Can I trust my dentist?
 

I am brand new to this forum and need some help.
Here is my story...

I went to a new dentist yesterday for a cleaning...the first I have had in two and half years. I am unemployed with no insurance. I have never had a cavity, brush at least 3 times a day, floss daily, yada yada. When I made the appointment I told them I have a severe fear of the dentist and would need nitrous to get through the visit.

After waiting for nearly 30 minutes in the waiting room listening to the drills and such, they finally call me in a take xrays. They tell me I have bacteria below the gum line and they'll need to do FIVE sessions of root planing and scraping so my teeth don't fall out. They tell me I my jawbone is deteriorating from this bacteria. This is going to cost me $1300.00 and they don't have a payment plan. They say I once they start the planing, bacteria will be released in my mouth which can go into my blood stream and give me a heart attack, so they will prescribe an antibiotic rinse. Mind you, my gums do not not bleed when I brush or floss and I take VERY good care of my teeth.

So the hygenist gets in there and cleans all over the mouth, not just the first quadrant as the dentist explained. She says everything's coming off very easily and there's little bleeding. She says my gums are very tight and my deepest pocket is a six (at the back where my molars are). She expresses this to the dentist and feels I will only need TWO more cleanings, not FOUR more. He says "well we really wont know until we get in there". Then no one seems to know what that first visit costs so the dentist says 1/5 of $1300.00 and they don't prescribe the antibacterial rinse! They basically scared the living daylights out of me, had me hyperventilating in the chair because of fear of pain as well as the cost and don't seem to know what is going on!

I told this story to my mom and best friend who both told me the dental industry, like any other service industry, is hurting because people don't go to the dentist every six months anymore, so they're using scare tactics to get people in the chair. I seriously don't know what to do! I do not have the money but am afraid to lose my teeth! but they look and feel FINE!!! can anyone advise?

Thank you.

Get a second opinion. When we moved to our town 20 years ago, we tried a new young dentist with an office in an expensive medical building. He said I'd need most of my old fillings replaced.

I hadn't been ignoring my teeth and in fact had had regular dental visits before moving there.

We decided to try another dentist, one who attends our church and has a small and modest office. He said my fillings were fine and all I needed was a cleaning and checkup.

There's no way I'd believe that dentist under the circumstances, it sounds fishy to me.

If you have been diagnosed with, say, symptomatic MVP (Mitral Valve Prolapse) or another heart condition, the ADA's guidelines do recommend antibiotics prior to and following dental procedures.

I also think that getting a second opinion would be a good thing to do, but without telling the second dentist what the first one had stated. If the opinions match, then, you'll, at least, have a choice of who you want to see for treatment(s).

PLEASE get another opinion.

Many years ago, a very sweet, well loved Dentist told my husband that he needed deep scale scrubbing, and would need to book several surgical appointments. He was at the desk signing up for all of these services, when I came out and started playing 20 questions. I REFUSED the surgery. I got him a very nice Sonic care toothbrush, and gave him better instructions on how to brush. He was not brushing the gum line, just the tops and sides of his teeth, as no one taught him better. I booked an appointment with another dentist, and while he confirmed that my husband had a large build up of tarter, and may benefit from the scaling, it wouldnt hurt to try better brushing techniques with a better brush and some time. We went back three months later, and it was much improved. We did three month professional cleanings for 2 years, and the problem resolved with hard work on our part, and education on better care. My husband was flossing, but would just snap the floss between his teeth, and not pull it through against the root line to pull out debris.

If your gut is telling you that this is wrong, seek another opinion. Ask if there are alternatives to this treatment. Ask if they are willing to work with you on other methods BEFORE resorting to expensive surgeries, and painful proceedures. Lack of insurance shouldnt make you a target. Paying cash should net you a discount, as they dont have to deal with insurance companies. They should be deducting at least 10% off the bill.

Make some phone calls, and seek a 2nd opinion for ANY surgical proceedure, dental ones included.

Hi Jack Sprat,

Perhaps I can help you.......I'm in the dental industry.....over 30 years. It is very unfortunate that the majority of the public continues to be terribly misinformed about their teeth and how to keep them healthy. I think the information you were given was accurate but definitely not presented to you very well. I think I can offer you some insight based on what you have written here...... hopefully it will be helpful to you.

