Is this dental procedure worth my money?
April 13, 2010 9:18 AM   Subscribe

Is my dentist doing a pointless procedure on my maybe-cavity?

For about 5 years I have had a spot on my lower back molar near my gum line. Ever year, my old dentist called it a defect and told me to keep it very clean, but never said it was a cavity. My new dentist said he can't tell what it is, and wants to cut open my gum to see if anything is underneath my gum line. This costs $2000, of which my insurance will pay $1700.

If this *is* a cavity, I don't even know what the next step would be or how much it would cost.

I have never felt any pain from this spot and I have never had any other cavities.

I am losing my dental insurance indefinitely in less than 2 months and do not have time to get a second opinion.

Should I just get the procedure or does it sound unneccessary?
posted by kmavap to Health & Fitness (14 answers total)
Have you had X-rays taken or is this a spot visible with the naked eye? As someone who just had a dozen cavities done, and is gearing up for a root canal next week, I'm surprised at the cost for diagnosis. Is there any way you can get a second opinion with either your old dentist or a second dentist?
posted by PhoBWanKenobi at 9:23 AM on April 13, 2010

Should I just get the procedure or does it sound unneccessary?

Just because you think you don't have time to get a second opinion doesn't make the advice you'll get over the internet any better. Even a dentist reading this would likely not have sufficient information to go on.

That said, in your shoes, I would go ahead and do it. My rationale is as follows: better to have an unnecessary dental procedure which will heal well and be down a few hundred bucks then to have a serious dental problem that shows up when I risk being out a few thousand dollars and further complications.
posted by Inspector.Gadget at 9:26 AM on April 13, 2010

I have had xrays taken by my old dentist and he didn't seem concerned.
posted by kmavap at 9:29 AM on April 13, 2010

I would call a new dentist this week and make an appointment to get a second opinion, including X-rays (particularly if your insurance will cover those). Second opinions are awesome; for example, I got one at the beginning of my dental journey after metafilter recommended it when I asked this question (read to the bottom for the final outcome). Despite the fact that the new dentist didn't take my insurance, it ultimately saved me several thousand dollars in unnecessary dental expenses. My instinct was to just do what the dentist was telling me to do, to get the problems resolved as quickly as possible. But it really, really wasn't needed.

If you have a deep cavity, it will show up on the x-ray. A single bitewing X-ray will cost much less than $300.
posted by PhoBWanKenobi at 9:38 AM on April 13, 2010

Do get a second opinion, don't let this dentist spend your money for no reason. I have a crown with one steel edge showing; it freaks dentists out, but the dark colour of the steel edge has never represented a cavity or any other kind of issue. I had one dentist I went to see propose to pop off the crown to "see what was underneath". I can tell you what the hell is underneath, I don't need to pay you $2000 for the privilege!
posted by LN at 9:43 AM on April 13, 2010 [1 favorite]

Get a second opinion, fast. I have had thousands of dollars of dental work, just about everything you can think of, and I've never heard of someone cutting into your gums for exploratory reasons. Ugh.
posted by JoanArkham at 10:09 AM on April 13, 2010 [1 favorite]

I have horrific teeth, have had a bazillion cavities filled, and several root canals. Some I could see with my naked eye, but only one was so bad I was in serious pain. Never once have I had a doctor suggest cutting into the gum to take a look. Definitely get a second opinion with xrays. Aren't xrays the gold standard for dentists? If nothing show up on those, what exactly are they looking for that's potentially so bad that it needs exploratory surgery? Random gum-cutting does not sound like fun, even if you ignore the financial aspects of it.
posted by cgg at 10:23 AM on April 13, 2010 [1 favorite]

the top hit for me in google for 'exploratory dental surgery' was talking about surgery on a hamster, so i'd vote nay on the gumwork. get a second opinion ... and don't be so eager to fix something that isn't a problem.
posted by lester at 10:43 AM on April 13, 2010

Something doesn't sound right about cutting into your gum just to look around. I'd get a 2nd opinion, and maybe a new dentist. Even if the procedure is justified, you don't know that the cost is fair. Years ago when I had my wisdom teeth removed I saved about a $1000 when I got a 2nd opinion. I did need the wisdom teeth removed, but the 2nd oral surgeon was $1000 cheaper, and came with sterling references. In fact, my dentist stopped referring to that first oral surgeon when I told her how expensive he was compared to the other guy just down the street.
posted by COD at 10:45 AM on April 13, 2010

Isn't this already a 2nd opinion?
posted by smackfu at 12:51 PM on April 13, 2010

Yeah, cutting the gum is considered an extreme measure by most dentists. Usually, it's done to get rid of the edge of badly damaged gums, or to make an extraction come out cleanly. If my dentist were that worried about a defect, he'd just drill and fill the damn thing, without touching the gum.

The gum incision would take several days to heal, and it would be ouchy. The filling is actually considered the less intrusive approach.

I really don't like this guy. I think he's trying to push you into a perio procedure for more money. Please find another dentist.

Good luck!
posted by Citrus at 1:13 PM on April 13, 2010

2nd opinion hands down. Xray and probing usually is the protocol for questionable cavities. This guy is scamming or very conservative. I had a dentist go "we need to fill EVERY tooth". Why? No cavities but I have deep creavaces in my teeth and he felt that it would prevent cavities and he wasn't talking about sealants. He was talking full blow fillings.


Moved on to my current dentist. His reaction to that guy's advice--"What???".
posted by stormpooper at 1:21 PM on April 13, 2010

I have horrific teeth, have had a bazillion cavities filled, and several root canals. Some I could see with my naked eye, but only one was so bad I was in serious pain. Never once have I had a doctor suggest cutting into the gum to take a look.

This, this, this. I've also had 'issues', never ever had a dentist suggest cutting the gums open.
posted by gimonca at 3:41 PM on April 13, 2010

Consider these things:

1. Dentists have been known to scam people.

2. Cavities always get worse. When they get bad enough, they hurt. If that spot on your tooth has been there for years, hasn't changed, and is not causing any pain, I'd wager it is not a cavity.

Even if you have to go out-of-pocket, pay someone else to determine what's going on with that tooth.
posted by justcorbly at 4:22 PM on April 13, 2010

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