I should ask this question while I still *have* teeth.
June 4, 2012 10:55 AM   Subscribe

I am a bad human being and have not been to the dentist in...well, a very very long time. Help me figure out options, like insurance and such?

Long story short I've always had great insurance but dental has *never* been an option. Ever. Epic suck. I think the last thing I had done was a cleaning when I turned 18, I am now 32.

My childhood dentist apparently SUCKED, because he allowed my wisdom teeth to crowd all my bottom-jaw teeth, and now they're 10 kinds of screwed up, jutting out and whatnot. I don't have any obvious or painful cavities (never had any as a child either), but I can look in and see that I've got some pits and whatnot. I was told a LONG time ago that to fix my bottom jaw teeth I'd need a root canal or two (see, my front teeth used to just be a little misaligned, then when I was in 3rd grade I knocked them all out in a bicycle accident. They sewed them back in straight, and later a friend punched me while fooling around and knocked one crooked. Now they've crowded, so the crooked one is now very crooked that it's been crowded for so long.) All my bottom teeth are TIGHT (like, sometimes they even shred Glide floss) and my tops have gaps (food gets stuck).

Anyway, googling "buy independent dental insurance" is google-linkbait-hell and I'm not finding much. It is NOT an option via my work insurance. (Ok, it is, but it's super expensive and has a year wait to only pay 40% of procedure cost.)

Our local university does have a dental school where things cost *less* (fillings are like $60), however because the students HAVE to do X number of procedures, they tend to stack you up with more than you need. Scheduling is also a nightmare, as they have a limited number of chairs and times when faculty can supervise. So far, this seems like my best option.

The exacerbating factor here is that we're relatively rural. I've found some decent "discount" programs for like $8/month or whatever, but of course none are available in my area or my state. This would be North Central West Virginia, in case you want to check some option you know about.
posted by TomMelee to Health & Fitness (20 answers total) 5 users marked this as a favorite
 
Don't beat yourself up, you did the best you could with what you had.

I'd try to schedule at the university. That seems like your best bet. You might want to call around to a community college to see if there's a dental hygeinist program where you can get a good cleaning.

There's no way around the fact that you've got a problem. But you can't let it go, dental health is associated with cardiovascular health, so now that you can, you should take care of it.

Good luck.
posted by Ruthless Bunny at 10:58 AM on June 4, 2012


however because the students HAVE to do X number of procedures, they tend to stack you up with more than you need.

I have gone to dental schools back before I had insurance and I would be somewhat wary of this assertion. I have found that there are always more people needing services than the school can provide so they don't have to give any one person "more that they need". It is possible I am wrong, but that was my experience.

I agree entirely with RB. Even taking the starting steps to getting this taken care of is a huge deal and a great thing for your future dental health. The option that many people I know use for big dental bills [dental insurance actually isn't that great in many instances, it may be better to go on a payment plan] is CareCredit which is basically like a credit card for medical/dental stuff. They have reasonable repayment terms but the big whammy is that if you don't pay the thing off in some certain amount of time, they get up into nasty interest rates. If you have the ability to manage money you may want to consider it. It's also worth calling your health insurance to make sure wisdom teeth might not be a covered medical expense if you got it done in a hospital.

If I were you, I'd schedule a cleaning/x-ray appointment at the school and have someone who is a professional evaluate your other issues to see what is the most urgent, what is less urgent and what isn't a big deal [spaces between teeth, for example, while maybe not aesthetically great are often less bad because you're not long-term trapping food there] so you can make a treatment plan about how you want to approach the rest of things.
posted by jessamyn at 11:06 AM on June 4, 2012 [1 favorite]


By the way, you are not a bad person for ignoring the dentist, and in my experience, they totally understand and are not judgey or patronizing when you explain why you have been negligent. They see it (and worse) all the time, especially in rural areas.
posted by Rock Steady at 11:18 AM on June 4, 2012


I can't see dental insurance being much help. The whole point of insurance, from their perspective, is to cover as many people as possible who have amazingly pristine teeth so that they don't have to pay out much in claims. Independent dental insurance is mostly going to appeal to someone like you who knows they need a lot of work, so if you can get it at all, it will probably be fairly expensive, not actually cover a whole lot, and have various waiting periods and limitations. You're probably better off with the dental school option or negotiating payment plans directly with dentists.

It might be interesting to try the dental school route for an initial checkup/cleaning. You'd have a chance to have the faculty instructor consult on a treatment plan for you. You can make a list of what you need to get done and then shop around a bit and take care of any procedures in order of necessity.

