Dental implants? Any dentists?

[spyrosmom]

So yeah, 32 yrs old and I'm still afraid of the dentist. And he is a sex-ay dentist, too. YUM!!!! Anywho, I digress.

I was never a fan of the dentist, but I had one crown that went badly, so now anything more than a cleaning gives me the heebie jeebies. I am in the midst of a crown right now (just the temp, waiting the the permanent one) and the icky owie part went well, so hopefully I'm on my way over it.

Anyway, I had a gum abcess (ew, I know) in Oct, the dentist wasn't sure what caused it, no nicks, cuts, etc, and nothing to drain just really, really swollen and painful. Did a course of antibiotics and it cleared up. Swelled up a bit now and then over the next few months, but nothing bad, so I ignored it. Got nasty again in April and back to the dentist, this time he referred me to the periodontist, b/c he still isn't sure what is causing it. Can see the ow, but not sure of the origin.

Swelled up again (blueberry sized - ew!!!) last week, and then all of a sudden went down on Fri (of course, bc my appt was today) I saw the perio today, and he thinks the tooth may be cracked under the crown that is there. I can't recall when I got that crown, so its been there for years. He asked if I grind my teeth - yes - when I sleep, when I'm awake, I chomp ice and chew on my pens, too. He said it isn't showing on an Xray, and he can do a CAT scan ($$$$$$$) but it normally won't show there, either. The best way is to cut it open and then if it is cracked, he can pull it at the same time.

Its the very back bottom molar (not the wisdom tooth - I don't have those any more) However, if it's pulled, he has to do an implant to hold the spot, so the top tooth above it doesn't get out of whack, and the bottom teeth don't all shift around. Having a screw inserted into my jaw bone and then a crown stuck on top doesn't sound like the most pleasant thing ever. He said he can't gaur it's cracked til he can see in there, but it more than likely is.

His part of the bill is 3700, part of which the ins covers, and part they don't. My dental maxes out at 1000 anyway, and I'm maxed for the year, but my policy runs July-June and is about to reset. They cover 50% of some of the procedures and 80% of others, but they cover NONE of the actual implant which is $2100. And then I have to get the implant crowned by my regular dentist, which is another $1200, and my benefits will be maxed by then, if they are paying the other stuff.

So anyone who's had this done?

How bad does it hurt? - having a screw shoved in my jaw sounds really sucky, as does having a tooth yanked (only once before in my life, I was about 5 and it sucked) and my gums cut open.

Maybe I can just deal with periodic swelling issues or is it going to get worse?

Why the hell is it so expensive???? I hate to use my credit card, but I'm sure the card co would love it. They do offer a program called Care Credit, which is 12 months interest free, and then it jacks up to some astronomical rate, but that still around $300/m. That's a car payment.

Right now I'm waiting for the ins to pre-auth the treatment, or they won't pay at all. That should be a joy. It took 4 appeals for them to pay for the crown the dentist is working on now. The idiots wanted to fill a broken tooth - there is nothing to fill - BUSTED!!!!! Silly cubicle insurance workers!

On the upside, the periodontist said other than that, everything looks faboo. He was kinda sex-ay to, in a older, gray haired sort of way. Apparently, I have knack for picking good looking, expensive dentists who are out of network!!

Another rant - all the dentists who are in network have offices that are kinda scuzzy looking, complete with foot-pedal drills from the 1800s. I can't get with that. Why are all the good, comfy dentists out of network?

Nan

 

[janie1234]

Why are all the good, comfy dentists out of network?

Because they bill more but see less patients and the in network dentist barely make a profit and they see a ton of patients.

Nan, . . .sorry you are going through all this. I'm no dentist but I am a dental insurance biller. What kind of insurance do you have. What tooth is it?

Also I'm sorta surprised that they cannot find the source of the infection. Something is going on there to cause it. I don't really know why they couldn't save the tooth and just do a retreat (root canal redo) and recrown and post, . . that is WAY more affordable than implants. Dentists like to do implants because they make more profit but they are not always necessary. Not only do you have to pay through the nose for it all you have to have what they call a cap on the implant for about six months. That is 6 months with no tooth, . . nothing. The bone needs that long to take the implant before the crown is placed. With all that said and done there is never any guarantee that it will take and you could be out all the money. I'd get another opinion and ask for other options AND get a pre-authorization!!! I ALWAYS reccomend that esp for expensive treatment. I'd also give an in net work dentist a try, . . they may not all have marble counter tops and look good but they are not all bad.

Good luck!!

 

[aveggiegirl]

Not a dentist.

