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Patrick Sawyer
climber
Originally California now Ireland
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Nov 26, 2012 - 04:06pm PT
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Fear is right, there are some nerves that run along the underside of the bottom teeth in the jaw. If the implant goes too deep, or there is deterioration of the bone, then if these nerves, or one of them, are damaged you could have a numb/'dead' jaw forever.
While I trust my dentist, and he's done implants, certainly for lower teeth implants I'd have a specialist carry out the procedure, not that I can afford an implant, I can't even afford a 'sticky bridge'.
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klk
Trad climber
cali
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Nov 26, 2012 - 06:35pm PT
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wow, sorry to hear this, tar.
i'm not so sure russ isn't onto something.
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Tarbuster
climber
right here, right now
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Topic Author's Reply - Nov 26, 2012 - 07:38pm PT
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I only need one upper implant. (The tooth is already out and bone graft is in place, although I included the extraction/graft in my quote in the OP, because interim sinus drop might bump it back up to $18k).
The 11 needed onlays pertain to unconscious grinding/clacking at night. (Upper nightguard doesn't protect lower teeth; they put hatchet marks in the night guard). Ripping out the remaining 27 teeth just for the sake of dentures would likely not be cost-effective. I'll look into it. This has nothing to do with vanity.
Periodonticly speaking those 27 teeth are stabilized. That means the gum disease is reasonably controlled with each and every one of them.
I've been making lots of phone calls to get a picture of what is going on with these discount dental plans. It's looking like this is for the average person who doesn't need the kind of care my genetics predispose me to. I'm finding a lot of the dentists, (but not all), who contract with discount plans are in fact just out of dental school.
Probably the best way to go about it is to get really good referrals from people who have personal experience with dentists in my area and see if those dentists happen to also contract with these discount plans. It's looking unlikely in the specialties, especially if I want an experienced dentist. I do, if I want any at all.
Medical tourism with excellent references might work. But that's difficult to achieve. I have a couple feelers out in this regard.
Thanks for the help folks.
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rottingjohnny
Sport climber
mammoth lakes ca
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Nov 26, 2012 - 09:50pm PT
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Goatboy...I use to see Dick Kiel on occasion at the auto-body shop next to my employers place of business...Dick was a big SOB...
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goatboy smellz
climber
Nederland-GulfBreeze
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Nov 26, 2012 - 10:00pm PT
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What about Barbara, did you ever see her roaming the eastside?
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susan peplow
climber
Joshua Tree, CA
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Nov 26, 2012 - 10:24pm PT
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I'm not sure my personal story will provide any insight but here it goes. Working for the man for 20+ years I had the luxury of dental insurance with minimal subsidized cost from me through payroll deductions. I'm one of those people who actually LOVE going to the dentist and would do so quarterly if it were covered by insurance. I fully took advantage the semi-annual cleanings and always had appointments booked long before any postcard arrived.
With that, dental insurance worked for cleanings and the occasional fillings. I've had two crowns, one done in the States with my dentist of many years at considerable cost even with insurance. When the time came for the second I went to Mexico for a significant savings (Gal don't be nervous!). Interestingly enough, when I go to the dentist now the crown of question is actually the one done from the US Doc, not my Mexico one. I would have zero hesitation to traveling south for major dental work. Quick, fast and big savings to be found.
I'm now one of the millions that are self-employed I pay for health insurance but skip out on dental. As a result I'm anxiously wanting a cleaning and recently called a local dentist which was referred to me from a friend. I also checked out the dentist for other reviews before calling them to see what Dental Plans they accept. I found the same thing as Tarbuster in that you pay an annual fee to a company which in turn provides a discount via the dentist for services rendered. I did my research starting with the dentist I wanted to visit and reverse engineered the plans they accepted. As a result, I found a few options for Dental Plans that have no annual limits and likely not costing much more than what it would be should I have had insurance other than now I need to pay for cleanings. Big Woo.
Tar, if you have a significant amount of work to be done I wouldn't rule out costing out a trip to Mexico. They have local labs which seriously reduces the time associated with work done. Fly down, walk over the border, have a burrito and the next day you'll have a new set of choppers. Any future maintenance to be handled by a local dentist of course. It's huge business and people from all over the US and Canada endorse it as "the way" YMMV.
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fear
Ice climber
hartford, ct
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Nov 26, 2012 - 11:58pm PT
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A fellow Grinder!
I apologize ahead of time for the long post.