First of all, it is true that the bacteria in our mouths travels to other areas of our body. The mouth is literally the opening to our digestive immune system. So if there is a chronic build up of bacteria below or above the gumline, it is going into our immune system which can negatively affect any of our major organs.

The plaque that accumulates along the gumline, is the same plaque that clogs our arteries. Since the mouth and immune system are so intricately connected, it is wise to have the plaque below the gumline removed at best 2times a years by a hygienist. On a daily basis we need to brush gently, but thoroughly twice a day and floss gently but thoroughly once a day. Brushing or flossing more than that is truly unnecessary and could actually cause some gum recession. It is also important to brush and floss properly. Did the hygienist show you how to do those things?

It sounds like you do not have your teeth professionally cleaned very often and because you brush so frequently, you think you are not building up plaque and tartar. Your xrays showed you have bone loss which means that you are building up bacteria under the gumline and would benefit from more frequent professional cleanings.

The procedure that the hygienist performed is called a Full Mouth Debridement. This is a rough scaling of the entire mouth to remove the heavy tartar/calculus buildup. This is done to remove the above the gumline tartar so that the tartar below the gumline can be gotten to at a later time. The tartar itself is actually very irritating to the gum tissue. So the idea in doing this procedure is to cause the least amount of trauma to the already irritated gum tissue. That's why you need subsequent visits to complete the removal of the tartar below the gumline. It is also very difficult to determine how many visits this will take until the gum tissue heals a little after the full debridement. Generally it is 2 to 4 more visits. It is also impossible for a dentist or hygienist to initially know how difficult it will be to remove your tartar because in some people, it comes off easily and in others it is very tenacious. It sounds like you will have areas that the tartar comes off easy and other spots where is will be a bit more difficult.

The average fee for a Full Mouth Debridement is $250.00 to $400.00 depending on how "tenacious" the tartar is to remove. You did not get ripped off at $260.00. Root planing per quadrant averages $250 to $400 per quad. So the estimate of $1300 for 5 appointments is completely reasonable in the scheme of things.

With regard to the antibacterial rinse....... this rinse is totally meant to protect you. Google periodontal disease and bacteria under the gumline. You will see that the information they gave you is correct. However, many of the rinsing agents are full of chemicals. If they use a product called Closys or one called Tooth and Gum Care, it would behoove you to go back and buy some. Both of these have great antibacterial agents in them that will not cause any adverse affects. Products like Listerine or any of the other OTC rinses that contain alcohol will actually harm the tissue and dry up the saliva making us more prone to tooth decay. So I would avoid the alcohol based ones at all cost.

With regard to your last paragraph......<<I told this story to my mom and best friend who both told me the dental industry, like any other service industry, is hurting because people don't go to the dentist every six months anymore, so they're using scare tactics to get people in the chair. I seriously don't know what to do! I do not have the money but am afraid to lose my teeth! but they look and feel FINE!!! can anyone advise?>>

The dental industry is definitely being affected by this economical meltdown. However, it is unethical to deliberately scare someone into the dental chair and provide unnecessary dental care. Does it happen........ yes it sure does! But only by those dentists that practice that sort of dentistry as a living in good times and in bad. I'm sure there are some offices that have increased their fees because their volume of patients are down and others who have reduced their hours to maintain a realistic production level to keep their business afloat.

From what you have described in your post...... you were informed in an unprofessional manner of what the findings were on your xrays. But you were not ripped off.

Let me know if this post has helped to clarify some things for you. In case you think I replied to your post in defense of dental profession........feel free to read some of my previous posts to other members....... I'm in this business long enough to know what goes on and rarely come do I ever feel the need to defend what they do.

I hope you are going to follow through with the other appointments!

Bryanna

Hi ewizabeth,

I'm sorry you had an unpleasant experience with this new dentist. It sounds to me like he was very preventive oriented perhaps moreso than your previous dentist. Thus the recommendation to remove your old fillings.

Mercury fillings (silver colored) are highly toxic. We breath the mercury vapors from these fillings every minute of every day. After about 10 years, these fillings start to break down which causes additional vapors to leach off of the filling. With composite (tooth colored) fillings, their life span is about 7-10 years and then they start to break down. With crowns and bridges, the cement lasts about 10 years or so and then the adhesive bond breaks and bacteria starts to get in underneath them.

