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Medical Forum / General / Dentistry / October 2005$1400 for 14 year old's 5 fillings ?
Hi, My dentist specializes in cosmetic dentistry and has an office in downtown San Francisco. On occassion I'll have her do a root canal and install a crown. I think of her prices as expensive. She's great at making it so that you never feel pain - and when she does a root canal she does the entire operation by hand rather than with a drill. I've been happy with her work. Mostly - I did have a situation this year where she installed two brand new crowns and didn't do a root canal - then the teeth went south and we had to reinstall the crowns. Anyway, this week I had a 14 year old friend of mine get a teeth cleaning and a few X-Rays. The price for that was $330. $300 for four different exams and 30 for an extra X-Ray. She discovered 5 places where the kid needed fillings. She wants $1,400 to fill all 5 cavaties. She plans to use the composite material to do the fillings. Of the 5 cavaties two require special attention because of the way the surface of the tooth has to be polished. I suppose I can afford the $1400 but I wonder if I'm paying way to much for service. She says that her margin is less than 20%. Is it possible that she's right and that the price - considering the patient service - is reasonable? >Hi, > >My dentist specializes in cosmetic dentistry and has an office in >downtown San Francisco. Two fillings or more than two? Joel >On occassion I'll have her do a root canal and install a crown. I think >of her prices as expensive. [quoted text clipped - 28 lines] >Is it possible that she's right and that the price - considering the >patient service - is reasonable? Five fillings. Most of them on the lower back teeth. >Hi, > [quoted text clipped - 7 lines] >does a root canal she does >the entire operation by hand rather than with a drill. My opinion: Rotary endodontics is preferred over "hand-drilled." Its like corned beef. Some people prefer hand sliced, but I prefer machine sliced. Joel >I've been happy with her work. Mostly - I did have a situation this >year where she installed two [quoted text clipped - 21 lines] >Is it possible that she's right and that the price - considering the >patient service - is reasonable? Tough question ....... I agree with you ... where have we come to in this profession? Joel >Hi, > [quoted text clipped - 33 lines] >Is it possible that she's right and that the price - considering the >patient service - is reasonable? > Hi, > [quoted text clipped - 33 lines] > Is it possible that she's right and that the price - considering the > patient service - is reasonable? Possible. Some offices run up extremely high overheads. OTOH, that really shouldn't be your problem, and I'm a little uncomfortable with this dentist pleading her case that way. Furthermore, I'm not sure what is meant by "special attention" for polishing needs. These fees are very high IMO. Some star dentists can get these fees because they are stars and (deservedly or not) have that reputation. But you should know there is no recognized specialty as such as "cosmetic dentistry". Some dentists may of course be more skillful than others. 5 resin fillings for $1400 is probably close to twice what I would charge. And my profit margin is a heck of a lot higher than 20%. Of course, she may be far more competent than I. ;-) Steve  Signature{\rtf1\ansi\ansicpg1252\deff0\deflang1033{\fonttbl{\f0\fswiss\fcharset0 Arial;}} {\*\generator Msftedit 5.41.15.1507;}\viewkind4\uc1\pard\f0\fs20 Remove "nospam" to reply\par } > 5 resin fillings for $1400 is probably close to twice what I would charge. > And my profit margin is a heck of a lot higher than 20%. > Of course, she may be far more competent than I. ;-) Not knowing the size of the planned restoration, and knowing that the cost of keeping an office open is much higher in California, I would venture to say that the fee might be accurate. $280 for a posterior resin would not be out of line if it requires 5 surfaces of restoration and complex anatomical shaping to achieve good results, plus the California cost of living. If the decay is minor decay between the teeth (I am talking just barely through the enamel in one tiny spot on each tooth), then the price is too high anywhere. Restoring 5 teeth with an indirect porcelain would cost $3-4K Signature/ Amatus / > >> Hi, [quoted text clipped - 48 lines] > > Steve From what I hear, it costs a lot of money to live in California. Those fees are outlandish for Kansas City, but who knows? Dartos > 5 resin fillings for $1400 is probably close to twice what I would > charge. And my profit margin is a heck of a lot higher than 20%. > Of course, she may be far more competent than I. ;-) > > Steve I have a hunch that if we go to Chinatown we can get a Chinese dentist to do the job with mercury fillings for $600. >do the job with mercury fillings for $600. You have to mix the mercury with something or it will just pour right out of the tooth as soon as the patient lies down. Signature/ Amatus / >I have a hunch that if we go to Chinatown > we can get a Chinese dentist to do the > job with mercury fillings for $600. >>do the job with mercury fillings for $600. > > You have to mix the mercury with something or it will just pour right out of > the tooth as soon as the patient lies down. That's Joel's line. Steve Signature{\rtf1\ansi\ansicpg1252\deff0\deflang1033{\fonttbl{\f0\fswiss\fcharset0 Arial;}} {\*\generator Msftedit 5.41.15.1507;}\viewkind4\uc1\pard\f0\fs20 Remove "nospam" to reply\par } > That's Joel's line. I know, he lent it to me for one day. Signature/ Amatus / > >>>do the job with mercury fillings for $600. [quoted text clipped - 5 lines] > > Steve >>>do the job with mercury fillings for $600. >> [quoted text clipped - 4 lines] > >Steve Post-op instructions ...... sleep in a sitting position with head upright ..... Hey! What about uppers? How do you guys get the mercury fillings to stay in there? ANSWER: Bond in magnets first. The silvery stuff must be magnetic. Joel > I have a hunch that if we go to Chinatown > we can get a Chinese dentist to do the > job with mercury fillings for $600. ____________________ Before you opt for amalgam or for composite, be sure to read the Dental Materials Fact Sheet that every dentist in the state of California is REQUIRED to discuss with you before placing fillings. Amalgam fillings are easier to place and last a long time, but their dark color means that 14-year-old will be living with them for years. For appearance reasons, most people these days choose the white, composite resin fillings -- but it's your choice. There ought to be a number of dentists in the area who can place the fillings for less cost than $1400. Get a second opinion. Sometimes I get calls from people who want to know the cost of five fillings, or a crown, or whatever. Over the phone we don't even know whether they really need five fillings in the first place! A second opinion may even give you the pleasant surprise that fewer then five fillings are needed. When I'm asked to examine a patient for a second opinion, this happens quite often. It depends on the philosophy of the dentist -- some dentists advocate placing fillings as a "preventive" measure, and others do not. If San Francisco prices are too high (and almost everything in San Francisco is overpriced, believe me) you could try San Mateo or San Leandro. A bit of a drive but worth considering. I would think that you should be able to find a dentist close by. The main thing is to determine what fillings are "needed" and which are optional. - dentaldoc > > I have a hunch that if we go to Chinatown > > we can get a Chinese dentist to do the [quoted text clipped - 9 lines] > For appearance reasons, most people these days choose the white, > composite resin fillings -- but it's your choice. Anecdote is not the plural of data, and I am a patient, not a doctor but here's my anecdote for what it's worth: When I was a child/teenager, amalgam fillings were what you got, and therefore, that's what I have in many of my teeth. As an adult, I needed further fillings in other molars, and was persuaded that white composite were just as good as amalgam. I have had to have two of the white composite-filled teeth extracted after the fillings failed catastrophically, and three others needed root canals within 2 years of having the "just as good" white composite fillings done. The amalgam-filled teeth remain sound, 22 to 30 years after being filled. It could be that the dentist who did the later work was a terrible dentist and the material itself was fine; I don't know. I do know that I insist on amalgam fillings. I also know I feel no embarassment over my dark fillings but plenty over my missing teeth. Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather |
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