Good to hear you only need one implant. That leaves the world of Dentistry and enters the realm of real surgery.
By inlays do you mean crowns/partial crowns?
I'm also a severe night-grinder. Been that way since I was born according to reliable sources... I chewed up nightguards monthly. I'll be in your situation eventually.
For crowns/large inlays always go gold. It's softer and won't destroy the opposing teeth/crowns like porcelin will. It's also much easier for them to adjust. As grinders, our bites are extremely strong and complex and getting the crowns shaped correctly takes time and a patient dentist. Gold does not mark very easily with the bite strips so frequent visits are common. Do not waste time with porcelin or composites.
Brush with a soft nylon brush and a mild non-whitening toothpaste. We have more dentin than enamel which is much easier to abrade away.
I have tried every kind of nightguard known to man, and then some. I've probably dropped 5k on guards alone. Most of them are in pieces around the world. The best for me are the cheapo ones available in any drugstore that you form with boiling water. The best have a two-layer soft layer of blue rubbery stuff over a harder (but not rigid) clear plastic. These last up to 6 months for me and cost about $40.... A wee bit cheaper and far less annoying than the dentist... If I wear mine religiously I can reduce the future damage by about 90%
Dentistry ain't rocket science. The only reason I'd advise against going out of the country is the fact that adjusting that many crowns/inlays is going to be a long process with many, many visits. A lifelong process actually as the gold crowns and remaining teeth continue to wear down.
My family has had good luck getting in with a local University dentistry program. The work is top notch and extremely cheap. The only downside is the length of time we have to wait for appointments.
If it's got tits or wheels... or enamel... it's gonna give you trouble eventually.
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Tarbuster
climber
right here, right now
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Topic Author's Reply - Nov 27, 2012 - 12:08am PT
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Copy that Sooze.
I just finished getting both hips replaced and the state covered my $10K monster deductible through one of those bottom feeder programs.
(Helped that we've dropped a wad into the medical establishment for all that arm/neck/knee/foot stuff and had a pile of receipts to push across the table).
Gotta look to find.
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Tarbuster
climber
right here, right now
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Topic Author's Reply - Nov 27, 2012 - 12:18am PT
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Fear:
The nightguards you are using don't sound like they can be adjusted for equillibration, but then I don't break mine. (Same unit for 13 years w/ one retread on it). Otherwise, yes, similar stone to push up the hill.
Thanks for the input: you are correct, I'll need temp onlays (yes, onlay is like a partial crown), pause some weeks/months for my musculature to adjust, then the "real" onlays go in. A three step process at the outset [maybe two in Mexico], plus, as you said, adjustments for sure due to our particular/peculiar conditions. The dentists don't know that much about etiology of bruxism, they just react to it ($$$).
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tooth
Trad climber
B.C.
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Nov 27, 2012 - 02:45am PT
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Check out Dr. Jim Beck... in Pueblo CO.
Your dentist has been patching, and it looks like you are about to get some expensive patches on your teeth again, what have you done about the problem causing the need for enamel replacement? Jim Beck has more experience and knowledge and skills with this sort of thing than anyone I know, and anyone I've heard of.
Have you had Botox masseter injections to calm those grinders down? Have you used an NTI? Have you used a tens machine? Have you used a functional appliance? Have you had TMJ injections? Skull/hair injections?
These are all different steps in looking at the big picture and trying to address causes rather than effects. He knows the etiology - I guarantee nobody in Mexico comes close. And they will have a bigger profit margin, especially since they don't maintain or warranty their work.
It is funny reading the posts of everyone here - I just wrote an article with pictures of all the nightmare dentistry I see coming out of Mexico to India. Just last week I saw what looked like a wood screw put through the side of a tooth into the bone in India, the woman was in my office asking my why her gums were bleeding... every crown (8) should fit like a beanie, they all fit like sombreros when you get them done in mexico. Food goes under, rots, you loose the tooth in 5 years instead of just the crown in 20.
I have done dentistry in 5 countries this year alone, there is no way I would recommend having it done anywhere but NA.
The cheapo guys in Mexico are doing it that way because they buy the dental products that have sat on docks in hot shipping containers and were sold off at 10% cost, it all fails and then I have to fix it all (in Canada) and the local dentists never experience their failures, they think it is all perfect - and the patient is embarrassed so they never admit that it was done in Mexico. But a sombrero is a sombrero, we don't make them in Canada.
