a dental dilemma

[pinkytoe]

I finally found a dentist to try here and he seemed very competent. After my exam, he informed me that the one and only crown I have ("installed" after cracking a tooth on popcorn) needs to be replaced and since I don't have dental insurance, my cost will be $1600. He said it shows signs of not covering in the back and that if I don't replace it, I might need a root canal in the future when/if decay sets in. Since this is a major expenditure out of the blue, I am wondering best course of action or if I even need to have it replaced since I haven't ever had problems before. If you were me, would you:

Get a second opinion and look for better price
Ignore
Just get it done and be done with it.

I've even thought of flying back to TX and seeing my old dentist but that's probably overkill.

[Tradd]

Can't hurt to get a second opinion.

[Yppej]

Ask Rob, here on these forums, where he goes in Mexico for dental work. It's not much further than Texas.

[sweetana3]

Very worth getting a second opinion. Often, if asked, it is less cost than a full exam. (many dentists do it to make possible new patients feel more comfortable.)

[Zoe Girl]

How old is the crown? They do wear out, my mom is getting to that age. We have teeth that tend to be bad, so with 5 root canals and 5 crowns i get conservative on dental work.

I did use to have care credit, a way to pay for just medical bills over time. It made some necessary work possible.

[dado potato]

I have generally been a skeptic about dental insurance. Rather than pay premiums I put some money into savings every month earmarked for dental expenses. The amount is based on the long-term experience of my wife and I (we are empty-nesters now, and we drink no Mountain Dew.)

The time to start saving for dentist bills is sort of like when is the best time to plant a tree (at least 10 years ago). But in the case of the specific "$1600" crown, is it possible to defer the date of service, without pain or disruption?

It may be that for a crown, approximately half the cost would be paid when the crown is ordered by the dentist, and the remainder would be due when the work is completed.

Is it possible to negotiate a buy-now-pay-later agreement for the the second payment? There are all kinds of dentists in the world. Some are compassionate towards people who honestly keep their promises, but can only afford to pay cash at $100 per month, say.

For the first payment, if a patient does not have the cash saved by the time that it is due, there may be options that would be lower cost than carrying a credit card balance. Sometimes (not always) a local credit union or an online bank can make a personal loan for a lower annual percentage rate than your oh-so-convenient VISA or Mastercard. I have not shopped for a personal loan... I am just going on the principle that one can always shop for a more competitive interest rate.

[CathyA]

Hmmm.....did the crown break? lose a piece of it's porcelain covering.......or is it metal? I've had a crown fall off, which the doc put back on, and I think the procelain can be repaired. I'm also thinking that the dentist could build up a little of your own tooth, if necessary, before putting the crown back on. Can you be more specific as to what happened for him to say what he did?

[pinkytoe]

I have the savings to buy the crown but am a bit shocked by the price. I called my old dentist back in TX and they said it was done in 2006 so much older than I realized. It is a firmly attached metal and porcelain crown and my understanding is that he believes it wasn't done correctly. The space in back did not show until they cleaned my teeth so maybe covered with scale.

[SteveinMN]

I have the savings to buy the crown but am a bit shocked by the price.
Don't be. I had a few crowns "installed" this year; $1600 apiece (while shockingly expensive for what it is) is not atypical. :(

At that price, though, a second opinion is not at all a bad idea. The opinion, though, should be geared toward alternatives to a crown, since it strikes me as unlikely that another (stateside) dentist is going to come in much cheaper if (s)he's doing what your current dentist is doing. Then again, if it took you this long to find a dentist you like, do you want to risk going with a dentist you may not like as much?

[CathyA]

Yeah, the price is a little high. I live in a small town, but have the best dentist on earth. It used to cost 3-400 at his office. But when he realized how much they were charging elsewhere, it went up to at least $1,000. I have about 13 of them. :(
The last one was for a smaller molar towards the front. I asked him if the small ones were the same price as the large ones and he said yes. So I told him to use a large one. :~)

How did you come to find this dentist? Does he seem competent? Yes, it wouldn't hurt to get a second opinion, if you can find another one with a good reputation. But you will also pay for that visit. And he will probably also want to do xrays.......unless you can get them from the first dentist.

[Teacher Terry]

Dental costs really vary by region. My son lives in Wichita, KS and dental work is about a third of the prices here. I flew there 4 times for implants because even with the plane tickets it was so much cheaper.

[sweetana3]

And a good dentist will tell you things like if you have a metal based crown with a porcelain cover and some of the porcelain chips, the whole crown does NOT need to be replaced. I have a spot on one that we are watching. I trust him to tell me if I might need to get it replaced. We discussed it last time and he was not concerned with any issues.

