October 17, 2012

Dental Expense Crankiness

I am feeling cranky, because I took Henry to the dentist and it cost $155. No cavities, no x-rays, just a totally routine check. The dentist poked his teeth, the hygienist brushed and flossed them and did a 1-minute paint-on fluoride treatment, and it was $155.

The fluoride treatment alone was $38. That's the same price I'd pay for 950 daily chewable fluoride tablets (generic, without insurance), so HOW CAN THAT BE? The fluoride came in a little plastic ketchup packet and was painted on with a little paintbrush.

And this wasn't some sort of super-extra-special dentist---not a pediatric-specialist dentist, or a dentist with lots of child-distracting stuff or TVs or whatever. Just a regular family dentist.

HOW CAN ANYONE BE EXPECTED TO ROUTINELY AND UNBLINKINGLY PAY THIS TWICE A YEAR PER MEMBER OF THE FAMILY? PLUS EXTRA FOR X-RAYS AND FILLINGS AND SO FORTH???

Ahem.

Also, may I suggest that while charging $46 for seriously under a minute of tooth-examining, the dentist not mention his children are taking horseback-riding lessons? I realize even the children of regular-earning people sometimes take horseback-riding lessons, and that the dentist might very well send his children to such lessons even if he were, say, a teacher or a Target clerk instead of a dentist---but it is an unfortunately expensive hobby to bring to my mind at a moment when I am wondering WHY ON EARTH DENTISTRY COSTS SO MUCH.

45 comments:

donna said...

It used to drive me nuts when I would stare at my orthodontist's gold Rolex as he poked around in my mouth for 30 seconds every month.

Slim said...

Well, how else are his kids going to be ready for polo lessons? IT'S A PROCESS, Swistle.

StephLove said...

I had an emergency root canal last week and I'm feeling grateful for decent insurance. We paid $150 for a $1,000 procedure. So my root canal apparently cost less than Henry's routine check-up. I agree keeping quiet about the horseback riding lessons might have been a good idea.

Noelle Spooner said...

I paid $116 to have my toddlers teeth "cleaned" and today it was $234 to have a cavity filled. Oh yea, I'm super cranky about it.

Amanda said...

I KNOW. We have good dental insurance but I still just ran in to something similar. My youngest has braces and has a tooth that without the braces she would have been able to wiggle out on her own but because of the weird positioning we had to get it pulled. When I got there they asked me if I wanted to pay an extra $46 or whatever for the laughy gas. I stood there hesitating thinking "She'd pull this tooth out herself at home with nothing, but am I an asshole if I say no?" and then I said "well she just had novicaine for a cavity" and they said "oh we'll give that anyway" and so I said no to the gas and it all took three seconds and wasn't more complicated than pulling out a tooth at home. It's much like the flouride - did he need $40 worth of it?

Amanda said...

Not that I begrudge a dentist making a living but...

Brigid Keely said...

We are lucky enough to have insurance through the state for our child, but even though the general accepted guidelines for checkups are every six months, the state only covers yearly checkups. We can't afford to pay out of pocket for a check up, so my kid's going to have yearly checkups only unless one of his parents somehow manages to find a job that has insurance which HA HA HAAAAAAAAAAAAAAAAAA is very unlikely considering we've both been looking for such jobs for, uh, 15 years now?

Brigid Keely said...

Oh, also, I used to read this doctor's blog. He was complaining about HOW HARD IT WAS to be a doctor and HOW LITTLE MONEY HE MADE and it was SO UNFAIR etc etc but his previous post had been all about the cruise he was taking his entire family on. He takes two cruises a year, his kids ALL play musical instruments and attend private school, he drives a luxury car, etc. Well. Different standards of living, I guess. I'm not saying doctors don't work hard, but please don't play THE POOR CARD when your vacations cost more per year than my household makes.

Lyndsey said...

Well, I have two thoughts on this. First, this is why insurance is a good idea. Between my husband and I we had dental expenses approaching $2,000 this year. Of that we ended up paying only about $600 (and 400 of that was a deductible).

