help.

May 12, 2009 2:17 PM

My teeth are bad. Really bad. Totally rotted in the back, cavities in most of the surviving ones. I need help.

This stated after going though emotional trauma in my late childhood, early adolescence. And in an attempt to gain some control over my life, I totally and completely neglected my teeth (I know it doesn't make sense, but personal and family issues manifested themselves in this weird way). I feel so stupid, embarrassed, so regretful for this, but I can't go back. I desperately want to have my teeth fixed - to feel good, not in pain, ease in eating, and maybe feel better about myself.

Are there any services in the Boston area that will help me, and help with the costs? (I am just out of school, and looking for a job, do not have a lot of savings).

I am tired of living like this and really need some help. Any thoughts, directions, or services you can point me to would be really really really appreciated.

posted by anonymous to health & fitness (23 answers total)

MassHealth has dental benefits. In the pre-MassHealth days, a lot of my low-on-cash friends used to get their dental care at the internship clinic at Tufts Dental School.

Best of luck to you.
posted by Sidhedevil at 2:22 PM on May 12, 2009

My wisdom teeth came in fine, but when my jaw was completely open the top and bottom wisdom teeth were still very close, so it was tough to brush them, and they got food in them and eventually developed big nasty cavities in a surprisingly short amount of time. Simplest, cheapest way to solve it: Dentist pulled all 4 of them under just novocaine, an hour in the chair, and I was on my way home. Depending on how many and which ones, you might not really need those teeth -- drilling and filling would definitely be more expensive than pulling them; good luck. Some areas have programs where dentists do simple, pro-bono work certain times of the year, for the homeless and the poor; check the bulletin board at social services or a homeless shelter, and you might find out how to get it done for cheap or free.
posted by AzraelBrown at 2:26 PM on May 12, 2009

Most dental schools have clinics with reduced prices. Also, you might want to check the Craigslist "volunteers" section for students offering free cleanings, exams, and fillings.
posted by aquafortis at 2:33 PM on May 12, 2009 [1 favorite]

Whatever you do, try find a place that will offer sedation dentistry. I have more than a few friends who had similar issues with multiple cavities, massive plaque buildup, etc, and that's the BEST way to go. If you're out they can do it all at once, otherwise you're looking at a dozen visits to take care of everything separately since there's only so much you can withstand with just Novocaine.
Added bonus is that you won't be tense, as anyone would facing major dental work, so your jaw won't cramp as bad and you won't be all fidgety.

It's more expensive in the short term, but in the long term you may save since you're looking at one or two visits instead of a dozen, even with the cost of the anesthesia.
posted by Kellydamnit at 2:34 PM on May 12, 2009

I agree with kellydamnit... do sedation and, if possible do it all at once.. I spent 8 hours in the chair, had massive work done (you do NOT want the list), and remember about 5 minutes of it and experienced NO pain..... good luck and good for you in getting this taken care of, it will make a world of difference for you....
posted by HuronBob at 3:24 PM on May 12, 2009

Agree with Aquafortis.

I got so many medical treatments done in Boston that I could not have afforded elsewhere due to the insane number of teaching hospitals in the area. Tufts dental school is one (I believe) that offers low-cost services. Be prepared though: If you use a school, your visit will take twice as long. It's very thorough and generally involves several instructors reviewing the students "work" once their done. It's completely worth it, though. Sometimes it can be a 50-60 percent savings.
posted by notjustfoxybrown at 3:50 PM on May 12, 2009

I second tufts dental school, much less expensive than seeing a private practice dentist.

There is also some evidence to suggest diet's can significant impact dental health.
http://wholehealthsource.blogspot.com/2009/03/preventing-tooth-decay.html
http://wholehealthsource.blogspot.com/2009/03/reversing-tooth-decay.html
posted by zentrification at 4:03 PM on May 12, 2009 [1 favorite]

(I am just out of school, and looking for a job, do not have a lot of savings).

you might still be covered by your university's health services! at nyu our insurance coverage was from the start of one schoolyear to just before the start of the next, so from the start of august till the end of july.
posted by lia at 4:29 PM on May 12, 2009

As someone who has cycled through some really horrible dental problems in the last two years, a whole series of them, I don't have anything to offer other than the resources others are suggesting for you other than this: you'll get through it, a little at a time. I'm sure it seems terrifying and monolithic and like it will take forever and a million dollars to deal with now, but at some point, as we say around here, it'll be in your rear-view mirror. Just deal with it one thing at a time.
posted by A Terrible Llama at 4:42 PM on May 12, 2009

Most dental schools have clinics with reduced prices.

