I need to replace my mouth
May 12, 2016 8:53 AM   Subscribe

So a combination of subpar dentistry, un-fluoridated water, and previous neglect have left most of my teeth in A State. A state that really needs to be fixed. At this point, I need a full reconstruction and I'm rather overwhelmed by choice and, I guess, fear. Help?

Problem 1: My teeth are crumbling
Problem 2: An overwhelming dental anxiety (No seriously, Valium doesn't work that well, and if it "weren't that bad" I wouldn't be in this state)
Problem 3: The sheer number of days off from work I'd have to take to fix everything
Problem 4: My insurance covers like $2,000 which, for the amount of work I need, is basically zero dollars
Problem 5: My anxiety and "time off" problems aren't letting me deal with this as quickly as my teeth are crumbling

Solution 1: Sedation dentistry!
Knock me out for a few long sessions, and I'm solid. (Literally.) Sounds like heaven, and solves all of the problems.
My first quote was approximately $34,000, god help me. I am getting a second (and possibly third) opinion, but from what I hear, that's not too far out of the ball park. Can anyone confirm from experience that this figure's about right? I'm really nervous about being taken for a ride.

Solution 1a: Get a loan.
There are *so many options.* And many of these "medical loan companies" I've never heard of. Has anybody worked with one of these companies and can reassure me that it's not a scam or predatory?

Solution 2: Medical tourism.
I don't have any innate fear of getting my teeth fixed in a different country‚Äďat least no more fear/anxiety than visiting an American dentist. But should I? Have you done this? Is there a country that is best? Costa Rica vs. Thailand vs. Mexico, and so forth? Do you think this option will actually save me money, or do you think that with travel and hotel my total will actually come out about the same?

If you have any other solutions I haven't thought of, I'm all ears and busted teeth. Thanks in advance!
posted by functionequalsform to Health & Fitness (18 answers total) 17 users marked this as a favorite
This $34,000 quote, is it for implants? A relative of mine paid about this much for full-mouth implants, and that was square in the middle of the quotes she got. Hers was a single (very long, full-sedation) procedure.

I have personally used CareCredit for dental procedures and found them to be...fine. They are somewhat predatory, in that the interest rates if you mess up and miss a payment are exorbitant, but they are pretty straightforward to use and if you can afford to set an auto-pay every month, you will not trigger the late fees or new interest rates. I was very terrified to use them, but it went well, and I am now fully paid up. Probably not a great idea if you have the kind of unstable income that would risk a missed payment though.
posted by We put our faith in Blast Hardcheese at 9:20 AM on May 12, 2016 [1 favorite]

Response by poster: (Sorry for threadsitting)

It's a really fun mix of root canals, extractions, crowns, bridges, implants, and more. I don't have the explanatory paperwork in front of me, but pretty much every tooth needs *something* extensive done to it.
posted by functionequalsform at 9:28 AM on May 12, 2016

I had six teeth done in San Francisco a few years ago and it was $10,000. So $34,000 for everything sounds like a bargain. Could be cheaper in India.
posted by parmanparman at 9:39 AM on May 12, 2016

If this is giving you a lot of anxiety, I would take traveling out of the country off the table just to reduce the stress of too many choices. If you were going in for a full set of implants, that might be one thing, but this sounds a lot more complicated and it may need to be done in stages. Also, when you get implants (and root canals) you have to wait between treatments for things to heal or for things to be made (like crowns). If your mouth is a mess you might need bone graphs once they get in there. It's not like a fly in, get 'er done, fly out kind of thing like getting an appendix out.

Care Credit is great if you pay it off in a year (no interest!) but once the interest starts, it's killer. You could get the care credit for the year and then pay it off before the interest sets in with something else. People do get loans for these kinds of things and the amount you are quoting is not that high. My mother-in-law spent $65,000 in the US for full implants and that was almost ten years ago.

Good for you for doing something about it. Do what you need to get it done. If that's sedation, get sedated. This is not the time to be trying to fix your dentist anxiety.
posted by orsonet at 9:50 AM on May 12, 2016 [1 favorite]

Inquire at a dental school? I have had friends who had no insurance and received excellent care at a much lower price.
posted by k8oglyph at 9:50 AM on May 12, 2016 [2 favorites]

Say no to bridges. I learned this forever ago. You basically sacrifice two fairly healthy teeth to anchor down a false tooth/teeth. Save your money and go for implants. If any teeth are removed, ask for bone graft powder to be inserted at time of removal. If they won't put in bone graft powder then, find another dentist. We traveled to the Louisville, KY area for my husbands implants. They did extractions, grafts, and the implants. Worth every penny.
posted by PJMoore at 9:52 AM on May 12, 2016 [5 favorites]

Here in SoCal, I routinely cross paths with people who have all their serious work done in Tijuana by impressively-credentialed dentists with state of the art equipment, most of whom will arrange transportation back and forth from San Diego for you, and depending on where you are and who you know, you can likely get to and stay in San Diego for however many days for far less than the flight to India or Thailand.

You might weigh the difference in being able to make multiple shorter trips to either CR or TJ (depending on whether you are closer to the East or West coast) versus what would likely be a one-time trip further abroad, given that you need several different categories of work done.
posted by Lyn Never at 9:54 AM on May 12, 2016 [2 favorites]

Have you looked at "twilight" sedation? My mom always gets nitrous oxide at the dentist. It does cost something but it's a lot cheaper than being fully unconscious. Also, that would allow you to go for a few hours at a time rather than taking whole days off work.

Is your insurance $2000 a year? In my experience, dentists are very accustomed to working with limitations like that and can work out what has to be done now and what can wait. You can even split up some procedures - for example, I had a root canal done last year and left with a temporary filling, then had the crown put on this January after my insurance "reset". It sounds like insurance won't cover all your immediate needs, but you may have to borrow less than you think if some work can be done later.
posted by pocams at 9:55 AM on May 12, 2016 [4 favorites]

Have you considered dentures? I know that is probably the last option on your list, but they are much less expensive and if done right, look great.