But second, while I understand the feeling of "but it is just a tiny bit of product and it does not take very long and he clearly is making money!" I also kind of disagree with that line of thinking. Although perhaps this is not the kind of thing that you want to have rationalized out, you just want to feel what you want to feel about it and be done with it. If that's the case, please skip past my post :)

Anyways. A dentist is running a business, obviously. And he has lots of expenses as I'm sure you're aware. Rent on the building, utilities, equipment, phones, computers, internet service, staff, INSURANCE (huge cost), professional fees, student loans, etc. And then he does still need to make some money because why else go through all the schooling and debt if not to make a better-than-average living. If he didn't make a better-than-average living there would be no incentive in his going through the trouble to become a dentist and the world would have no dentists. So although it may seem ridiculous that a cleaning + 1 minute flouride pack costs that much money, when you consider all the overhead and the fact that his making a decent profit is actually a good thing-- I don't think the cost sounds nearly so unreasonable.

Jen said...

I am wondering if you need to price shop a little bit. That seems REALLY expensive for a regular cleaning/checkup. At several points in time, I've had to pay out right for cleanings and the MOST I have paid was $75. So maybe get a few friend's recommendations and call to ask for the base price? Dentists seem to vary widely in price and what they consider necessary, as I've had a dentist INSIST on x-rays when I didn't forward them on from the last dentist after a move, even though I had had them within a year.

Mary said...

Exactly why I didn't see a dentist for 3 years between graduating college and therefore losing my parents coverage, and getting my first big girl job. I feel super lucky to have awesome dental insurance now. I may barely make a living wage, but at least I have great insurance.

shin ae said...

The dental issue has been a continual source of stress and irritation in our family. We've had insurance through the state (just for the kids), no insurance at all, and private insurance through my husband's employer. Every scenario has had its moments, and by that I mean ridiculously bad moments.

Also, I've noticed that trying to ask about price is not smiled upon by the front desk staff. When I've done it, they have not been helpful. In one situation, I was paying cash--this was right out of college, before I had insurance--and I needed to have an idea about what I should have on hand when I arrived. I ended up calling several offices because some people were so rude when I asked the question, and I was told it was impossible to tell me approximately how much I would pay. Obviously it should not be this way, but for me, it was. Oh! And when I finally chose a place, I told them repeatedly I was paying cash and had no insurance, and when the time came to pay, they asked AGAIN about my insurance, I told them AGAIN I was using cash. They cheerfully told me they'd bill the insurance. I AGAIN told them there was no insurance to bill. So, they gave me a total, which I paid. A couple weeks later, they billed me for more! Because my "insurance" had rejected that part of the claim.

JodieG said...

My old dentist used to regularly talk about his sailboat. It was a big thing. Then one day I went in for a checkup and no kidding, he had sold the practice to some young dentist and took off on his sailboat. Evidently the staff and I found out the same day--the day I went for my checkup!

MelissaInk said...

My husband told me my kid was on our insurance, so I took them in. They weren't (which I didn't learn till after the fact). I called and said there was no way I was paying $160 for the 45 seconds they spent in my kid's mouth, especially after waiting nearly an hour, I said if they made me pay, I'd be taking my business elsewhere (that's all my future appointments, my sons's, and the baby on the way). They offered to let me pay for just a VisiCalc exam ($45). I wasn't thrilled with even that, but it seemed REASONABLE, and they kept my business. I might speak to the office manager beforehand, let them know you are paying cash and see if they will wok out a better deal for you, since you supply them with so many patients and save them insurance paperwork headaches. Doesn't hurt to ask. And I'd never pay for flouride. Is in the water, toothpaste, etc. our insurance used to not cover it, and I'd sometimes get "a look" about it, but we've all been cavity-free for years ...

MelissaInk said...

That should say visual exam. Autocorrect is not my friend.

clueless but hopeful mama said...

A direct quote from my high school boyfriend who became a dentist just like his father and uncle before him:

"I'm going to be a dentist because you make a shitload of money for very little work."

There you have it.

Karen said...

Oh I feel your pain here. I just went in this week and found out I need my wisdom teeth out, as well as a root canal/extraction and the grand total AFTER my insurance $5,680.

Ouch.

Swistle said...

Lyndsey- Are you remembering to add in the amount you paid for the insurance plan? Or is that paid for completely by the employer?

No, you're right, I would like to just feel that I got a very bad value for my money. Because that IS what matters to me: I don't care what the dentist's expenses are, I care about whether the service/product I'm getting should cost what it does. And in this case I'd say no.

Natalie said...