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Fluoride
Trad climber
West Los Angeles, CA
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Nov 27, 2012 - 05:12am PT
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I had dental insurance when I ended up needing a double emergency root canal and crowns (Lynne and Jaybro remember my pain trying to eat at the Mobil before I went in and got the diagnosis in summer '10).
The insurance was worthless as the bill ended up being around $8K. Insurance topped out at $1500 of it.
Even the receptionist at my dentist's office said that dental insurance is worthless. Even when I went in for once a year cleanings and x-rays I still had a co-pay.
If anyone needs a good dentist in SoCal who is somewhat affordable, I have one in San Fernando. It's in a Clinica Dentista but the staff is great and the dentist is wonderful (Dr. Araujo). I learned about him cause he was the neighbor of one of my former work photographers. His prices definitely beat the ones at the Beverly Hills dentist I had been going to (even though his work was peerless).
I have a cracked back molar now but just can't afford to get it fixed. It's not causing problems now and can't afford a new crown even at my SF dentist. I don't have dental insurance anymore. But like it mattered anyway.
Dental work is SO expensive.
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rottingjohnny
Sport climber
mammoth lakes ca
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Nov 27, 2012 - 08:03am PT
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At least with your name , you have fewer cavities...
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tooth
Trad climber
B.C.
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Nov 27, 2012 - 09:52am PT
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Dental insurance is different than any other insurance.
Other insurances, like life or fire, are for one-time catastrophic events. They know the chance is low, but they will have to pay out a lot at once.
The companies know that people will need a few thousand a year for dental work. The equivalent of buying gas insurance for your car - and then them putting a 2-tank limit on what they will pay for, and at $2.00/gal.
The next thing they do is delay agreement for any work for as long as possible, that way they can collect in monthly payments what they will pay out. It is like you not paying bills for a month or two, then just starting up with rent again and never paying the past few months.
Then they deny claims, again and again, until we ask to speak with a dentist on staff (who usually graduated bottom of his dental class - or didn't make it in private practice - just like the guys working at universities). This allows them more time for collecting monthly dues - and the staff at the ins. co. get paid bonuses for high rate of denials.
I have a dentist who works for a co. lined up to speak for at our dental meeting in the spring to let us know how to get more approved for our patients. Basically, you have to bribe them - the company has to pay it's employees, and their CEO's make millions a year. You know it is coming from the difference between what you pay for your dental insurance and the benefits you receive.
My complaint is high dental costs too. But I know that if people just showed up for the appointments they made, I could cut my operating hours by enough to lower prices 25%. Dentistry is a highly skilled/labour intensive business, we can't just have minimum wage people standing around like at WalMart.
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Karl Baba
Trad climber
Yosemite, Ca
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Nov 27, 2012 - 11:03am PT
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Getting financially screwed is also an injury to life. I just can't buy that Tooth seems to say only dentists in the US and Canada (I wanted to say "White guys" but prolly not fair) are good dentists.
Had dental work done in India and also an ex-girlfriend with worse problems did too. 1/10th of the cost and no complaints. The materials cost the same or more cause they are imported but the labor is way cheaper. You can find plenty of dentists who went to school in the US or Canada. Yes there are lame dentists there to so you have to be choosy. but even the best, though they cost more by India standards, are infinitely cheaper than in the US. And it's super cheap to stay there while you get your work done. (might be a hassle for somebody needing work extending over months and months, but just saying for folks who google this later) India dentists sometime don't have the lastest fancy chair and bells and whistles, but they also don't mind spending the time doing the work.
Lots of people going to India, even for Heart Surgery.
My Parents on the other hand, seem to always have their expensive us dental work fail repeatedly. They won't quit their dentist as he lives almost next to my sister so they feel socially obligated. It's an art and also a science. There are crap dentists in every country'
Peace
Karl
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micronut
Trad climber
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Nov 27, 2012 - 11:16am PT
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Tarbuster,
Sorry you're having to navigate this. I'll read the whole thread and then give you my two cents based on your specific needs. I'm a periodontist, not a general dentist, I do gum disease and dental implants. Regular drill and fill isn't my day to day thing. Two things though:
1. Dental insurance is great for a cleaning or two or a small filling/maintenance work, if you have it given to you by an employer. Look at it as a coupon for maybe $1000 or so per year. Better than a stick in the eye. BUT, if you buy it on your own it's usually basically a scam. The best cover up to $1,000-1,500 per year, but cost more than that in monthly premiums. Dentistry is expensive. If you value it, you have to save up for it, like a wall rack, a Kayak, a BASE rig. It is not a right. It's like your car transmission, there's never a great time for it to go out and its never a fun thing to spend money on. Its a real drag, I know, but you get what you pay for in Dentistry in America today.