Also, if you're in any way nervous about dental work (lots of people are!), you might want to look for a dentist in the area who specializes in dental phobia. Some dentists can be great at taking things slow, explaining everything, relaxation techniques, anesthetics, etc...
posted by zachlipton at 11:26 AM on June 4, 2012 [1 favorite]


Dentistry has changed a lot even from my childhood- now with all the x-rays and what we know about the self repairing properties of teeth, as well as changes in diet, my dental visits are more like weather forecasts and warnings while my parents wander around with mouths full of metal.

So fear not, there's a chance your time in the chair will just involve a nice lady with a minty dremel and metal picks chiselling your teeth free of plaque and a consultation about how you feel with your wisdom teeth. And you'll leave with the sensation of looseness in your bottom teeth and discover the floss slides in nice and easy now because an accumulation of what basically acts like weird mouth coral has been blasted away.

Cleaning and x-rays alone, even without insurance, won't set you back too far for a middle class salary, though i don't know your exact financial details. You're also allowed to stagger procedures and tell them no if they start waving drills at you. And even cleaning is going to help.
posted by Phalene at 11:29 AM on June 4, 2012 [2 favorites]


I dealt with this issue last month as well - my work doesn't offer dental, the nearest school is 60 miles away and has a 6 month waiting list. Perhaps instead of focusing on dental insurance you can see what other options are out there.

I called my city's health and human services to find out if any other options existed - turns out there was a very new dental clinic in my city for people w/o insurance, each visit is $20 dollars, and is partially funded by donations. It had zero internet presence.

I would start by calling to see what community resources besides the dental school might be available. Failing that you can call the dentists in your area directly and see if any of them offer a sliding scale for people with out insurance, or even for barter (if you have any skills that might be useful, etc.)
posted by Syllables at 11:44 AM on June 4, 2012 [3 favorites]


Private dental insurance usually comes with a waiting period - 6 months for checkups, 1 year for xrays, 18 mo to 3 years for anything major. It is, as you might suspect, designed so that people that have avoided the dentist for years can't just buy insurance and try to catch up on their dental heath. The policies also often have a fairly low annual limit, around $1000 or $1500.

I live in a very expensive part of the country, and a cleaning with Xrays around here is only $100 - $150. You should do that no matter what, then work with dentist to develop a plan to handle whatever issues are uncovered in the check up.
posted by COD at 11:46 AM on June 4, 2012


I went a long time without going to the dentist and was feeling terrible about it, and when I finally did go, they were totally friendly and cool, and when I said it had been over a decade since I'd been to a dentist they didn't even seem to care.

Their job is to help take care of your teeth. Their job is not to make you feel bad about yourself. Among other reasons, making you feel bad doesn't bring back a lot of repeat business.
posted by aubilenon at 12:14 PM on June 4, 2012


If I were you, I'd schedule a cleaning/x-ray appointment at the school and have someone who is a professional evaluate your other issues to see what is the most urgent, what is less urgent and what isn't a big deal

This is the approach I took when I came off a period of five years without insurance and no visits. I'm still waiting on a few procedures as my dentist won't do them until other things are where they need to be.

My gums and teeth are sensitive in the extreme. The first couple of cleanings I had my dentist freeze my mouth in the area they were working. Insurance paid but I think it was like $30 per mouth quarter. This was much better than my previous visits where I was in agony the whole time. Also my hygentist uses a ultra sonic water jet for some heavy cleanings which I prefer over the metal picks so I ask for it.
posted by Mitheral at 12:21 PM on June 4, 2012


Thanks for the answers everyone. The funny bit about the "procedures you don't need" is that I'd never heard that, but my fiancee went to the dental school for her work this last year and was told that by her student---that other students stack up procedures to get done faster.

I'm not the least bit apprehensive about what they're going to do to me, I'm just worried about paying for it. Our budget is so very tight right now and I promise you there's not a single place to trim it. Unfortunately we're just over the cusp of any public support (which is a good thing, I suppose) so we pay full price for everything. (Seriously, if we made $200 a month less, we'd have childcare for $67 a month and my son's insurance would be $29. As it is, those two things together cost just over $500 a month and that's only having 3 day care!) I digress. Thanks everyone!
posted by TomMelee at 12:23 PM on June 4, 2012


I have dental insurance and it covers some weird things and doesn't cover some weird things. For example, I just got two wisdom teeth out and it covered the removal, but not the anesthesia. So I paid mostly to get high as a kite. (Worth it!). I have used ehealthinsurance.com to buy regular individual health insurance and they do have dental insurance on offer. I'd see what you could get. It may not cover you right away, but it'd be something. But don't look at it as a panacea for everything.

My dentist is very good about working with you on your budget. My wife needs some work done and without it even being a hassle, his business office produced three different 0% interest finance plans based on what we could put as a down payment, from $0 up to a significant percentage.

He (or she) probably isn't going to throw you up on the metaphorical rack and doing thousands of dollars worth of work without your say-so. Mine always gives me a full care plan for anything he's proposing outside of a cleaning with a breakdown of exactly what everything will cost, and gives a discount if you pay cash rather than making him deal with the insurance companies.

