I went in today for a crown, that is, preparing for the crown.
My Delta PMI insurance is supposed to cover this so I was pretty sure
it was going to be in the neighborhood of $275. But when I got there
he told me it was going to be $525.

Let me clarify that I know Delta PMI is a rip-off; but this is the end
of the year and I had already had this dentist examine me and
determine that the crown was needed, and I did not want to switch
dentists. I also am under the impression that the dentist does good
work (the least painful shots I've had and he seems to know what he is
doing (??), and he's a member of both the ADA and the state
association for around 14 years, for what that's worth.

So anyway, I go in and he tells me it is $525 and I say, "Well, I
don't understand that because I checked with Delta PMI and they said
it was only around $275." A woman on the phone at the insurance co.
had told me it was around $275 as I recall, at the outside (highest it
could be). But to be honest my memory is not real clear on that, nor
do I know if the exact same materials and procedures were accounted
for. But I am positive it was quite a bit less than $525.

Anyway, he says, "Look, it's like this: I send my lab work out to a
lab that I work with and the prices Delta gave you are based on
Delta's labs which I don't work with. If you want to have it done at
that price you would have to make an appointment with another dentist,
and that would be a shame since we're here today, ready to do it. I
used to do it with their lab, but I don't any more."

I could see I was being snowed, but the fact is, I DID want to get it
done today, and I figured by the time I dealt with the hassle of
getting these x-rays transferred over to another dentist, or made
another 2 appointments with another dentist before he'd do it, it was
just too much trouble to go somewhere else to get it done. In other
words, this guy had me by the balls.

So I agreed to it.

But I said, "Tell me, doctor: Does this insurance really do me any
good, or would it cost the same if I came in without the insurance?"
He said, "Oh, no! The insurance is good, for YOU. But not for me. I
only make a few dollars per month off insurance but you are getting a
good deal because I usually charge $1200 for this." I said, "Really?"
and he said "Yes, that's what I would usually charge."

So here's how he broke down the price:
"Treatment for Tooth" [what is this, exactly?]  $ 30
"Standard co-payment: PFM Crown or Onlay"        100
"Porcelain"                    150
"Porcelain margin"                 75
"Noble or high noble metal"            200

TOTAL                        $525"
*****************************************************
Well, first of all, I just now realized his math is wrong, and the sum
actually comes out to $555, but he wrote $525.

Okay. Now it gets so weird, I thought I was in the Twilight Zone.

After the procedure, he tells me, "I had to go very deep. I did not
reach the pulp, but I still think you should get a root canal, just as
a preventative, so that you don't need one later and have to drill
through the crown to do it. If I were you, I'd schedule it now and get
it done before I do the crown, just to prevent needing it later."

I said I'd think about it.

He came back after he did the impression and said, "So, do you want to
schedule the root canal or not?"

I said, "Well, I'd like to think about it overnight.  How much would
it cost and who would do it?"

He said he'd refer it out to an endodontist and he'd have his
receptionist check on the insurance price. She ended up telling me it
would be only $100-150.

So then he put in the temporary filling or whatever it is, and then I
went to pay the $525 and make an appointment for the crown to be
installed in 2 weeks.

So I said to the receptionist, "He said I should make an appointment
to have a root canal done, just in case, so I don't need it later,
after the crown is put on. I'm not sure if I'm going to do it, but I
would like to know how much it would cost me if I do."

She said, "Oh, he didn't write that, here, let me check with him."

So she goes to talk with him and comes back and says "No, he says you
should only do the root canal IF it starts hurting."

I said, "But that's not what he told me, just now. He specifically
told me that he recommended doing the root canal as a PREVENTATIVE
measure, so I wouldn't have to do it later."

She said, "No, I just asked him, and he said to ONLY do it if you have
pain. So let us know if you do."

I said, "Well that's strange because he just told me something
different..."

And I left.

What's up with this guy? Is he a TOTAL CON ARTIST, or what?

Did he change his mind because he realized insurance would not approve
a "preventative" root canal?

Is it acceptable to prescribe a "preventative" root canal if one
drills close to the pulp?

I specifically recall him saying "It's close enough to the pulp that I
would go ahead and do it if I were you, but it's not NECESSARY." But
he was definitely pushing for it and I said, "And what is the downside
if I DON'T do the root canal now?" And he said "Then you might have to
drill through the crown later, which would perhaps weaken it and lead
to later chipping or cracking it".

I must say that I hate going to dentists and feeling I'm being sold
sh.t I don't need. I hate going to a dentist and feeling like I'm
dealing with a slimy used car salesman.

I know, I know, I have to stop going to Insurance dentists. And I
intend to. But now I'm not sure I'll trust a non-insurance dentist,
either.