2. I really, really try to urge friends, family and patients NOT to get thier work done in Mexico, Brazil, etc....
I remove teeth and all kinds of dentistry and do all kinds of repairative surgery on very kind, smart and well meaning patients who choose to have work done outside the US. Last month, I had to extract six teeth on an upper class lady in her 50's who wanted to save some money and went to Mexico. She went to a very upscale office (I saw the website and it looked nice, and the guy seemed well educated), and her work had been fine in her mind for about 5 years. But it was a bomb zone under the work. Really sad. She totally could have afforded the work here, but went on the recommendation of a friend. I eventually saw the friend and it was the same scenario. SUre, there is some good dentistry being done down there, but honestly, it is far and few in between in my opinion and not worth the risk. I know this is a real drag, but its the reality. The good ol' USA is really your best bet when it comes to dentistry. Though there are plenty of crummy dentists here as well.
Like I said, I can give you some sound advice on your situation once I read the whole thread, but I have a busy day ahead and may not be able to get back soon.
email me if you want.
-Scott
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micronut
Trad climber
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Nov 27, 2012 - 11:24am PT
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Locker, "satisfied" often doesn't mean much in dentistry. Satisfied means it doesn't hurt right now and looks fine. Sadly, it can be rotting underneath and when it finally does become symptomatic, the repair is of a massive magnitude, including losing teeth. That's been my experience from treating hundreds, maybe thousands of patients who get work done in Mexico. My hometown is in Central California, and has a huge mexican population, from migrant to uber-wealthy folks from Mexico.
Every once in a while, I mean every once in a blue moon, I see good work from down there. Its one of the low points in my day telling a really nice guy that his work is failing and that it will cost gobs of money to avoid dentures. That's why I feel so strongly about this. Its a real bummer though, because I know how much good dentistry costs. But its worth it if its done right.
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Chaz
Trad climber
greater Boss Angeles area
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Nov 27, 2012 - 12:05pm PT
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Karl B writes:
"The materials cost the same or more cause they are imported but the labor is way cheaper."
Spoken like a True Capitalist!
Isn't that what Romney said when asked to justify what Bain Capital was doing, outsourcing and offshoring jobs?
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tooth
Trad climber
B.C.
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Nov 27, 2012 - 07:08pm PT
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Micronut, I think we do our friends a disservice when we describe dental work failing like we do. It isn't that it just fails in 5 years and takes the whole tooth with it, it is that there is no way to even brush or maintain that dental work that will keep it any longer.
The photo above, Karl, is an example of what I saw from India this week. I saw much more of it when I was in the country, or next door in Burma last month. Micronut will tell you why all the missing bone around the end of the screw is a bad thing.
90% of what I see, and 100% of what was in this woman's mouth is like this. She is blissfully unaware of her imminent loss of teeth. If you ask her, she will tell you that she has always had her work done in India and she would recommend it to anyone.
90% of what I see done in N.A. that people are complaining about recurrent (repetitive) decay and cracks are not for the same reasons. It is due to diet/hygiene and something I do not see rampant in other countries, clenching and grinding.
So yes, people who have work done here again and again - it does happen. But if you had the work done by the dentist in India who did the above work, you would't have it done again and again because when it fails, the tooth comes out.
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tooth
Trad climber
B.C.
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Nov 27, 2012 - 07:13pm PT
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Can you see how there is no way that the person could ever hope to clean that glob of food fossilizing behind the last crown on the bottom because the crown sticks out so far that it would take surgery to access it?
I agree that you can find good or bad dentists anywhere, 95/5. From what I've seen looking at x-rays and teeth and extracted teeth of 1000's of people in 5 countries this year, 5% of work done in Mexico, Guyana, Burma is as good as 95% of the work done in Canada and the US.
ps. I hardly ever see a tooth that has been crowned in India that hasn't also been root canaled. Can anyone tell me why that is?
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micronut
Trad climber
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Nov 27, 2012 - 07:26pm PT
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Tooth,
Thanks for the good work you're doing out there, both in private practice and in the far reaches of humanity. Its hard work doing good dentistry in today's financial and societal ecosystem. Your posts are always clear and concise. Keep up the solid work.
Look me up if you're ever in Cental Calif.
Scott
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