How do people afford dental work?
September 27, 2022 10:10 PM Subscribe
I have really bad teeth, and I'd kind of like to have not-so-bad teeth. I have dental insurance, but it only covers like $2000 a year. The last time I saw a dentist, like ten years ago, I got a referral to an oral surgeon, who quoted me like $3000 just to extract my wisdom teeth. I need a lot more than that now. How?
In addition to the four impacted wisdom teeth, I have several broken teeth that would need to be extracted, and somehow replaced. I've read that dental implants cost thousands of dollars each, and even dentures are pretty expensive. How the heck am I supposed to pay for this? Is oral surgery covered by regular health insurance or something? $2000 in dental insurance would barely cover anything.
I saw a tweet once saying that dental insurance is really just a coupon for a free yearly cleaning, and I'm really feeling that now.
(And yes, I'm aware that the correct answer is that I should have done this before now.)
In addition to the four impacted wisdom teeth, I have several broken teeth that would need to be extracted, and somehow replaced. I've read that dental implants cost thousands of dollars each, and even dentures are pretty expensive. How the heck am I supposed to pay for this? Is oral surgery covered by regular health insurance or something? $2000 in dental insurance would barely cover anything.
I saw a tweet once saying that dental insurance is really just a coupon for a free yearly cleaning, and I'm really feeling that now.
(And yes, I'm aware that the correct answer is that I should have done this before now.)
Payment programs, dental schools, gofundmes :(
posted by music for skeletons at 10:31 PM on September 27, 2022 [3 favorites]
posted by music for skeletons at 10:31 PM on September 27, 2022 [3 favorites]
I saw something on Facebook about someone who took up a side hustle of restoring furniture to be able to pay for some kind of dental or medical bills.
posted by kinddieserzeit at 10:33 PM on September 27, 2022
posted by kinddieserzeit at 10:33 PM on September 27, 2022
My teeth went bad early. I have a TON of experience with dentists and using the free low income health insurance (and, before Obama, no insurance).
* Start by going in for a checkup and a cleaning. That's covered by your insurance. You don't have to do anything they suggest. But in the meanwhile, checkup and cleaning will let you give you a sense of what you might actually be needing. Know that some dentists will want to drill-and-fill every little cavity, and other dentists will take a much more conservative approach. Look for a dentist that wants to keep as much tooth as possible - this is good for your tooth health (and, bonus, good for your wallet).
* When I had more dental work needed than my insurance would cover, I asked my dentist's office if I could do what was covered now, and then do the rest after January 1. They were fine with that. Ask them what you should prioritize, and do that first. I'm guessing extracting the broken teeth is going to be a high priority.
* Are your impacted wisdom teeth causing problems? If not, it might be ok to leave them.
* Shop around - you can call up other dentists and ask what they charge with your insurance for the each of the various procedures you expect to need. You can have your dentist email you your x-rays. X-rays (along with checkup and cleaning) should be covered by insurance, mine always has been (but I've been in CA & OR).
*Avoid dental schools. I had a bad experience. Reeally look around to find a good dentist. Things I look for: above-and-beyond continuing education training, availability of SDF, covid cautiousness, compatible with insurance. For some reason, I've personally had good luck with the cosmetic dentists (It just worked out that way - I could care less how my teeth look, I just want them to be healthy and clean. Picked one based on great reviews and the other based on insurance plus willingness to use SDF) and bad luck with a variety of other dentists.
* Do all the suggested dietary and hygiene things to keep your teeth from getting worse, if you aren't already.
* Also, yeah, dental tourism. I saved as many as thousands of dollars on my dog's needs by walking my dog across the California/Baja border. Spent a couple hundred instead. Would do the same for my teeth or health if needed. I do worry about the across-the-border health gentrification issue this seems to make, though.
* Self-love is important, too. You are you, teeth and all. There's only right here right now. And right now, you have the bandwidth to work on figuring out how to do deferred maintenance for your teeth. 🎉
posted by aniola at 11:00 PM on September 27, 2022 [21 favorites]
* Start by going in for a checkup and a cleaning. That's covered by your insurance. You don't have to do anything they suggest. But in the meanwhile, checkup and cleaning will let you give you a sense of what you might actually be needing. Know that some dentists will want to drill-and-fill every little cavity, and other dentists will take a much more conservative approach. Look for a dentist that wants to keep as much tooth as possible - this is good for your tooth health (and, bonus, good for your wallet).
* When I had more dental work needed than my insurance would cover, I asked my dentist's office if I could do what was covered now, and then do the rest after January 1. They were fine with that. Ask them what you should prioritize, and do that first. I'm guessing extracting the broken teeth is going to be a high priority.