Many of these student clinics are based around teaching the aspiring dentists how to extract the maximum total fees. The per-procedure cost may be lower, but they might try to involve you in developing a comprehensive and complete plan that, after multiple evaluation visits and lots of pointing and head nodding, finally arrives at a 5 year $50,000 project. Cough, NYU, cough cough, Columbia, cough.

If you qualify for medicaid or something like that, take advantage of those clinics first. Those places see a lot of people in your condition and they won't be guilt-tripping you. Take care of the ticking time bombs first, you don't want to wake up someday with a basketball sized throbbing blob on the side of your face.

The lower end clinics will not do root canals, they will push you to extract. But they will fill cavities, clean, take good xrays. If you don't have the ready cash you can have the root canal done and a temporary UV cured crown put in, that will last 6 or more months while you scrape up the cash for the crown. Go directly to the root canal specialist, instead of letting another dentist refer you.
posted by StickyCarpet at 4:55 PM on May 12, 2009 [1 favorite]

Do not ignore the periodontal implications of neglect. Teeth can be replaced with implants if crowns are no viable due to tooth damage but the underlying bone, once damaged, is gone forever. See a periodontist. It is really, really important and, in my opinion, more important to establish your gum and bone health before any tooth restoration takes place.
posted by bz at 5:24 PM on May 12, 2009

Depending on how many and which ones, you might not really need those teeth -- drilling and filling would definitely be more expensive than pulling them

After experiencing persistent (over the course of a decade) probs with a tooth, I thought so, too, and asked my dentist: why not just pull the fucking thing out?

The dentist didn't respond; his assistant did. If you pull a tooth out, whatever tooth is above or below it will start to grow down or up into the empty space.

On a bright note, I asked him what people did before Novocain. He said in the old days, infection would loosen up the gum so much that it would be possible to pull out rotten teeth by hand.

Anyway, get your teeth checked. It's not always as bad as you think. Go to a training college if you can't afford it.

A Terrible Lama also says it best.
posted by KokuRyu at 6:46 PM on May 12, 2009

If you pull a tooth out, whatever tooth is above or below it will start to grow down or up...

Yeah, teeth will shift noticeably in a matter of weeks. There's a bigger problem than that, though. It has to do with how long you are planning to live. People in their 70's can say, "screw it, pull them all and I'll get dentures." But without teeth in there the underlining bone will gradually disintegrate to the point where in 30 years you might need bone transplants just to have a functioning jaw. It seems that implants also stimulate the bone enough to keep it sturdy.

For me the final solution is a trip to China, where the exchange rate is good, where porcelain was invented, where dentists have tiny hands, where metallurgy and metal craftsmanship have always respected. Give me a full set of titanium implants with porcelain crowns and I'll be the only guy in the nursing home who doesn't take his teeth out at night. The chicks love that.
posted by StickyCarpet at 7:47 PM on May 12, 2009 [1 favorite]

Many of these student clinics are based around teaching the aspiring dentists how to extract the maximum total fees.

A patently absurd assertion with no basis whatsoever in reality. ignore all that follows.
posted by OHenryPacey at 11:59 PM on May 12, 2009 [2 favorites]

I had a very good experience during college at BU's dental school getting my teeth fixed up---5 or 6 cavities after not going to the dentist in a number of years. The waiting was a pain in the ass---since it is pretty much a free clinic, lots of folks come by and the students have to have their work checked by a prof., but it wasn't a big deal since I was a student I had the time.

It was super cheap, like $90 for a year. I worked with the same student the entire time and treatment started on my 2nd visit.
posted by chiefthe at 4:51 AM on May 13, 2009

without teeth in there the underlining bone will gradually disintegrate to the point where in 30 years you might need bone transplants

Are you sure you're not overstating that a bit? My father's had dentures for fifty years or more and there's absolutely nothing wrong with his jaw bone.
posted by Phanx at 6:53 AM on May 13, 2009

A patently absurd assertion with no basis whatsoever in reality.

I guess we live in different realities. Sure, pulling a wisdom tooth, or filling a cavity went smoothly for me as a student. I can refer you to several people, who, like the poster, have problems on a larger scale, and they have not got past numerous (paid) appointments with the "team" planning out an epic war plan. Perhaps I am editorializing a bit. Due to a couple of accidents, I've spent more time in a dentist's office than many of the dentist's I've seen. In my experience, 25% have been craftsmen who take exceptional pride in doing the best job, and consider the patients finances. A small group on the other end of the spectrum are those that, for instance charge $400 for a referral to another specialist, or add things like X-rays and Novocaine after the fact onto a price they stated for a procedure.

