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The Real Cost of Dentistry

By Robert Griggs, DMD

Too many times patients put off maintaining their dental care.  Often they cite “I was waiting to get dental insurance” or “I don’t have dental insurance”.

I thought it was time to consider these statements and evaluate what the “real cost” of dentistry is for those who choose to put off their dental care due to the lack of insurance.

In order to compare costs, first we must consider what the average dental insurance plan covers and costs the employee.  On average the coverage (benefit) amount is $1,500/year.  The cost to the employee varies from as little as free, to as much a $700/year.  For our analysis we will consider the employee contribution of $25/month annualized to $300/year.  A traditional 100/80/50 policy with a $50 deductible on basic (80) & major (50).

First we will consider the patient who has dental insurance and maintains his dental care as recommended. We’ll call him Patient I. Our experience tells us that patients who maintain good home care and maintain their dental appointments have very few restorative needs.  In an effort to try to make this fair we will consider that Patient I has one cavity /year and we will amortorize the cost over  5 years to include periodic x-rays and a full mouth series of x-rays  What is Patient I’s cost per year?

Procedure Qty Total Cost Patient Pays Ins. Pays Time
Full Exam
Full x-rays
Periodic x-rays
Periodic Exam
Dental Prophy
2 Surface Filling
Ins. Premiums
5-Year Totals
1
1
4
9
10
5
$96
$134
$244
$459
$1,020
$1,350
$0
$0
$0
$0
$0
$47
$1,500
$1,970
$96
$134
$244
$459
$1,020
$880
.5


2.25
5
2.26

10.25 hrs

Using the same 5 years, Patient N (no insurance) has not seen a dentist in 3 years and now arrives to the office with a dental emergency.  The emergency exam reveals several teeth with serious decay.  The tooth Patient N is complaining about can’t be restored and must be extracted.

Following the extraction Patient N is advised to return for a complete exam to determine the best course of action to restore his dentition.  Patient N says “I have no insurance, I’ll have to wait”.  Patient N leaves the office and doesn’t make a next appointment.  Eight months pass and it is the day before Thanksgiving.  Patient N calls the office at 10 AM and begs to be seen the same day because he is in severe pain.  The tooth had been bothering him for several weeks but the pain usually went away by itself or when he took a couple pain pills the doctor gave him for his previous back surgery.  The receptionist says please come down right now.

Patient N says “I have to work till 5:30, can the doctor see me at 6?”  The kind receptionist empathizes with Patient N but explains that the office will be closing promptly at 5:30 due to the holiday but that we would be more than happy to see him at 2 PM.  Patient N realizes that he is in a pickle and the doctor had previously warned him.  Patient N leaves work early to deal with this emergency.  Good news this time!  The dentist tells Patient N he can save his tooth.  It will require a root canal, you know, one of those 3 rooters and a post n’ crown.

A crown?  Patient N thinks to himself, am I really worthy of being the King?

You betcha! King Procrastinator…  The dentist starts that root canal and reminds Patient N that a full exam and treatment plan to resolve his dental problems should be given a second thought.  After all, Patient N’s philosophy of fix it when it hurts isn’t working out so well for him.

Patient N sits back the next day to enjoy some of his wife’s best cooking with his closet relatives.  Uncle D reminisces the days when he would go to the dentist and they would just yank one out.  Uncle D really enjoys the mashed potatoes.  After all, chewing that corn on the cob is out of the question with those old, worn out dentures he wears. It was also good to see Patient N’s bother-in-law, boy he’s got a great smile.  He couldn’t stop talking about that promotion in sales he got last week.

Wow, is that the famous N family apple pie coming to the table, a-la-mode?  Patient N, moves the ice cream to the side, it hurts too much when the cold hits his teeth.  At that moment a spark ignites in Patient N’s brain.  You know, one of those moments of ispiration.  Patient N says to his wife, “can you please schedule a check-up appointment with the dentist next week for me?”

The following week Patient N arrives to his appointment.  Following a full set of x-rays and a comprehensive exam by the dentist they review the necessary work.

Patient N knows this is not going to be inexpensive.  After all he hasn’t spent any money to maintain his teeth for the past 4 + years.  The only reason he bought a new toothbrush last year was because he accidently dropped the old one in the toilet.

So here is how it breaks out for Patient N over the 5 years;

Procedure Qty Patient Cost Time in Office
Full Exam
Recall Exam
Emergency Exam
Emerg. x-rays
Full x-rays
Periodic x-rays
Extraction
Bridge to replace tooth
Root Canal (3 rooter)
Post
Crown
Fillings
S&RP (deep cleaning/quad)
Perio hygiene (every 3 mos)
Lost Wages
Lost Tooth
5-year Totals
1
1
2
2
1
1
1
1
1
1
1
15
4
2
4.5
1
$96
$51
$144
$42
$134
$61
$189
$3,624
$1,153
$318
$1,208
$1,350
$1,004
$268
$90
Priceless
$9,732
.5
.25
1



.5
2.5
2.5
.5
1.25
2.5
2.5
1.5


15.5 hrs

If Patient N had gone to the dentist like Patient I it would have only cost Patient N $660/year!

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