So as you can see, no dental restorative material has an indefinite shelf life in the mouth. We don't necessarily develop symptoms at the onset of the breakdown unless part of the filling comes out or the tooth breaks or infection occurs. But the breakdown is there and someone very preventive oriented will bring it to our attention before it becomes a problem.

FYI...... I work for two separate practices, both in different but very expensive high income areas. The one office is very preventive oriented and the intention is focused on the betterment of the patients overall health. The patients in this office have beautiful well crafted dentistry and they are by far healthier patients. The other office is much less preventive oriented and the patients mouths are not taken care of like they should be and it is very evident in their ill health. Both offices have similar fee structures. So I just wanted to share that it's been my experience that the guy in the nice building is not necessarily out to get your money but the guy that overlooks the old and worn out may not have your best interest in mind.

Everyone has to do what they feel is most comfortable for them. I hope your relationship with your dentist continues to be a good one!!

Bryanna

Hi Bobbi,

The American Heart Association changed their pre medication protocol several years ago for people with MVP. It has been established that the premedication is not necessary for most dental treatment in "healthy" people with MVP. There are exceptions to this rule, but only for certain individuals having certain dental procedures.

http://www.americanheart.org/present...tifier=3047051

Bryanna

Hi Dejibo,

I just want to comment on part of your last paragraph.....<<Ask if they are willing to work with you on other methods BEFORE resorting to expensive surgeries, and painful proceedures. Lack of insurance shouldnt make you a target. Paying cash should net you a discount, as they dont have to deal with insurance companies. They should be deducting at least 10% off the bill.>>

Unless I am mistaken, I don't believe Jack said anything about "surgery". He stated root planing which is a non surgical scraping of the teeth. No cutting, no suturing. I also didn't get the sense that he was "targeted" simply because he didn't have insurance. And finally, paying cash does not entitle him to a discount, unless he wants to receive less than quality care. Many of us in the dental field are well educated and state certified professionals with many years of experience. We devote a great deal of our lives to helping others. Not just in our work environment, but as volunteers in places like hospitals and nursing homes and even the internet! Some of my fellow peers have gone to third world countries <on their own dime> to provide dental care to those in need. Our experience, skills and devotion are reflected in the salary that we are entitled to earn. Please, before you decide to cut my paycheck, kindly give some thought to how hard some of us are working to help others get well.

Bryanna

Mercury Fillings
 

Hi Kitt,

There will always be a group of some sort that will ignore all the biological data on the toxicity of mercury. Just as the tobacco industry continues to manufacture and market cigarettes in spite of all the data opposing it. It really is hard to ignore or dismiss all the data that has come out about this subject. Even with the thermisol (mercury) in the vaccinations...... how many more children need to become neurolgically impaired before this ingredient is removed for good!

I agree that most everyone would test positive for mercury toxicity at some level. Because as you said, mercury is found in food, water and the air that we breath. So without too much thought....... would you say that's alot of mercury being absorbed by our bodies every day? Now add to that burden our dental fillings which are near our thyroid gland and our brain with vapors continuously come off which are inhaled and swallowed into our digestive system. Mercury toxicity is cumulative...... it builds up in our body's tissue and organs. It doesn't matter what type of mercury we come in contact with, it is the abundance and frequency that creates such levels of unhealthy toxicity.

I truly hope you never experience any ill effects. But there are so many common illnesses that are associated with heavy metal toxicity (not just mercury). How would we know if we were dealing with that or not?

Bryanna

Bryanna,

In ALL areas of the medical field you CAN and SHOULD ask for a cash discount. ALL local dentists here are happy to give a cash discount, because it means that they dont have to deal with the paper work, or tie up office staff to resubmit what has been rejected. If a dentist submits a repair for $100 to the insurance company they typically get about half what they ask for, plus the cost of office staff to track down that payment adds up. It is a COMMON practice to step into ANY medical office, and tell them that you are UNinsured, and are paying cash, and wish to discuss a cash discounted service. You are NOT ripping off the dentist, or any other pro you are seeing, as a matter of fact, they get MORE money from your discounted cash payment, then from the insurance companies that most patients carry. Unless you are in the UK or Canada. So, please know that your paycheck is NOT cut by my discounted cash payment, as a matter of fact, its larger than if I showed up waving my insurance card.