I currently do not have dental insurance, my routine check-ups are periodontal (which basically means that they do the exact same cleaning, but because you have this classification, they charge you more), and it is still less than what you just paid (not by much). I suggest finding a new dentist.

Sarah said...

And this is why we switched dentists a few years ago, because just a regular exam costs a hundred and twenty and we don't have dental insurance. We found a guy in town who does a reduced rate if you don't have a dental plan, so now it's sixty per visit. Still a lot though, for a family of six. And the sixty is strictly for the exam, nothing extra like fillings, x rays, sealing the molars, etc.

Joanne said...

Oh, that is bullshit! That's a lot of freaking beans for a regular old checkup, especially one that is of a tiny mouth. My oldest has autism so we take him to a pediatric and special needs dentist. He just had a back tooth with a cavity that was abscessed and had to be pulled, and while he was sedated, they did an xray and found two more cavities and when it was all done the bill was $1400 and out of that, our insurance pay $112. Wonk wonk. Dental insurance is notoriously HORRIBLE, and my husband is a federal employee and their insurance is the WORST. Every year we have wondered if we should get the supplemental insurance and I think this year we are proving that YES we SHOULD. But even this expensive dentist, my point is, only costs $75.00 for a regular checkup and cleaning. I wonder if you can't find one that's cheaper. My mom goes to the dental school by us, which is fine in that she gets good care but she has to wait FOREVER, which is just not worth it to me at this point. Anyways, my long winded point is I'm sorry and that sucks. That is a lot of freaking money.

Anonymous said...

Hahaha ... I am fortunate to live in Canada where generally no one gives a moment's thought to the cost of health care (dental is not covered by the government but is covered by most employee plans at no cost - medical is for the most part, absolutely free, and no one ever even lets you know how much it would have cost, had it not been free). BUT I have been through two rounds of IVF, which is DEFINITELY NOT COVERED, and I always wondered why our (lovely, actually) specialist couldn't PUT DOWN THAT $4 LATTE whilst meeting with patients about their failing gametes. Of course, I also indulge in $4 lattes from time to time, and why bother begrudging a man his coffee? BUT STILL.

Anonymous said...

(Also, I meant "fortunate IN THIS RESPECT", not "fortunate generally", to live in Canada (although on the whole spectrum of places to live that is of course also fortunate). I think your country is lovely, and would also count myself lucky to live there, and am by no means a smug Canadian who thinks we've got everything figured out. And I realize that health care is never free and we're paying for it somewhere, and maybe our bridges will crumble or something, but it is still rather nice not to have to think about money/paperwork every time you get a UTI or your kid runs a high fever or some such. That is all.)

Beylit said...

Just got back from my dental cleaning. I had to have a polite conversation with my dentist about how I would be declining half the things she wanted to do to me including fluoride and irrigation. My bill went from $150 to $32. Considering she spent 10 minutes scraping my teeth and 1 minute polishing them, I do not feel that $32 was completely unreasonable.

I think that is the first time I have said that about my bill at the dentist.

Meggan said...

See, this is part of the reason why I am terrified to take my 2.5-year-old to the dentist for the first time, and why my husband and I haven't been for many, many years.

We NEED to go, I know we do, but we don't have dental insurance and I don't have a good concept of what dentistry costs without it. And if it can be over $150 PER PERSON for a simple cleaning... that is a whole lot of money at once.

I should probably call around as other commenters have suggested, but I haaaate the phone. I wish all healthcare providers had online appointment scheduling and clear pricing posted on their websites. My life would be so much easier.

Lyndsey said...

To answer your question directed to me, we pay about $170 per year for our dental insurance because it is through my husband's work. Although I understand from a previous post that yours is closer to $1,700 (although you do have 7 people to our 2 so that might help even the field a little bit).

But I understand the sentiment of just feeling like you got ripped off. I have similar rants about a variety of things. I think I only identify with the doctor somewhat because I am in a business that is consistently undervalued (photography) because people think "well if you spent an hour taking my picture and then give me a cd... it only cost you what, like, an hour and a dollar? why charge so much?" because people don't include all of the many many overhead expenses photographers have + the fact that if it is your job, you do actually need to make income on it and not work for free :) But that is just my own personal bias.

artemisia said...

You know, many other people go through just as extensive of training, paid just as much for their education, and might get paid as much as doctors and dentists, but I never hear them complain about how it isn't fair they can't make "any" money.

