El Dentista

September 21, 2012 8:43 AM

Dentalfilter: I have several old amalgam fillings with decay under them that I need to replace. Should I get dental insurance? What kind? Also, UK or US?

I have a few very old amalgam fillings with decay under them that I should get fixed in the next few months. I'm not in pain, yet, but one caused a toothache, and I had to get it replaced on an emergency basis, which led to the discovery of the other ones. Getting all of them replaced at full price would probably cost several thousand dollars.

I would like to save on costs and can wait a few months to have them done if necessary.

I don't have dental insurance in the US, but I do have medical insurance. I also have access to the NHS in the UK. I could go to a teaching clinic at the local dental school if that makes sense.

Questions:
- Should I buy dental insurance in the US, wait out the waiting period, and then get them fixed? Is there a particular company you would recommend? I've heard that dental insurance can be a rip-off.
- Can I get these fixed in the UK through the NHS? I'm trying to figure out how that system works.

Thanks so much, Mefites!

posted by carolinaherrera to Health & Fitness (16 answers total)

I have no idea what the insurance situation in the UK is like, but in the US, your fillings would likely be pre-existing conditions that would not be covered by new insurance. Ask around, but my guess is that there's not really a way to save money on these using insurance. Ask your dentist about discounts for paying cash and about long-term payment plans, such as Care Credit.
posted by decathecting at 8:46 AM on September 21, 2012

If you can use the NHS, here are the NHS Dental prices to compare with whatever the US costs are. Only obstacle would be finding a dentist who has a space for a new NHS patient, although that was fairly easy for me earlier this year.
posted by EndsOfInvention at 8:48 AM on September 21, 2012

Are you registered with an NHS dentist in the UK?
posted by pharm at 8:48 AM on September 21, 2012

(At that price, you can probably afford to fly somewhere where dentistry is cheap but high quality and get the work done there...)
posted by pharm at 8:49 AM on September 21, 2012

Response by poster: Pharm, I'm not registered with an NHS dentist. I do have a doctor through my university if that helps at all.

Also, I'm open to flying/driving somewhere cheap and getting the work done. Any suggestions for good places for dental tourism in Europe, Canada, or Mexico?
posted by carolinaherrera at 9:01 AM on September 21, 2012

One great resource would be the dentist's office. The desk staff there know a lot about how dental insurance works. You mentioned emergency work, maybe you don't have "your dentist" on a regular basis, but you'd need to find one to get this done anyway. Talk to the staff about what "preexisting condition" clauses are. Fixing old fillings is totally included in my dental insurance, same as a new filling (i.e. there's decay in the tooth, drill it out and fill it, it doesn't matter whether the decay is under an old filling or not). I have no idea how dental insuance, waiting periods, and cavities already diagnosed work together.

Another decent resource would be the places you're considering buying dental insurance from; don't be shy about making the phone calls and talking to their info desk. Be careful that they're not agreeing to anything to get you to buy a policy, though; see if they can refer you to documentation instead of just giving you verbal assurance, or doublecheck with the dentist's office's experience with a specific policy/brand.

Basically, there's "usual" - and I think that usually, dental insurance would cover this, so you're just looking at costs, waiting periods, how much you can get done in one year or by December, and what the annual cap is - but "usually" is no substitute for specific knowledge about specific policies and specific dentists.
posted by aimedwander at 9:36 AM on September 21, 2012

It'll probably count as one job for an NHS dentist, so total cost to you should be £200
posted by ambrosen at 10:28 AM on September 21, 2012 [1 favorite]

Fixing or replacing old fillings in cases where they are degraded or chipped, or where further decay has been discovered, is absolutely covered by US dental insurance. However, US dental insurances rarely if ever cover the full costs of any procedures other than biannual exams and cleanings.
posted by Sidhedevil at 11:14 AM on September 21, 2012

I have Delta Dental, which at the time I did research was the best dental insurance available to me, and the last time I had a filling replaced the out-of-pocket cost to me was $85.

So it sounds like the NHS would be the move if you have more than three fillings that need to be replaced.
posted by Sidhedevil at 11:17 AM on September 21, 2012

Dental amalgam has been and will continue to be one of the best restorations that a dentist can place. I'd be skeptical if all my fillings had broken down to the point of needing replacement at the same time.

I don't know your specific situation but I'd get a second opinion from a dentist referred to you by a friend.
posted by Cuspidx at 12:56 PM on September 21, 2012 [1 favorite]

I don't have specific suggestions, but my bf has gotten dental work done in Tijuana before and there are a ton of good (American) dentists down there just over the border. I would do some online research and definitely don't rule out Mexico as a possibility. (I might be able to get a recommendation for you if you MeMail me.)
posted by désoeuvrée at 1:22 PM on September 21, 2012

Dental amalgam has been and will continue to be one of the best restorations that a dentist can place. I'd be skeptical if all my fillings had broken down to the point of needing replacement at the same time.

Also, just to say that I am in the same situation as the OP in terms of needing a ton of old fillings replaced. Second opinions are always good, of course, but it doesn't sound particularly sketchy to me.
posted by désoeuvrée at 1:26 PM on September 21, 2012

If you have access to NHS dentistry (you are resident in the UK and you can get registered with an NHS dentist), then the most expensive procedure you can have will cost about £200. It's probably worth registering and paying the £20 for a checkup to get their opinion, and to know how it would be charged. Get a dentist recommendation from a friend.

In fact, I think even if you can't get registered with an NHS dentist, it would be worth going to a private dentist for an opinion/quote in the UK since you'll then have a concrete number to compare to.
posted by plonkee at 1:45 PM on September 21, 2012

I needed a bunch of old fillings replaced all at once. Not everyone's previous dentistry has been up to par. Also, new X-ray tech is better at detecting decay.
posted by Sidhedevil at 2:43 PM on September 21, 2012

Does your University have a dental service carolinaherrera? If not, the NHS direct page on how to get yourself on the books of an NHS dentist is here.
posted by pharm at 4:20 AM on September 22, 2012

If you can register with an NHS dentist, it's probably worth having it done there provided you get along with them - under the NHS scheme you pay for a whole course of treatment at the appropriate band, so a checkup and initial appointment would be 20 pounds, and then having all the fillings sorted out would probably count as a single course of treatment in band 2 so it would be 48 pounds to get all of them done. Whether you can find an NHS dentist with space on their books does vary with region, but I had no problem finding one last year and getting an appointment within a fortnight.

If you can't find an NHS dentist, it's worth talking to a private UK dentist to see how much it would be - I've paid 40-50 for a filling in the past, so it may still be cheaper than getting it done in the US.
posted by penguinliz at 4:37 PM on September 22, 2012