I had my very back bottom tooth pulled. No big deal (compared to two root canals gone bad). No implant and my top tooth above the hole is just fine. I don't even notice that a tooth is missing. My dentist said if I missed having a tooth there I could get an implant, but because of the location (at the very end) I did not need one.

It sounds like you need a night guard. Protect those other teeth!

 

[spyrosmom]

Because they bill more but see less patients and the in network dentist barely make a profit and they see a ton of patients.

Nan, . . .sorry you are going through all this. I'm no dentist but I am a dental insurance biller. What kind of insurance do you have. What tooth is it?

Also I'm sorta surprised that they cannot find the source of the infection. Something is going on there to cause it. I don't really know why they couldn't save the tooth and just do a retreat (root canal redo) and recrown and post, . . that is WAY more affordable than implants. Dentists like to do implants because they make more profit but they are not always necessary. Not only do you have to pay through the nose for it all you have to have what they call a cap on the implant for about six months. That is 6 months with no tooth, . . nothing. The bone needs that long to take the implant before the crown is placed. With all that said and done there is never any guarantee that it will take and you could be out all the money. I'd get another opinion and ask for other options AND get a pre-authorization!!! I ALWAYS reccomend that esp for expensive treatment. I'd also give an in net work dentist a try, . . they may not all have marble counter tops and look good but they are not all bad.

Good luck!!

The dental is Assurant (as in we assure you we aren't going to cover jack diddly poo)

Its the bottom right last molar. He thinks its cracked below the crown, below the gum line. I asked all the other stuff, he said the root canal looks good on the Xrays, and the crown is not wiggling on the tooth. But as I grind my teeth (bad Nan, bad) that puts alot of pressure on that spot. I may have cracked it on the inside or below the gum line. He did say that the good thing is that it doesn't hurt all the time, so it may not be cracked, there may just be something else going on in there, but he at least needs to cut it open to see.

I did ask if they have to do all this,can I save the old crown and we can stick it back on so I don't have to pay for another - the answer is no! Buggers!

The in-network dentist offices that I've looked at are seriously yick. I've been going to my dentist for years, and I love them, but I would switch if I could find just as good and cheaper. Yes, my dentist has shiny new TV's and paint and carpet all over the place, but the other's that I looked at were seriously 1970's looking. If you can't take care of the office, you're not going anywhere near my face. Crowded waiting rooms, old chairs, yicky old place smells, old paint, one of them had cracked vinyl on the chair covers, unclean bathrooms. Just yick!yick!yick! I wouldn't be surprised if a roach crawled over my toes. Yes, I know they all have to meet some state/government standards, but ew! If you can't vaccuum the carpet, I don't want to know what you do with your dental instruments. And there are only 3 or 4 in networks dentists in town. The only one that is decent care-wise in town is the dentist I had prior to this one, and he is a giant, ignorant, rude, asstastic, arrogant bastard, who I wouldn't give a dime too.

So now I am waiting for the pre-auth. It took 3 or 4 appeals for them to approve the crown I'm getting done now. I'm hoping he'll cut me open, not see any cracks or anything, clean it out, sew me up, and send me home. And I can save a whole lot of cash!

I wish dental ins would cover like medical does. Someday they'll wake up and realize it should b/c it does affect your overall health and wellness, as well as all your bodily systems. I would even pay more for more coverage. It'd be nice to have a basic coverage (cleanings, filings) and expanded coverage as an option (crowns, surgery, etc) *sigh*

Nan

 

[MommaPew]

Hi Nan

So sorry about all the worry you're going through here. I had to get 2 titanium inplants on my front teeth due to trying to catch a baseball with my mouth so I've been through the process. It was about 9 years ago and back then for the 2 the total cost was around $6k. I lucked out b/c my insurance paid all of the bill due to it being an accident.

I've had a LOT of work done on my mouth (I'm now 41) and the technology has come a long way. I didn't experience any pain for the procedure and I swear it took only about 1/2 hour to take out my old roots and replace with the inplants. The pain was afterwards for a day or two but the but Tylenol 1s (I think) helped with that. I had to wear a mouth plate with 2 fake teeth (so I wasn't walking around looking like a hockey player) for 6 months, waiting to make sure the inplants "took". Then the Dentist started working on the actual crowns. The whole procedure took about 1 year from beginning to end. I due have some gum issues (i.e. receding) b/c the gum is now sitting on something not organic and I guess it doesn't like that.

Of course since it was my front teeth I was having the work done regardless. Are you able to get a 2nd opinion to see if you can have any empty spot back there?