* Are your impacted wisdom teeth causing problems? If not, it might be ok to leave them.
* Shop around - you can call up other dentists and ask what they charge with your insurance for the each of the various procedures you expect to need. You can have your dentist email you your x-rays. X-rays (along with checkup and cleaning) should be covered by insurance, mine always has been (but I've been in CA & OR).
*Avoid dental schools. I had a bad experience. Reeally look around to find a good dentist. Things I look for: above-and-beyond continuing education training, availability of SDF, covid cautiousness, compatible with insurance. For some reason, I've personally had good luck with the cosmetic dentists (It just worked out that way - I could care less how my teeth look, I just want them to be healthy and clean. Picked one based on great reviews and the other based on insurance plus willingness to use SDF) and bad luck with a variety of other dentists.
* Do all the suggested dietary and hygiene things to keep your teeth from getting worse, if you aren't already.
* Also, yeah, dental tourism. I saved as many as thousands of dollars on my dog's needs by walking my dog across the California/Baja border. Spent a couple hundred instead. Would do the same for my teeth or health if needed. I do worry about the across-the-border health gentrification issue this seems to make, though.
* Self-love is important, too. You are you, teeth and all. There's only right here right now. And right now, you have the bandwidth to work on figuring out how to do deferred maintenance for your teeth. 🎉
posted by aniola at 11:00 PM on September 27, 2022 [21 favorites]
Depends on the school and what's being done. Dentist going for upper degrees are pretty experienced. First year, yea no. I had a very good experience at Tufts(Boston) but it took a really long time. Also review if insurance covers carefully as the policies are arcane.
posted by sammyo at 11:39 PM on September 27, 2022
posted by sammyo at 11:39 PM on September 27, 2022
As someone with low income and no insurance, I’ve had good experiences with dentistry in Bangkok. The bonus is you get a a Thai vacation.
posted by miles1972 at 12:08 AM on September 28, 2022 [1 favorite]
posted by miles1972 at 12:08 AM on September 28, 2022 [1 favorite]
1) Payment plan arranged with dentist's office
2) Credit card with 'zero percent' introductory or low interest rate
3) CareCredit
"The medical credit card company CareCredit offers cards with promotional periods with 0% interest lasting anywhere between six and 24 months. As long as you pay off your balance before the promotional period ends, you won't have to pay interest. But with such an offer, also known as a deferred interest offer, interest isn't waived — it's just put off until later. If you don't pay the entire balance before the promotional period ends, you'll be on the hook for all of the interest — not just the interest on the remaining balance." - Should You Get a Dental Credit Card? (Nerdwallet, Oct. 26, 2021)
"It’s generally not advisable to use a credit card for medical expenses unless absolutely necessary." - Best Credit Cards for Medical Expenses (Nerdwallet, Sept. 26, 2022)
4) Some credit unions offer personal loans with low interest rates.
posted by Iris Gambol at 12:42 AM on September 28, 2022
2) Credit card with 'zero percent' introductory or low interest rate
3) CareCredit
"The medical credit card company CareCredit offers cards with promotional periods with 0% interest lasting anywhere between six and 24 months. As long as you pay off your balance before the promotional period ends, you won't have to pay interest. But with such an offer, also known as a deferred interest offer, interest isn't waived — it's just put off until later. If you don't pay the entire balance before the promotional period ends, you'll be on the hook for all of the interest — not just the interest on the remaining balance." - Should You Get a Dental Credit Card? (Nerdwallet, Oct. 26, 2021)
"It’s generally not advisable to use a credit card for medical expenses unless absolutely necessary." - Best Credit Cards for Medical Expenses (Nerdwallet, Sept. 26, 2022)
4) Some credit unions offer personal loans with low interest rates.
posted by Iris Gambol at 12:42 AM on September 28, 2022
Sadly, CareCredit is the only realistic option for dealing with dental costs, available to most americans. The dental industry exists outside the regular medical system here, and prices itself in a sort-of “take it or leave it” fashion.