I do not think that healthcare, and the business of healthcare is, or should be, cheap. I mean, there are a lot of research, schooling, equipment, etc. dollars invested. I get it. But still. (Also - I think it is how the insurance companies have it rigged to make an insane profit that ultimately makes healthcare so insanely expensive, but anyway.)

A friend from high school, who I like very much and with whom I enjoy keeping in touch, is married to a doctor. A urologist, I believe, is what he decided to specialize in. In their Christmas letter we always got updates on his med school status and adventures. It was nice to hear about life on the "inside." It was never condescending or arrogant or anything like that. Just an update on what is a big part of their lives.

It was the year Hubby was to finally get out of residency -- and the Patient Protection and Affordable Care Act was up for debate in Congress -- where it all fell apart.

Hubby actually included a paragraph -- in the family Christmas letter -- about how horrible this bill was and how crappy it is that after racking up all his med school loans, he is now going to be poor and not be able to earn a living as a doctor.

I- I, still, can't even.

I absolutely feel for people facing huge student loans and an economy in which none of us are being compensated properly (if we are lucky enough to have jobs). But that felt so entitled and tone deaf. I am still in shock and its been years.

Tina G said...

I know that many people don't agree with planning a downsized family for economic reasons but in all honesty the costs of having a kid to care for and pay for everything pretty much made me not want a larger family. I ended up having my two kids 14 years apart, so really only paying for stuff in a serial fashion with my two "only children". That was not a conscious plan, but it worked out nicely anyway. Shoes, braces, clothes, FOOD...ack! I just cannot fathom feeding a family of 7 (every day for many years) But I have no issue with people with large families- I just knew it wasn't for us.

MomQueenBee said...

When the Boys were young and we were a one-income family I actually asked our dentist which of them truly needed every-six-month check-ups and which ones could lengthen that schedule. Turns out only one of them had teeth fragile enough to need to be checked and cleaned every six months, and the other three were just fine going in yearly. It worked for us.

jill said...

This is why we go to the dental school at our local university, and are darn grateful to have the option. Even then it's pricey, but it's not near what a regular dentist would charge.

Megan said...

I called every dentist in our town, trying to get my teeth cleaned without insurance. The rates were between $325 and $400. I thought the same thing - HOW do people manage that? Especially people with families.

Swistle said...

Tina G- Yes, there are advantages and disadvantages to every family size---and "having more money" definitely belongs to the "smaller family" side! It was a trade I am still glad to have made, but I can certainly see why some families would prefer not to.

Susie said...

I just went to a dentist in Beverly Hills today and paid 95 bucks (no insurance) for a cleaning administered by the dentist herself! I felt like I was getting ripped off, but now I feel like I did okay. I do need a new tooth though and in my brief visit to the periodontist's office I saw a lot of diamonds on his staff, so I'll price shop on that one.

Alexicographer said...

In contrast to @Lindsey, above, I pay $114 out of pocket (in fairness that is pre-tax, so really comes to something closer to $90 in "real money") per *month* for dental insurance for me and my 2 family members (DH, DS). We have come out ahead for several years, and will at least next, because we have over $1K of dental expenses per grownup per year (last year and this it was a root canal + a crown each, and next DH is already scheduled to get an implant on a tooth -- previously root canaled and then apicocectomied, you can look it up -- that had to be extracted). As there is a $1K max per person per year, I know the costs have been way more than that, but not by how much.

With lots of kids you'd probably be in the same boat -- you wouldn't have the same per-person costs (I hope) that we are experiencing, but I'm pretty sure most plans have a "one person" a "two spouses" and a "whole family" premium, and that the latter is constant no matter how many kids you have. So this could be one area where having lots of kids is actually "economical," in some miniscule way.

Doing My Best said...

I have said "no" to the fluoride treatment too, just so you know that it's possible =).

But I have experienced times when I would rather pay $38 than be hassled by someone, so no judgement here if you just can't deal with it!

Swistle said...

Alexicographer- That's correct: the plan we had access to was the same price whether it was one child or five. (It had that same $1000/person cut-off, too.)

JEN said...

I have SERIOUS dental issues. Between implants and the like - I can't even tell you the amount. I just had a partial made that cost $6000. And ouch it hurts.

Suki said...

