A Helpless Hostage of the Dental System

Blog#153- 4/6/23

Richard Davis

If you want to have the experience of being powerless and victimized by an elite corps of professionals simply seek dental care. I have watched the prices of dental care soar to obscene limits over the years and have felt helpless and hopeless because I know there is nothing I can do to change the situation.

The dental profession’s expertise is not in question. Practitioners are extremely well trained and they provide a high level of care. The problem is the business model that controls the delivery of dental care.

Most dentists are either private business owners or work for entities that are private businesses. While there are a number of health related regulations that dental practices must follow, when it comes to cost it is the wild west.

There is no control over dental prices. In this country you can look in a person’s mouth and get a fairly accurate read on their socio-economic status. Low income people cannot afford dental care and even middle and upper middle income people cannot afford dental care beyond cleanings and fillings and routine care.

A few years ago I went to Costa Rica to have some dental work done. It would have cost $8000 for that care in the U.S. and it cost me $2000 in Costa Rica. The clinic was well equipped and was staffed by a group of subspecialists. The facility was state of the art. In Costa Rica dentists are not members of the upper echelon of income earners and they make far less than $100,000 a year.

What got me worked up once again about dental care was a number of recent encounters I have had with the elite tooth fixers. One of the inevitable hardships of aging is the loss of dental integrity. But if elders are living on fixed incomes they can’t afford to pay for implants and dentures and they learn to gum it for the rest of their lives.

I went to my dentist to find out why I had a lingering toothache. The dentist determined the tooth was dead but said she could not do a root canal and I would have to go to an endodontist. This was a few months after she referred me to a oral surgeon because she said that pulling a tooth required more expertise.

It took me a month to get an appointment with a oral surgeon who charged me $400 for the extraction that took all of 15 seconds. I am convinced my dentist had the expertise to pull that tooth for a lot less than $400.

I had to wait about a month to see the endodontist I was referred to. He did the exact same tests that my dentist did to determine the tooth was dead and he charged me $250. I had assumed he would do the root canal at that appointment but he told me I would have to book another appointment for that.

Three months later I finally had the root canal after having two bouts of sepsis causing me to have shaking chills and feel extremely lousy for a number of days. When I told the endodontist I was not happy about having to wait so long his response was “Well, you’re here now.” Arrogance and indifference.

The root canal cost $1600. I did try to shop around and found that this is now the average price of a root canal. Most family dentists won’t do root canals, deferring to those with more expertise. When the endodontist “finished” the root canal he told me I would have to go to my local dentist to have a filling placed in that tooth. So $1600 was not enough to get the job done.

That is bordering on criminal.

I have lost so many teeth I am now looking at another $1500 for a partial denture that will only solve part of my dental problems. I can’t chew hard food and my mouth is constantly irritated because of my poor chewing ability. My bank account is suffering just as much.

Comments | 2

  • I just had the opposite experience

    Ouch. That sounds awful.

    I’d like to introduce you to Windham County Dental… a program for those of us of limited means and insurance. It’s located across from BMH and will be soon expanding and moving a few doors down in the direction of Exit 1.

    I broke a tooth during COVID and lived with it for almost a year. I was obsessively cleaning it after every meal, which was starting to drive me nuts. Finally COVID receded enough for me to make a call.

    I contacted WCD on a Monday morning. They wrote back and said they had a waiting list for new patients, but also that there was an open slot that afternoon if I could make it in. I raced over.

    Very friendly folks. They had me sit in a chair and tell them my woes. I explained the situation and said I didn’t know if I had enough tooth left to put a filling or patch of some sort, or if it should be pulled. It was a lower back molar so if it had to be pulled, I didn’t mind.

    They took an X-ray – of the single tooth (not the entire set) – to save me money and to see what they needed to do. They decided to pull it and would have done it that day but I wasn’t quite ready, so we set an appointment for a couple weeks out.

    When the day came, I went in, they gave me novocaine and started yanking. It wasn’t super pleasant, but it was what I expected, and within 20 minutes the old tooth was out.

    X-rays, analysis, and extraction for about $300.

    What I liked was that they worked with my budget and schedule, and were very professional throughout.

    While I was getting my X-ray, I overheard them working with a young girl from Afghanistan in a neighboring chair. They let her operate the chair controls and hold the suction equipment, and had excellent bedside manner, even helping to make sure mom understood what was going on and what to expect. They played favorite songs an made it fun for the girl. It gave me confidence for my extraction. : )

    Part of the way they save money is that they use almost-graduated dental students. My “dentist” will become a graduate in a month or so. Works out well for all of us… the student gets to practice, and we get up-to-date care at a discount.

    One of the best things, now that it is over, is that I can stop the continually worrying about the back of my mouth. It’s clean, healthy and not a bother anymore. Well worth the effort.

    A note – this was very much in contrast to previous dental visits, where the dentist would insist on doing work I didn’t want done… it would have been easy to pile on all sorts of other work here – full X-rays, meticulous teeth cleaning, checking each tooth individually… but WCD listened to me and did what I wanted. I think folks with insurance get extra care they don’t need. When I had great dental insurance my Boston dentist had me in every few months and was ALWAYS finding something to futz with. Ugh.

  • Windham County Dental Center

    I have also heard great things about this practice. However, I believe they have a VERY long waiting list for new patients–which speaks to how great the need is for the services they provide.

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