There is also the Aspen Dental chain. I’m always loathe to recommend them, though. They began life as primarily a low-ish-cost denture specialist chain. They’ve tried to re-brand themselves as more of a low-ish-cost whole dental care place, but I think they still emphasize getting dentures into people’s mouths. YMMV, of course. Maybe someone with more recent experience with Aspen could chime in?
posted by Thorzdad at 3:49 AM on September 28, 2022
There is also the Aspen Dental chain. I’m always loathe to recommend them, though. They began life as primarily a low-ish-cost denture specialist chain. They’ve tried to re-brand themselves as more of a low-ish-cost whole dental care place, but I think they still emphasize getting dentures into people’s mouths. YMMV, of course. Maybe someone with more recent experience with Aspen could chime in?
posted by Thorzdad at 3:49 AM on September 28, 2022
aniola already covered everything i was going to suggest. i also saved a large chunk of money for several years for "dental stuff" which isn't as fun as a vacation account, but america.
posted by misanthropicsarah at 4:21 AM on September 28, 2022
posted by misanthropicsarah at 4:21 AM on September 28, 2022
Seriously, Thailand, if you can get the time away. I have recommendations and this is the low season.
posted by TWinbrook8 at 4:27 AM on September 28, 2022
posted by TWinbrook8 at 4:27 AM on September 28, 2022
We went through a BIG dental journey with my wife; and are now watching her brother go through the same thing years later. We used a graduate dental clinic at the dental school of a local university and had a very good experience; he is going private and it has been . . . difficult so far. I think the main difference is just coordination. The clinic we went to was able to coordinate with the other specialist clinics (e.g., endodontics, prosthodontics, etc.) and the priority was implementing the best possible treatment plan. Whereas with private dentists, even specialists, there are practical limits--they got bills to pay; they only have the equipment the practice can afford; etc.
I think a lot of people tend to treat dentistry like a menu--get an extraction here or an implant there. But for truly complex dental needs, access to specialists and continuity of care is critical. That level of work takes time--to heal between procedures, to adjust fits, etc. I couldn't imagine adding international travel into the mix, myself.
The clinic was substantially cheaper, but at this level you are still dropping a ton of cash, tens of thousands. We took out a loan to cover it and were lucky that was an option. Schools also don't bill insurance, so we had to submit all the claims ourselves. Ten years and two states later, though, every dentist has been shook by my wife's mouth--the work is phenomenal.
That said, you don't need the school clinic for basic stuff (cleanings, fillings). My wife used her normal dentist for that even during her treatment. Dental schools do have a faculty practice, but I have yet to find one that processes insurance so we use a private clinic with an endodontist for upkeep.
If you haven't already, start with the basics: floss daily, brush daily, fluoride mouthwash daily, cleanings every 6 months. All the dentists we have worked with have suggested pronamel toothpaste and ACT mouthwash and so that's what we use.
Good luck!
posted by ailouros08 at 4:50 AM on September 28, 2022 [3 favorites]
I think a lot of people tend to treat dentistry like a menu--get an extraction here or an implant there. But for truly complex dental needs, access to specialists and continuity of care is critical. That level of work takes time--to heal between procedures, to adjust fits, etc. I couldn't imagine adding international travel into the mix, myself.
The clinic was substantially cheaper, but at this level you are still dropping a ton of cash, tens of thousands. We took out a loan to cover it and were lucky that was an option. Schools also don't bill insurance, so we had to submit all the claims ourselves. Ten years and two states later, though, every dentist has been shook by my wife's mouth--the work is phenomenal.
That said, you don't need the school clinic for basic stuff (cleanings, fillings). My wife used her normal dentist for that even during her treatment. Dental schools do have a faculty practice, but I have yet to find one that processes insurance so we use a private clinic with an endodontist for upkeep.
If you haven't already, start with the basics: floss daily, brush daily, fluoride mouthwash daily, cleanings every 6 months. All the dentists we have worked with have suggested pronamel toothpaste and ACT mouthwash and so that's what we use.
Good luck!
posted by ailouros08 at 4:50 AM on September 28, 2022 [3 favorites]
For what it's worth, I had a not-so-good experience with the local dental school at time when I had no dental insurance. My dentist quoted me a price for some minor dental work, like filling some cavities. I ended up making an appointment with a clinic operated by the dental school in my city. The final price I paid them was only slightly less than what my dentist quoted me, and the experience of going to the clinic wasn't particularly pleasant.
Also, something else to keep in mind: A lot of dentists will try to persuade you to get work done that you don't really need. I got badly scammed when I moved to New York City and found a new dentist. I ended up spending thousands of dollars for work that I didn't need (I was young and foolish at the time). Caveat emptor.
posted by JD Sockinger at 7:15 AM on September 28, 2022
Also, something else to keep in mind: A lot of dentists will try to persuade you to get work done that you don't really need. I got badly scammed when I moved to New York City and found a new dentist. I ended up spending thousands of dollars for work that I didn't need (I was young and foolish at the time). Caveat emptor.
posted by JD Sockinger at 7:15 AM on September 28, 2022
Are you making sure that the doctors you are going to are in the network of your insurance policy? If you explain your financial situation, you may be able to negotiate and get them to accept assignment of benefits (which means they will take whatever insurance pays them and you won't owe anything more).