Thing is, honestly, you may not have money now, but your teeth are like ignoring your car making weird noises, in that there will eventually be a spectacular failure that winds up costing even more. You can't afford to ignore them.
posted by Ghostride The Whip at 1:11 PM on June 4, 2012


Stack up procedures: to me, that means doing lots of procedures at once on a patient, rather than have them come back for multiple appointments. I find it hard to believe that a student would blithely admit that the dental school routinely does unnecessary procedures on healthy teeth.
posted by Wordwoman at 1:15 PM on June 4, 2012


You're not a bad person because you've been avoiding the dentist, unless it was because you were too busy raping babies to go to the dentist, or something like that.

Some dentists accept credit cards, or may be willing to work with you to set up a payment plan.
posted by Anne Neville at 1:55 PM on June 4, 2012


I love my dental students and their work. It takes a bit longer, as you have to wait for their work to be checked, but it's far cheaper (and I've never found that insurance really covered all that much or provided that big a discount.) Why not to to the dental school and see what happens? I wouldn't let your gf's experience color your own.
posted by Ideefixe at 1:59 PM on June 4, 2012


Thanks. I've made an appointment at the dental school. I figure there's never a *good* time for out of pocket medical expenses, right?
posted by TomMelee at 2:41 PM on June 4, 2012


Dental insurance is the camel nose in the tent of US health care. Dental care is expensive; insurance is unobtainable or hardly worth the premiums. However, since you posted this, you know that time is not on your side. If you can access a university dental school, make the phone call. (meantime, you should be brushing after meals, flossing etc.)
posted by Cranberry at 2:42 PM on June 4, 2012 [1 favorite]


Oops. You have already done it. Good man.
posted by Cranberry at 2:43 PM on June 4, 2012 [1 favorite]


If you have a local cash health clinic, they will probably have a list of nearby cash dentists.

Dental insurance is of less value than health insurance, in general. The insurance co. needs to get more money from you than it pays to the dentist. And dental work is, on average, far more predictable and controllable than health issues, and prices are more easily compared, so the average "dental insurance" cost is much closer to what your cash cost would be with no insurance, compared to good health insurance (which can seem like a big black hole until you need it).

Since real full dentists work much less with insurance than doctors and hospitals do, and dentists have much less overhead bureaucracy to support just to deal with insurance, it is generally much easier to negotiate a cash price with a dentist, if you do actually pay cash or credit card on the spot. You don't need one of those "discount plans". That's usually just a cardboard membership card for $8 month. (I know.) You can ask for a cash discount without it, and you can even negotiate down from whatever they quote. (I know.)

In other words, dental insurance is much less valuable to you and much less profitable for an insurance company than regular health insurance, which explains why most "health insurance" excludes dental, and the same with eye/glasses.

So being without dental insurance is not so bad. So using the school for cleaning and x-ray should be fine. Watch out for charges for fillings for cavities you never knew you had and don't believe you had. They better show any to you on the x-ray first. There's no good way to prove it but there are lots of "stories" of dentists inflating their charges with unnecessary fillings.
posted by caclwmr4 at 4:10 PM on June 4, 2012


I have terrible, awful, really bad teeth. I once had a sadistic dentist tell me that everything that could go wrong in my mouth had gone wrong. Also, I have lived most of my life, and nearly all of the past 20 years, without dental insurance. I've sunk the equivalent of a very expensive sports car into my mouth.

That said, I found my current awesome dentist nearly 20 years ago at a dental school clinic. She is always looking for ways to save me money. She understood when I couldn't afford a cleaning, and that there were times when I had money and needed to get the work done while I was earning. She has a no-interest time-payment option (but I pay cash, always). A good dentist will never judge you for putting off dental work; they know no one LIKES going to the dentist.

Don't bother with insurance. Yes, I have it now and I use it, but it's through my employer. Private dental insurance is just SO not worth it. Find someone you like at the dental school clinic and don't be afraid to demand that it not hurt. It shouldn't hurt. I find it helps to take along my iPod and crank it while the drilling and scraping is going on.

You will feel so much better when your teeth are fixed, I promise.
posted by caryatid at 5:46 PM on June 4, 2012 [1 favorite]


I went to my local dental school for about a year, I just recently switched because while they were super nice, they were soooo slow. Instructors have to check nearly everything, so it makes the visit take twice as long.

That said, I started going there because they offer payment plans. I had a root canal with no insurance and I paid half up front ($250) and then was able to make payments every month ($49?). After the students create the "treatment plan," you meet with a financial person and they go over the costs of everything, what/when you'll have to pay, so that was really, really nice.

Good luck!
posted by thisisnotkatrina at 6:48 AM on June 5, 2012


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