreed to lower rates. With regard to these plans, Consumer Reports warns once more against “pricey add-ons and extra procedures (you) don’t need.”

Free or low-cost options

A few more possibilities:

  • Children’s Health Insurance Program (CHIP): Designed for families who don’t qualify for Medicaid assistance but can’t afford private insurance, CHIP dental coverage is good for children up to age 19. Coverage varies from state to state. To find out more, visit the CHIP website or call 877-543-7669.
  • Clinical trials: According to the National Institute of Dental and Craniofacial Research, you may qualify for studies that include your specific dental situation. This means free or low-cost care. To learn more, visit the NIDCR website and click on “Clinical Trials.”
  • Dental schools: The American Dental Association has a list of such schools; maybe you’re lucky enough to live near one. Don’t worry, dental students’ work is supervised.
  • Dental hygiene schools: You may be able to get low-cost cleanings at some dental hygiene schools. Check the American Dental Hygienists’ Association website to find the nearest school.
  • Federally funded health centers: These operate on a sliding-scale basis. The U.S. Department of Health and Human Services website has a health care finder tool.
  • Medicaid: Another state-run program that may cover dental benefits for low-income residents. Visit the website or call 877–267–2323 to learn about benefits in your state.
  • Online searches: Click around and you might find regional dentistry events. For example, the Fox Valley area of Illinois has an annual “Dentist With a Heart” day of free care. Aspen Dental has a mobile dental clinic that travels around the country providing free dental work through their Healthy Mouth Movement program.

Remember, dental problems won’t go away on their own. Allow them to get worse, and you’re looking at major pain, greater expense and a longer course of treatment. A crisis situation makes it difficult to make the best decision — you’ll just be looking for someone, anyone, who can make it stop hurting.

Prevention is easier (and cheaper!) than repair. If you haven’t seen a dentist lately, start looking for one.

What is your experience dealing with dentists and dental bills? Share with us in comments below or on our Facebook page.

Kari Huus contributed to this post.

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