Are you sure you're not overstating that a bit? My father's had dentures for fifty years

Perhaps, but it really depends on how much bone you have there to begin with. A woman friend with a dainty jaw is looking at a bone transplant where 4 teeth have been missing for 20 years.
posted by StickyCarpet at 8:43 AM on May 13, 2009 [1 favorite]

And I do appologise, OHenryPacey, if I get a little overheated on this issue. Just from the picture in your profile, I'd probably use you as a dentist if I hadn't already ruined our relationship.
posted by StickyCarpet at 8:48 AM on May 13, 2009

Everyone has some good advice about where to go for help, so I don't have anything to add in that regard. But it sounds to me like you're really beating yourself up about this...

Just know that you're not alone, and you're certainly not a bad person. People deal with stress and hardship differently, and I'm sure others have experienced the same approach. Congrats on taking these steps toward feeling better! I'm very excited for you.
posted by penchant at 9:00 AM on May 13, 2009

I ignored my teeth for about a decade, and then went to a MARVELOUS dentist in Wellesley named Murad Padamsee. He used to be a pediatric dentsist, so he was very good about my Dental Terror. :7)

He also staggered out all my work over several years so that my employer's insurance would cover it. He was very amenable to giving me an exam, figuring out what needed ot be done, and then planning out how we could do it without breaking me. (He seemed very aware of killing the goose that lays the golden eggs!) One day while working on my mouth he became very excited and said, "The insurance companies are always trying to screw you!" He was very much on my side, I felt.

He was also faculty at Tufts Dental, so often his assistant would be a fully-accredited dentist from another country who was going through Tufts to get a U.S. diploma.

So, in short, see if you can find someone who'll give you a exam and then get them to help you understand what you need and what you can put off. Then find a job with dental insurance to pay for it.
posted by wenestvedt at 9:37 AM on May 13, 2009

knowing the terminology that dentists use is very helpful. listen for someone who offers "conservative" treatment. this isn't their political philosophy, it is a school of wisdom in dentistry that says they will do everything possible and within reason to "save" the teeth you have, rather than a radical course of treatment like yanking teeth, etc.

i remember my mother simply gave up late in her life and made "the appointment" and had everything yanked. everything. good and bad. and then ended up suffering the last years of her life with ill-fitting dentures that probably caused more grief than her natural teeth ever did. plus, no one looks attractive without a mouth full of teeth.

and always remember, no matter how bad you think your teeth are, there's someone out there with a far worse situation, and a good dentist has seen it all before and will treat you with respect as they work with you to bring your mouth back to a better, healthy state. you must, however, bring up your half of the bargain with brushing and flossing. a good hygienist will always be willing to show you a few tricks of the trade or answer your questions about how to get hard-to-reach places, etc.
posted by kuppajava at 10:32 AM on May 13, 2009 [1 favorite]

And I do appologise, OHenryPacey, if I get a little overheated on this issue. Just from the picture in your profile, I'd probably use you as a dentist if I hadn't already ruined our relationship.

I am certain that what you were referring to, in terms of what Dental schools teach, is the tendency to require an 'ideal treatment plan' as part of the case work-up. In these days of implants, grafts, ridge augmentations and ortho/perio cross disciplinary planning, a complete reconstruction can run into tens of thousands of dollars. but dental schools do not teach their students to maneuver patients into accepting that there is only one option for treatment, far from it, and this is my complaint with your post.
I would be happy to have you as a patient, because i believe in my ability to listen to my patients and communicate with them in order to reach an understanding as to the direction that treatment would go.
A good patient should be a good consumer, and should question a provider as to available treatment options. Seldom is there only one (very expensive) way to get from A to B.
For the OP a trip to a dental school is not a bad option, but neither is going to a reputable private practitioner (soon) to at least get an idea of what can and might be done. Often patients tend to overestimate the cost of getting their mouth healthy enough to function...reconstruction can always come later, but getting the disease under control has to come first, and early as possible.
posted by OHenryPacey at 10:49 AM on May 13, 2009

Seldom is there only one (very expensive) way to get from A to B.

BioTemps is an example of an option that not every dentist will offer. It's a carefully made, cast-metal reinforced, cosmetically appealing, "temporary" solution that can last for many years, until you can afford something more permanent. The wholesale cost is $50 / tooth, with a five day turnaround.
posted by StickyCarpet at 11:19 AM on May 13, 2009