I'm old though, and at this stage of my life I would not spend 34 grand at the Dentist.
posted by cairnoflore at 10:02 AM on May 12, 2016 [1 favorite]

If your teeth are in such bad shape, I would strongly question the root canals and bridges.
posted by nobeagle at 10:04 AM on May 12, 2016 [2 favorites]

On the dental anxiety, there's this (via):
One of the approaches that I personally find useful is to cultivate the thought: If the situation or problem is such that it can be remedied, then there is no need to worry about it. In other words, if there is a solution or a way out of the difficulty, you do not need to be overwhelmed by it. The appropriate action is to seek its solution. Then it is clearly more sensible to spend your energy focussing on the solution rather than worrying about the problem. Alternatively, if there is no solution, no possibility of resolution, then there is also no point in being worried about it, because you cannot do anything about it anyway. In that case, the sooner you accept this fact, the easier it will be for you. This formula, of course, implies directly confronting the problem and taking a realistic view. Otherwise you will be unable to find out whether or not there is a resolution to the problem.

It sounds like you're not questioning what needs to be done so much as how you'll be able to afford it. Plus you're going to get second and third opinions, which will be a big help.

Solution 1b. I'd look at my savings and see what I could afford right now. I would go to the dentist and explain that I could only afford X, and that I would have to do the rest later. And let them help you choose what to prioritize. Your remaining teeth will still be crumbling when you have some more money saved up and they will be happy to help you at that time.
posted by aniola at 10:34 AM on May 12, 2016 [5 favorites]

Remember also that you can use FSA money to pay for most dental procedures. So, if your employer offers FSA accounts, you can at least manage to pay for some of it pre-tax.
posted by praemunire at 12:11 PM on May 12, 2016

Go to Costa Rica. It's much closer than India (in case you want / need a follow up visit), they have top quality dentists, the same materials and machines that they use in the US, and it's like a tenth of the cost. There are many medical tourism companies that will help you book whatever you need, including flights, hotels, and so on, and will chaperone you around so you don't have to worry about anything.

My dentist (downtown SF, graduated first in her class) goes down to Costa Rica twice a year for dental conferences and she speaks very highly of her colleagues there and confirms that they al do excellent work. She's had work done herself down there, as have I. I've been very happy with it.
posted by ananci at 12:14 PM on May 12, 2016 [4 favorites]

If your whole mouth is in that bad condition, I'm seconding the dentures. In my mid-30s years of problems caught up with me and I was given the choice of thousands of dollars of work which would be, at best, a holding action for about five years, or do nothing except minimal work which would later require a rebuilt jaw, or get dentures. I went to Mexico (Nogales, though I wouldn't go there now because of lawlessness) to a US-trained dentist. And they fit beautifully and looked good and I never needed to go to the dentist again. The cost was about $800 and they lasted for over 10 years. I'm planning to get a new set soon (my 3rd) and the cost will be between $2000-3000. For someone with extensive work needed, you should give this option careful consideration.
posted by MovableBookLady at 2:02 PM on May 12, 2016 [1 favorite]

I took a friend of mine to the dental school here in Denver, Colorado for a consult just today. He's going to have all of his decayed and broken teeth removed under intravenous sedation and dentures made. They say it's about 1/3 of regular dental costs and everything is state of the art. The consultation was $45 another $80 for full head xrays. I'm not sure what the total will be but it's worth checking it out if you are near one. I'll try to find out what the total will be but I probably won't talk to him till tomorrow.
posted by BoscosMom at 3:15 PM on May 12, 2016

On the dental anxiety, there's this

Many people's dental anxiety is not actually about the dental work, but abuse of various kinds by the dentist/staff. Some of it is a result of actual past abuse by a dentist/staff, or abuse in other context that can be triggered by the experience of dental work. That's not to say it can't be (or can't also be) about cost or pain or whatever, but it's often not quite so hand-wavable as all that.
posted by Lyn Never at 6:08 PM on May 12, 2016 [3 favorites]

Do you think this option will actually save me money, or do you think that with travel and hotel my total will actually come out about the same?

Depends where you live. I don't live all that close to Mexico, but there are dental clinics that run vans to pick up in my city, get the work done in Mexico, and drive back all in a day.
posted by yohko at 10:12 AM on May 13, 2016

I'm fortunate to live near UCLA, one of the best dental schools in the country. I'm getting a ton of work done there: two implants, two front veneers to fix a chipped tooth (and whitening the other teeth that goes with that), and a root canal, for well under 10K. That includes all the ancillary work that goes along with all that like a pulled tooth, cleaning, etc.

I have access to some of the best dentists and doctors in the country, if not the world; it was a professor here that diagnosed a very rare auto-immune disease. The only real drawback is that it takes time. The visits are longer because the work is checked at all stages and the appointments aren't as plentiful (ie, the endo clinic only takes appointments on certain days.) This works for me, it may not work for everyone. Like Lyn Never, I also know people who go to TJ for dental work but for me the travel costs would cancel out any savings. They even take some kinds of insurance but I don't have dental insurance.

I haven't had a problem with any part of the process or any of the student dentists, and on the plus side, I've never felt like I'm being sold a service or treatment I don't need. I do miss the warm, damp towels my old fancy dentist used to hand out at the end of the exam.

On preview, this would be a great setting for someone with staff-related dental anxiety since most work is done in a bullpen setting, and even the smaller, specialized clinics with more realistic office settings have multiple dentists, students, and patients sharing the space.
posted by Room 641-A at 10:33 AM on May 13, 2016

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