I was not suggesting that they were being targeted because they didnt have insurance. I WAS suggesting that it was handled in an unprofessional manner, and at the very least, it should have received a better explanation of what services they were speaking about. Since you and your family work in the dental field, you already know what they are talking about, but the rest of us that white knuckle our way through visits dont know, and need better explanations of even the basics. This patient spoke of such anxiety that they needed gas to make it through a cleaning with NO cavities. Very anxious people require more detailed, gentle explanations.

I stand by my advice. Seek a 2nd opinion BEFORE allowing drastic proceedures (whether you call them surgical or not) to your body, teeth, or hair. If your gut is telling you something is wrong, WALK AWAY! seek advice from another office.

I think bryanna provided a very nice, well detailed explaination of the proceedure, and I am sure that has relieved a great deal of anxiety, but it should have come from THEM, and you shouldnt have to rely on message boards to get real answers about your dentist has plans to do.

My Dentist--
 

Nothing wrong at all in asking for a cash discount. Even for simple procedures.

It is not cutting anyone's paycheck. The Dr is not having to pay someone in his/her billing department to fill out all the forms and bill the insurance company. Many times having to submit that multiple times. Then waiting for the money. Then more cost in recording and deposting that money.

Cash patients improve cash flow into an office.

(we had a clinic associated with our gym...medical billing and waiting to be paid was a pain in the rear...so yes..cash discounts were given)

Hi Bryanna,

That dentist was going to put in new mercury fillings, this was about 20 years ago. I don't think he had my best interests in mind.

I'm sure that you are an ethical and upstanding dentist, but there are those that are less than honorable in any occupation. I hope you don't think we're directing our remarks toward dentists in general. I appreciate your input on this forum. :)

Thanks for the support. As a nurse, I have worked in many medical settings, and we encourage those without insurance to ASK for a discount on services, as it saves us TONS of time, money, postage, aggrevation, and telephone time to sort out the many mistakes made by insurance companies. Then we only get pennies on the dollar. My MDs would rather make 75% from Cash paitents than 33% from insurance any day. I am very lucky in that I am over insured, but horrified when I see the bills come in that say my $800 MRI was paid at a rate of $114. My $90 office visit was paid at $17. That makes me feel my MD was cheated.

As an MS patient with a mouth full of mercury fillings, I can tell you quickly i have ZERO intentions of having these puppies removed unless, and until they become an issue. MS was around long before mercury fillings, and I suspect will be around long after we all have those old school fillings replaced with composite. I do go to the dentist every six months, and all of my dentists have agreed that mercury fillings have recieved a bad rap in the press. We have all agreed that once they become a problem, we will replace them, but until then, mercury or amalgam fillings are strong, long lasting and quite cost effective.

On the whole, I have received wonderful medical/dental care within my community, and yes, my MDs as well as my dentist all do volunteer works in the apalachian mountains, and dontate a great deal of FREE medical/dental care right here in our own community. There is a sign on the front desk that says "if you are paying cash, please speak to us about your discount!" Its a minimum of 10% and with extenuating circumstances can be as low as 50% or if you qualify, it can be free.

Dejibo,

I disagree with you about asking for a cash discount when it comes to medical or dental care. Some offices will go along with it if they feel pressured or put on the spot. Others offer it because the location is either poor or the practitioners make a living by participating in set fee schedule insurance plans, similar to medicaid. I personally do not know of one dental office that advertises cash discounts the way you mentioned it. From my chairside perspective, it's not hard to distinguish which patients have received discounted dental care from those who have not. The discounted dentistry is generally quite shocking. Of course the patient doesn't know any better and they think they've gotten a bargain which in my opinion is truly sad.

There is good, bad and mediocre in every industry and not everyone is technically talented. But in most industries across the board, I believe you can only expect to get what you pay for.

Bryanna



.........

Curious,

The majority of dental insurance is different than medical. The claims are filed online in a matter of 2 seconds to a major clearing house and payment is received within 7-10 business days. Rarely is it necessary to follow up the submission of a properly sent dental claim.

The discounted dental plans known as "set fee schedule" plans are similar to medicaid insurance. These claims generally have to be submitted by mail and can take a bit longer to get processed. They can get lost in the mail or overlooked by the insurance company, but this is truly a rarity. The only offices that deal with these types of plans are those that participate in them.

Just thought I'd offer that info out there to everyone ......

Bryanna

I would like to bring this train back up on the tracks.

How did Jack do? What has Jack decided? How is Jack feeling now that he has had a day or two to reflect? :cool:

Jack--