[pinkytoe]

I think a will formulate a long list of questions and go back to the dentist. Just not clear enough on why it needs to be done and why so quickly. He said it needed to be done next month as if urgent. Especially about possible repair vs replacement.

[CathyA]

Did he take xrays? Sounds like he was concerned that there might be decay under the part of the crown that wasn't covering the whole tooth? I don't know why it would be urgent, unless he was worried about decay. An xray would show that, and/or any cracks that go too far down into the root area. Were there a lot of people in his waiting room?

[Rogar]

I had a crown placed a molar that had an old filling about a year ago. I had dental insurance at the time which by my recollection was that total cost was close to $1000., which I paid 50% of. I recently dropped dental insurance. I think one advantage of insurance is that they can negotiate prices down. I've heard that people paying cash have had success negotiated doctor fees, but have never had the chance to try it.

[pinkytoe]

Yea, I feel like the uninsured get to pay the difference on what is charged to those with insurance, ie higher cost. It just doesn't make sense to carry the dental though since I don't usually have any issues and will just use savings. I know I paid $850 back in TX for the crown so prices have gone up since then.

[SteveinMN]

I've heard that people paying cash have had success negotiated doctor fees, but have never had the chance to try it.
Apparently the ability to do that varies by locality. When all our dental work this year maxed our budget, I did ask the last two providers if there was any discount for cash or for not going through insurance. The best they could do was charge me what they would have gotten from insurance, which was at least some discount from "rack rate".

[Packratona!]

I just used my Southwest credit card to fly to Cancun, cost about $5 for the airport tax is all each way. There are good dentists there. But what I did was take a comfy 4 hour bus (price is $15-30 depending on which bus, how far ahead you purchase) over to Merida, a fantastic and very safe city. I wanted to go there because it is a very beautiful ancient city with gorgeous antique houses and close to several awesome Mayan temple ruins and fabulous caves with underground springs to swim in. They close down the streets around the plazas almost every night for free folkloric dances etc. The business class hotel I stayed in was $35 a night hot breakfast included. Taxis are $2 each way, and the hotel will call them for you. I prefer the older hotels near the plazas, which are so fun to walk around in the evenings. If you would rather, You can get a super modern more pricey hotel right by the great hospital there which is also right next to the dentist I used. Consulate folks go to him, lots of Canadians and Americans as he speaks English and is well known. Food is cheaper than in US especially if you eat in the market. You need to go for a week plus one weekend to give time to get the crown ordered. I got a titanium crown with gold inside. It cost $350, had it done in November. That included a cleaning and one xray (I told copies of mine from my dentist here with me for him to look at too). Make sure to go in November to March, otherwise you will pass out from the heat! Check it out, I can send you the dentist's email if you want, he is good at replying to all questions. I can also answer any questions you have. If you would rather just stay near the beach, then Cancun is the place to go. You will go for 2 visits to get teeth cleaned and a temp filling put in. Then you come back 5 or so days later and get the permanent put in.
Oh, and you can fly directly into Merida, with a different airline if you would prefer. I just did Southwest as it was practically free with the points.

[boss mare]

I finally found a dentist to try here and he seemed very competent. After my exam, he informed me that the one and only crown I have ("installed" after cracking a tooth on popcorn) needs to be replaced and since I don't have dental insurance, my cost will be $1600. He said it shows signs of not covering in the back and that if I don't replace it, I might need a root canal in the future when/if decay sets in. Since this is a major expenditure out of the blue, I am wondering best course of action or if I even need to have it replaced since I haven't ever had problems before. If you were me, would you:

Get a second opinion and look for better price
Ignore
Just get it done and be done with it.

I've even thought of flying back to TX and seeing my old dentist but that's probably overkill.

I have over 30 years in the dental field. From what you are explaining, It sounds like there is open margins, which can develop into cavities . and depending how big the open margins are, and if they are on the buccal ( cheek side) or lingual (tongue side) they may be repaired by preparing the tooth and placing a fill along the margins. If they are between the teeth ( distal or mesial) then cutting off the crown and starting over will have to be done. Prices vary so widely depending on where you live .

[pinkytoe]

Thanks, boss mare. The margin or whatever he called it is on the back side (tongue?) of the tooth. It is visible if I hold a mirror to it but just barely. Just trying to understand the situation before I shuck out the bucks.

[Gardnr]

Something to understand: a healthcare provider cannot charge less for a cash customer than the highest negotiated rate insurance contract. If they do, it's a risk for a lawsuit.