I recently thought of you and your annoyance about the level of dental healthcare we are expected to maintain lest we be declared disgusting people. Crest has started a new advertising campaign for their White Strips with the tagline of, "If you're not whitening, you're yellowing". And I just thought, ugh. So now flossing, brushing and (for me) every 3 months cleanings are no longer enough? Now if I don't use your BS white strips on a regular basis, I am essentially saying that I don't care about my teeth and how yellow they are. Ugh. Sorry, had to ge that out.

Therese said...

I totally get your frustration! Like others, I would recommend dentist shopping. Depending on jobs and the quality/price of dental insurance plans, I have paid out of pocket for regular dental cleanings at times for both myself and children (there were times that the twice yearly cleaning bill was cheaper than the dental insurance premium through my employer). I don't recall (short of a full set of x-rays) paying more than $50-$75 dollars for a basic cleaning. That $150+ pricetag seems really high. I live in the mid South so maybe it's a regional difference but still. I also agree that any professional should keep his/her mouth shut about their personal financial situation when rendering your service. Even if (in their professional world) they are "poor" or "struggling," they are probably doing better than most. I don't begrudge them a good salary as I do fully believe their expertise and training warrants it, there's just no need to talk about it in that particular setting!

Anonymous said...

Ugh! I just had an appointment at the dentist as well, which I have avoided for last few years, ever since their "estimate" for the deep cleaning they insisted that I needed proved to be way off. Instead of $150, it cost double! I was so mad that I only sent my kids, until I broke a tooth the other day. Now he says I need two crowns, which, with teacher insurance that I pay for monthly, will cost $300+ each.That's just not going to happen for a while since my husband just called and said he's laid off again. Let's hope the fillings hold!

Katie said...

Oh wow, that is ridiculously expensive. I live in over-priced Southern California and we pay $80 at a children's dentist for the kids, and they do have the movie/video game screen for each dentist chair AND in the reception area. Flouride is not extra either. Geez, I'm annoyed for you.

My husband and I found a dentist who does our cleanings for $50. He's great, and although he is in a crappy area his office is well maintained and not a craphole like you'd think it would be for the cost and the neighborhood.

Elle C said...

Well...here goes nothing...I'm a dentist. While some of the comments are totally fair, some of them are also highly biased. Yes, some dentists have lots of money to throw around and some make a big show of it. Believe it or not, they are not really the norm. It's damn expensive to be a dentist. I paid more to go to dental school than my doctor did for medical school. I have amassed student loans that are higher than the total house price for most houses in my area (that doesn't include undergrad - which I paid for without loans). And that's just the start of my debt. To open my practice has cost me nearly a million dollars. And it's not a really over the top fancy one. I'm in a rural area. This debt, coupled with the fact that supplies, employee pay and other costs (like taxes and utilities) leave dental overheads at 75% are the primary reason that your prices are so high. That remaining 25% is what goes back into the practice or what goes home with the doctor...in my case most of that goes to pay my debt. I'm not trying to give off some holier than thou feeling here, I just want to make sure that it's understood that there are a range of dental types out there. I don't wear a Rolex. I don't own a sailboat. We went on a family vacation this summer for the first time in 3 years and we went on a short RV trip with extended family...no cruises, no Disney World or Europe. My charge for a child patient? Assuming cleaning, exam and fluoride...you're looking at right around $100. And if you have insurance, I'll get paid around 85% of that. If you have Medicaid, I'm really seeing you just to help out...because your insurance will only pay me about $55...far less than my 75% overhead. I hope this didn't come off as angry...I just want to make sure that we don't all become the bad guys. Some dentists are in the profession for reasons other than money...

Jo Ro said...

That's how all the dentists I know are RICH.

Is dental insurance available through your husbands employer?

It is totally worth it for us.

Swistle said...

Jo Ro- It is---or rather WAS: they offered it, but it wasn't a good deal so not enough people took them up on it and so now it's not offered. It was expensive AND had a $1000-per-person cut-off.

oilandgarlic said...

We try to keep costs low by turning down the extras. There is still a wide variety of prices among dentists. My husband's dentist charged $30 for a special mouth rinse, so he went to Walgreens with a presription (which they reluctantly gave him) and got it for half. I have found that the dentists themselves are more open to negotiation than the front desk, in general, since they have more power if they're the owner of the practice.