Help! Need Dental Advice!

Updated on January 24, 2008
J.R. asks from Cupertino, CA
11 answers

Hi, need some advice from someone who has worked for a dentist, is a dentist, or has had crowns put it recentlly!!! I have four crowns on my top four front teeth.. I have had these eight years or so. They are the old type crowns with a metal base. My top gums on the front two have receded a bit. One of the crowns is worn through on the back. The dentist is telling me I should go ahead and do the empress crowns, which will last 25 years as oppossed to the normal 6-7 years, look nicer, not make my gums tint black or recede... The last part scares me.... I don't want my gums to turn black or recede more. They have quoted me roughly $3900 with insurance or not to have this done, because apparently insurance does not cover much of the nicer crowns? We have Aetna dental DMO. I am not sure what to make of this decision.. That is a TON of money... but I do not want my gums turning black or receding, and obviously having longer lasting crowns and less dental procedures would be preferable. The fishy thing is before the office manager knew that my gums were receding and one was worn through (basically she thought it was asthethic only) she quote me $3900. When she added it up for insurance she added all these other costs (I assume that they would charge the insurance co.?) and it was a bit more out of pocket for us! So she said we would be better off going the first route? Any thoughts would be helpful, thanks!

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B.W.

answers from Dallas on

You might want to get a second opinion. When it comes to Dentist I have always gotten 3 opinion to see which two are the closest to what really needs to be done.

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T.F.

answers from Dallas on

I would certainly get a second opinion. That is a lot of money.

I have crowns on top and bottom (Thanks to TMJ) because I broke my teeth by grinding.

My crowns have been on over 6 yrs and I have the porcelon (sp) natural color crowns. We have good insurance, Blue Cross Blue Shield and MetLife handles the dentistry part. I do know, insurance only paid 1/2 of my crowns because I chose the porcelon and per the insurance, what I got was also partial cosmetic because they are nicer. I think my 1/2 of each crown was about $400 or a little less. I do know that the Dentist will "charge" more if they think they will get a bigger reimbursement from the insurance company.

I have had no issues with my crowns whatsoever. I am a coward when it comes to the dentist and they have to handle me with kid gloves because it freaks me out so bad. SO..for me to get these crowns was a big deal for me.

Good luck to you and I say it is worth the money for a second opinion. Also, send in the pre-dental estimate to see just what and how much the insurance will cover.
Susan

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R.B.

answers from Dallas on

Get a second opinion for peace of mind on the cost. But take care of your mouth and get the crowns. Look at your budget. What are you spending money on? Expensive coffees? Manicures? I agree $3900 is a lot of money, but you will spend it somewhere else if you don't spend it on your teeth. It is something you will think about every time you look in the mirror. I would make it a priority. I don't think you will ever regret spending the money on your mouth. Do you or your husband have a "pre-tax medical spending account?" You can have $$ deducted from your pay check and at the end of the year turn in the receipt and depending how much you make, you could save almost 40% because they will take the money out of your check without taking out federal taxes. I'm not a dentist, but that is my opinion. Your smile is worth it. And there are smart ways to pay for it. Ask your employer/HR dept about the medical spending account.

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M.W.

answers from Dallas on

Call & make an appointment with my dentist Rich Garcia. he is located @ Midway & Northwest Hwy. Tell him M. sent you. He also was chosen as best dentist in Dallas for children, He works on both children & adults. I have known him for more than 10 years.
He will tell you the truth & be fair.

Dr. Rich Garcia # ###-###-####

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M.H.

answers from Dallas on

My first thought is... get a second opinion. I agree that it sounds fishy. Costs vary by dentist for a lot of procedures no matter who the insurance company is. You could probably just call around with your list and ask what their charges are for each option. FYI, I do not work for a dentist or have crowns myself. I was a nurse before I was a SAHM and I found out over the years that there is a lot of variability in the medical and dental field on charges and recommendations. I would even double check your coverage with Aetna.

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M.S.

answers from Dallas on

Hi J.,

I am an office manager in a dental office. Empress crowns are nice, but porcelain fused to metal with a porcelain margin would do very nicely. The lifespan of a crown is really about 10 years, no matter what the materials. Another concern is your DMO plan. DMO is NOT insurance, they don't pay anything to the doc except a monthly capitation fee per patient (usually about $5 per month). Empress crowns are not a covered benefit, so they can charge you full fee rather than the discounted fee you receive for more routine care. I would get another opinion, and NOT from a monarch or castle dental (I'm assuming that's where you went). Ask for copies of your xrays and make an appt with a PRIVATE practice doctor for a 2nd opinion.

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K.B.

answers from Dallas on

J.,

I think everyone is right on the second opinion front. I used to do medical billing, not dental but I get the feeling they are similar. As far as the office staff adding things up differently when they learned about additional problems that is normal. They usually try lots of different code combinations to try to get the insurance companies to pay for as much of the proceedure as possible. The insurance companies all pay differently for each proceedure and sometimes you can get better response by coding your bill with different proceedures that basically do the same thing. I wouldn't worry too much about that as long as they are telling you which options your insurance pays the best on. Doctors want to get paid so they really do seem to try to get the most out of your benefits because they know you're more likely to say no when the cost keep going up! Hope this makes since and good luck.
K.

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C.G.

answers from Dallas on

I used to go to dentist, every 3 months for cleaning and usually got an infection which took about 2 weeks to resolve. I have a crown in front that is also a metal base at lease 15 years, still looks ok, but they want to remove and of course make money. I got fed up and now I have not gone to the dentise for 2 years, but I brush with rotary brushes and always always, floss and always use listerine at night, morning. I still have my old bridge and no infections and am always aware of cleaning my teeth. Also my 80 year old mother was quoted 36,000, that would buy a small home somewhere.

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C.M.

answers from Dallas on

Hi J., I'm a hygienist and I work for a dentist in Rowlett. The $3900 does sound way high to be paying with insurance coverage. Our office charges around $1000 for each empress crown and insurance usually covers 50%, so I would anticipate around $2000 as your out of pocket. The exposed metal margin and wear on the backs of your crowns are more of a cosmetic concern and your dentist is right that it will probably get worse over the years. The reason your gums will look dark is due to continuing recession and the metal showing through the tissue. So, without actually seeing you and only going on what you're describing, it doesn't sound like an emergency situation that needs to be done right away. I would take some time and do some research by getting a second opinion from another dentist.

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R.W.

answers from Denver on

Hi J., I have not worked for a dentist nor do I know much about dentistry. I have an older crown too...with some metal edge exposed due to receded gum. My dentist has never said anything about gums turning color and I do trust him completely. He has not said it needs to come off until has stopped doing what is supposed to do which is protect to tooth underneath. I do think a lot of dentists in this area try to push the cosmetic approach regardless of whether it is really necessary or with regard to cost to the patient.

Just my 2 cents....you may want to get a 2nd opinion.

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L.I.

answers from Dallas on

Hi,
I feel your pain! We just had to have a bunch on dental work done and even with insurance it really hurts the wallet!! I don't know how your credit is, but have you applied for Care Credit? You can apply at www.carecredit.com. Check to see if your dentist takes it - I think most do. They tend to be lenient with not so great credit - we got approved and our credit is terrible. Also, if you want another opinion - we Love our dentist!! He is Dr. Chuck Medearis ###-###-#### and is in Carrollton, near Josey and Beltline. Their staff is wonderful - we love them! Our family doesn't have a lot of money and my husband has really bad teeth and they always work with us - sometimes they will even do payment plans. If you go to them please tell them L. & Greg Iezzi sent you! By the way, they are awesome with kids too - my 3 yr old loves going there!! Good luck!

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