One of my kids recently had to have her wisdom teeth emergently extracted (one was infected). I only had to pay $300 out of pocket. I was pretty shocked, given that they sedated her and did full panoramic films. FWIW, we have MetLife Dental through Mr. dancinglamb's job.
posted by dancinglamb at 7:18 AM on September 28, 2022
One of my kids recently had to have her wisdom teeth emergently extracted (one was infected). I only had to pay $300 out of pocket. I was pretty shocked, given that they sedated her and did full panoramic films. FWIW, we have MetLife Dental through Mr. dancinglamb's job.
posted by dancinglamb at 7:18 AM on September 28, 2022
Look for your local Federally Qualified Health Center at https://findahealthcenter.hrsa.gov/. Most offer dental services or will refer you to one that does. FQHCs operate on a sliding scale, and their (government-funded) mission is to provide care to people who can't afford it. Give your local center a call, explain your situation, and they'll talk you through it. FQHC dentists have to meet very high standards. Often, they're experienced dentists who don't want to deal with private insurance telling them what they can/can't do - at an FQHC, they can do what's best for the patient.
aniola has lots of good advice, too. You can start with your insurance-covered cleaning, get a diagnosis/treatment plan, then take that to the FQHC for a second opinion. It would also give you a starting point so the FQHC staff can figure out a rough estimate.
Congrats on taking the steps to take care of yourself! Oral health is so important to your overall health. You've got this!
posted by writermcwriterson at 8:06 AM on September 28, 2022 [3 favorites]
aniola has lots of good advice, too. You can start with your insurance-covered cleaning, get a diagnosis/treatment plan, then take that to the FQHC for a second opinion. It would also give you a starting point so the FQHC staff can figure out a rough estimate.
Congrats on taking the steps to take care of yourself! Oral health is so important to your overall health. You've got this!
posted by writermcwriterson at 8:06 AM on September 28, 2022 [3 favorites]
Dental tourism is a thing and costs in the US and Canada are sky high. I know people without private insurance coverage that schedule dental work for when they are visiting family in Japan because it is cheaper than getting it done in Canada.
But also dentists are pretty good about working around the limitations of your insurance. So they can space procedures out to ensure that you're covered as much as possible although you may have to bite the bullet and accept that if you want to get the wisdom teeth removed then you'll be out of pocket and won't be getting any other work done that year.
posted by any portmanteau in a storm at 1:04 PM on September 28, 2022
But also dentists are pretty good about working around the limitations of your insurance. So they can space procedures out to ensure that you're covered as much as possible although you may have to bite the bullet and accept that if you want to get the wisdom teeth removed then you'll be out of pocket and won't be getting any other work done that year.
posted by any portmanteau in a storm at 1:04 PM on September 28, 2022
Can you investigate with your dentist and medical insurance regarding the impacted wisdom teeth? I know someone who was able to have their impacted wisdom teeth extracted through their medical insurance, which was much more comprehensive than the dental insurance. I believe they saw an oral surgeon, specifically, rather than a regular dentist, to have this procedure covered this way.
posted by citygirl at 5:23 PM on September 28, 2022 [1 favorite]
posted by citygirl at 5:23 PM on September 28, 2022 [1 favorite]
Another trick is to wait until near the end of the year (or insurance year if different from calendar year) to get your work done, so that if a dental emergency comes up, it will still be covered by the insurance.
posted by aniola at 6:36 PM on September 28, 2022
posted by aniola at 6:36 PM on September 28, 2022
Citygirl has an interesting take. Some/many health insurers treat oral surgery the same as any other surgery, and it is covered under your policy. But, you have to dig into the fine print to make sure.
posted by Thorzdad at 3:39 AM on September 29, 2022
posted by Thorzdad at 3:39 AM on September 29, 2022
Thirding Citygirl and Thorzdad: Mrs. SourceQuench had a complicated wisdom tooth extraction done by an oral surgeon, and it definitely was covered (modulo deductible) by our health insurance, which did not include regular dental care. (Locale: US, around 15 years ago. Alas, I do not remember the specific insurance involved.)
posted by sourcequench at 2:01 PM on September 29, 2022
posted by sourcequench at 2:01 PM on September 29, 2022
I regularly take people to Tijuana from San Diego for dental work. Would happily do so for a complete stranger. Dentists are (often) crooks. DM if you're interested in flying to San Diego.
Though Thailand is probably much more fun.
posted by booooooze at 11:54 PM on September 29, 2022
Though Thailand is probably much more fun.
posted by booooooze at 11:54 PM on September 29, 2022
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