Three different dentists have reduced me to tears recently. The first dentist didn’t touch my teeth, the second only poked around and took pictures, and the third worked on my adult son’s teeth, not mine. Obviously, it wasn’t physical pain that made me cry. It was something much tougher to manage: frustration over estimates and bills that only the wealthy could afford to pay.
My first experience was the most upsetting. Dr. W., my regular dentist, had been telling me for years that I should replace the crowns on my two front teeth. Crowns usually last ten to fifteen years, and mine were 30 years old. I finally agreed to talk about replacing them. I knew crowns would be expensive, but I figured that we could finally swing it with the help of money we had put aside in our health savings account. I figured wrong.
First, the dentist said that it looked like the root under one of the current crowns was damaged and would be unable to handle the trauma of crown replacement. The dentist sent me to an endodontist who, for $425, used a fancy machine and fancier language to tell me the same thing.
I went back to my dentist. “What should I do?” I asked.
“Crowns, and even implants, are risky with that root issue,” he said. He explained that he thought the best option was to pull my two front teeth and put in a permanent bridge. “I would do the bridge work,” he said. “I would recommend an orthodontist to move those front teeth closer together and a periodontist for some gum work.”
“I am not going to use an orthodontist,” I said. I had spent many thousands of dollars on orthodontic care for my children; it was not a luxury I could afford for myself.
“I understand,” he said. “You will, however, need a periodontist both to remove your teeth and lower your gum line.”
Then Dr. W. slid a paper across his desk to me. “Here’s my plan. It includes my charge. The periodontist would be extra.”
I blinked several times trying to bring the number into focus. $9,550. Close to ten thousand dollars. And that was without the periodontist.
“I need to talk to my husband about this,” I told him.
“Of course,” he said. He also gave me the name and number of the periodontist he wanted me to see about extraction and gum work.
I left his office, got in my car, and cried. I just wanted two decent front teeth. Why did that have to be so expensive?
I later joked with my husband. “Whatever dental care I do get done,” I said, “you have to promise me one thing.”
“If I should die suddenly, make sure I have an open mouth as well as an open casket.”
As I thought more and more about the absurdity of the number Dr. W. gave me, I began to feel numb. I decided to take advantage of that feeling to go see the periodontist.
Dr. S. looked in my mouth and took lots of pictures. He also mentioned orthodonture.
“It’s not happening,” I told him. “My husband and I refinanced our house to pay for our children’s educations. We don’t have tens of thousands of dollars lying around to spend on my smile.”
“It’s a big investment,” he said. “It’s almost like buying a car, albeit a used car.”
Maybe a used car for a dentist, I thought.
“Well, I can’t afford another car,” I said, “or a couple of teeth that cost as much as one.”
“I understand,” he said. He didn’t give me an estimate, which should probably worry me more than the sum on the piece of paper Dr. W. gave me. He simply said he would contact my dentist to talk about my options.
I was charged $275 for the visit.
I didn’t want to make a habit of it, but I couldn’t help myself: I got in the car and cried. When I made that first call to my dentist, I had been so excited. I finally had enough money (or enough credit) to replace these old crowns. But what I had imagined would cost $5,000 could now be four times that amount. Who, besides the very wealthy, has $20,000 to spend on two front teeth?
I dried my eyes. Whatever I was going to do about my teeth, I wasn’t going to be able to do it any time soon. I didn’t have to wait long, however, to figure out how I was going to spend the money I had set aside in my healthcare savings account.
The next week I took my young adult son to an oral surgeon for a consultation about his wisdom teeth. I had called the oral surgeon before our visit and, you guessed it, I asked what the cost would be. I was given an estimate of $2,800; the receptionist said that actual cost would be determined at the consultation.
“It could be less, though?” I asked.
Imagine my surprise when the receptionist said to me, ten minutes into my son’s consultation visit, “Your total is $3,250. How would you like to pay that?”
“Wait,” I said. “I thought this was a consultation.”
She shook her head.
“About the cost,” I said, once I wrapped my head around the idea that this was happening. “When I called, I was told it was going to be about $2,800.”
“That didn’t take into account the x-rays and the exam,” she said. “Also, your son asked for nitrous oxide, and that costs $150 extra.”
I took a deep breath; I could have used a bit of that numbing gas myself.
If my son hadn’t been under anesthesia with metal instruments in his mouth, I might have called to him that we needed to leave. Instead, I handed the receptionist my credit card.
Just over an hour later, he was done.
I did not cry when I got in the car this time. I didn’t want to upset my son. I did the next best thing; I laughed. I told my son that my financial pain matched his physical pain. When I told him the cost, he gasped as well as he could with a mouth full of gauze pads and four sockets where his wisdom teeth once grew.
I cried later in thinking about how used I felt. It would take me close to three weeks to earn enough money to pay for work that the dentist did in just over an hour.
I’m tired of crying (although one wise woman suggested I should use my tears to knock some money off of ridiculously high estimates). When the time comes, I am going to swallow my pride and negotiate regarding my own teeth. As for my son’s dental work, I sent a letter to the oral surgeon asking for a partial refund. He said he was “shocked” to get my letter and that the best he could do was charge me “on the low end of the scale” if I ever used his services again.
Drilling, scraping, tooth extraction. These are the talked about sources of dental trauma. What people need to talk about more is an equally painful source of dental trauma—the cost of dental care—and how few of us can afford to pay for it.