 

[DebbieH]

So sorry to hear you are going thru this. I had an implant and like you, I was very scared about the thought of it. (Stupid banana walnut muffin baked with the SHELL!) I have to say it was no worse then having novacaine and a filling! Seriuosly, I was so fortunate. I filled the pain med prescription for after the novacaine wore off but never took one! I did keep an ice pack on it as soon as we left his office to keep the swelling down. I was shocked how easily I survived what I thought was going to be a nightmare. (And, like you, I never liked dentists either & had a real fear of them! I've had so much dental work done in the past couple years that I think I am finally over my fear of them) I hope your experience is as good and hope they get to the bottom of your problem soon. Tooth pain is horrible!

 

[toffeedog]

Getting the tooth out was worse than the implant. Implant will take three months to knit to the jaw before the crown can be attached. Double injection to the palette and gum. Injection was worse. I shut my eyes and let them get on with it as I am not a lover of a dentist. Blood pressure was higher after that trip to the dentist. Overall implant was not painfull. Extraction was worse. Get someone to drive to you to anf rom dentist for the producre as it may knock you a wee bit.

 

[janie1234]

Nan you should look into your medical insurance to see if they will cover any of it. Sometimes they will.

 

[dr.mel_PT]

I wish dental ins would cover like medical does. Someday they'll wake up and realize it should b/c it does affect your overall health and wellness, as well as all your bodily systems. I would even pay more for more coverage. It'd be nice to have a basic coverage (cleanings, filings) and expanded coverage as an option (crowns, surgery, etc) *sigh*

I wish the same thing. I don't get why they don't. I've never had major dental work so I didn't know that cleanings/exams every 6 mos weren't guaranteed 100% covered if you max out. Initially, my insurance only covered $500 max so I was good with my twice yearly checkups; then this year, I had to get my wisdom tooth pulled so that with my cleaning maxed out the $500. I asked HR if cleanings were guaranteed 100% paid by insurance and they said yes so needless to say, they don't know much about how dental insurance works either. I had to upgrade my plan to the $1000 max now so I can get my 2nd cleaning. UGH!!

Also, I had no clue that just because a dentist says they accept a certain insurance doesn't mean they are in-network. I have Delta and the way they explained it to me is that dentists are not like doctors; they will technically accept your insurance but if they aren't participating dentists for that company, they bill your insurance more than say a participating dentist would. The insurance co. then turns around and says "well, your cleaning cost $200 but the lowest price in that area for a cleaning is $100 so we will cover the $100 and you pick up the rest." It is crap.

And I totally agree with you about opting for the more expensive option. My dentist is out of network but I love him; he has all the updated technology, his staff is awesome, he makes you feel SO comfortable, the office is always immaculate...I could go on and on. The dentists in my area that are in-network have offices that are so grungy and old, it makes me scared just walking in. I guess some things come at a price.

 

[pgun]

I am an oral surgeon assistant, have never had an implant. Your teeth on the bottom should not shift from having the tooth next to it extracted since it is the last tooth in the mouth. The upper tooth will only hyper erupt if it is not hitting the tooth below it after you have # 31 extracted, so look in the mirror at your bite to see if the upper tooth is going to hit the tooth in front of the extracted tooth.

It is said that having the tooth extracted is worse than the implant itself. I would not let a general DDS do the implant there is alot involved w/the process and it is better to have someone that does it daily to do them. I have only worked for the oral surgeons office for about 1 year and I am still learning about them as they are pretty complicated in the steps in doing an implant (only complicated from my side). For you they extract tooth, let heal, put in implant, possibly bone graft, let heal, place abutment then impression for crown.

As far as a crack in your tooth you can very rarely see them on xrays since you would have to have the exact angle w/the xray in order to see it on film. It would not be worth doing a CAT scan, I can't believe that was even mentioned.

It would not be good idea to deal with the swelling as you will always need more antibiotics to get rid of it if it does have something to do with this tooth. If you just let the swelling go you could end up in the hospital. You need to just fix tooth.

Oh and by the way for someone who hates going to the DDS you sure do find them all pretty "sex-ay". You crack me up! Sorry for the tooth issues and thanks for the funny post! LOL

 

[trixie42]

Just to add my 2 cents...

My husband had 2 molars extracted at the same time due to bad root canals. He is desensitized to the Novocaine and the dr. could not give him enough (he didn't want another needle in his mouth). He said it was the worse thing he had ever been through but the pain medicine helped once he got it. He waited about 2 years to get the implants but that was much easier. He had an oral surgeon do the extraction and the implants. Our insurance covered the extraction (mostly) but not the implants. We did use our FSA to pay for that.

I would get a second opinion to see if you can find the cause of the infection. Also, if you are eligible for an FSA that would help to minimize the cost since the money is pretax.