State of Decay

[lorin]

Recently I have been going through a lot of dental work. 99% of it is due to stress related fractures in my jaw. I am one of the fortunate ones that have a small dental insurance policy that pays 'some' of the cost but my out of pocket so far this year is 15 grand. The policy does cover regular maintenance and things like fillings and extractions up to 2000.00 a year so I am fortunate. But most of the world does not have insurance. Adult teeth are not covered in Obamacare, nor in many state medicaid plans. There is some coverage in Medicare but mostly just for extraction.

www.cnn.com/2013/10/08/health/dental-he ... -coverage/

As with physicians, the number of practicing dentists that accept clinic (medicaid) level patients is very low. Dentists do not feel they are offered a livable wage for their work. One solution is that some states, Minnesota and Alaska have increased the amount of clinics throughout the state that are manned by licensed Dental Therapists, the equivalent of a Physicians Assistant, to address routine dental issues in rural areas. Of course the ADA has come out against this policy.

www.usatoday.com/story/news/nation/2014 ... s/7422773/

I'm interested to know how other countries integrate dental care into their health care.

[aliantha]

I'd like to know this, too. I've shelled out several thousand dollars over the past few years to fix Batty's teeth. Insurance helped, but only minimally (and now that she's 27, she has none). Thank goodness I had the money in my 401(k) to cover it -- I have no idea what people without that sort of backstop do.

[rdhopeca]

My company provides amazing health insurance, including dental care, but I've never had any major work done so I'm not sure what would happen in that case. But all my routine stuff is pretty much fully covered, including fillings.

[Hashi Lebwohl]

I have no idea what people without that sort of backstop do.

They find a way to deal with the pain until they can have some extractions and partials put in place, presuming they don't have to go with full sets or the new implants.

I don't like talking about teeth and needing work done for personal reasons, which is another way of saying that I still need to have some serious work done.

[ussusimiel]

Dental care is always expensive and never seems to be adequately covered. In Ireland it is outrageous, so a recent trend has been for people either to go up to Northern Ireland, where the cost is at least a third (if not half the price) or else to go on 'dental tours' to eastern Europe. People combine a holiday with getting their dental work done in cities like Budapest. Personally it sounds like an awful way to see a city, but I have heard good stories about it.

u.

[Avatar]

Just depends on your medical aid here if you have one. If you don't, it's cash or the waiting list at the government hospital (or dental school if you're desperate).

--A

[SoulBiter]

I'd like to know this, too. I've shelled out several thousand dollars over the past few years to fix Batty's teeth. Insurance helped, but only minimally (and now that she's 27, she has none). Thank goodness I had the money in my 401(k) to cover it -- I have no idea what people without that sort of backstop do.

Glad you were able to take care of that. Keeping up with bi-yearly dental cleanings/checkups and the basics of tooth brushing and flossing at least twice a day are key to keeping costs down. I hate it when they find something at the dentist because even after insurance, the balance of the costs are high.

This is how my wife and I deal with that. We pay cash from savings. Eight years ago my wife and I decided to get totally out of debt, stop using credit cards, put together a real budget and stop living outside our means. It took a couple of years of scrimping but we went from always living paycheck to paycheck and broke, to having money and paying cash for everything. As part of that we have 8 to 12 months of expenses in savings. When we have an emergency, we dip into that savings account. When we dip in, we go back into refilling it. By doing so we don't have to use credit or dip into our retirement savings to offset costs.

Before we did that, we used to do exactly what you did. Dip into our 401K's or use credit cards to pay for unexpected events. If you aren't retired, that's the worst way to get cash for these things. You lose out on the compound interest on that money which can cost thousands if not tens of thousands of dollars when you retire.

[aliantha]

Congrats to you and your wife for managing that, SB.

[Ananda]

We have to pay for our own dental care here. We do have things in place like annual caps and subsidies, though, to keep the expense from going too high.

SB, my husband and I do about the same. We don't use credit cards and just buy things for which we have the money.

[SoulBiter]

SB, my husband and I do about the same. We don't use credit cards and just buy things for which we have the money.

Awesome!!!

We have to dip heavily into our savings between now and next year. We have two air conditioners in our house and both are 20+ years old and in dire need of replacing. We live in an area that it would be very difficult to not have AC. But since we know this ahead of time, we have time to get some estimates and get the best rate/deal. The worst time to buy an AC unit is in the middle of summer when it dies... cause then you are like "I don't care what it costs, we just need cool air!!!"

[Zarathustra]

Tooth pain is some of the worst kind of pain. Prior to my root canal, the pain was so bad I couldn't sleep. It was expensive. That's one instance when our high deductible really sucked.

My parents were very uninformed about health issues. My mother thought that flouride caused cancer, so I wasn't allowed to use it growing up. As a consequence, all my molars have fillings. But getting them all filled was such a traumatic experience as a kid, I made damn sure I took care of my teeth after that. Now my dentist tells me I have really good teeth, despite those ugly metal fillings. (They're old enough now that I've had many replaced with the new style white fillings. You can't even tell.)

But we make sure that our kids have their bi-yearly cleanings, and that they brush/floss at least twice a day. I don't want them to go through what I went through.

On those stress fractures that Lorin mentioned ... my dentist thinks my root canal was necessary due to me grinding my teeth at night. If you're a tooth grinder, do yourself a favor and get a mouth guard for sleeping. You do NOT want a root canal. In case you don't know what this is, they grind away most of the exposed tooth, and then drill down through the roots to take out all the nerves, killing the tooth. Then they insert a support system and attach a crown. It's one of the most horrific things I've had to experience. I think I'd rather be water-boarded.

[lorin]

On those stress fractures that Lorin mentioned ... my dentist thinks my root canal was necessary due to me grinding my teeth at night. If you're a tooth grinder, do yourself a favor and get a mouth guard for sleeping. You do NOT want a root canal. In case you don't know what this is, they grind away most of the exposed tooth, and then drill down through the roots to take out all the nerves, killing the tooth. Then they insert a support system and attach a crown. It's one of the most horrific things I've had to experience. I think I'd rather be water-boarded.

I have 6 root canals and posts already. My mother, like yours, never allowed fluoride. I didn't really have much trouble with the root canals. I just tell the dentist (endodontist?) to numb everything from the neck up and when they think there is enough novocaine, then double it.

My dentists keep giving me mouth guards but somehow I keep taking them out at night. I don't remember taking them out but I do. I think it has something to do with the other gift my job gave me, a broken nose, well something is broken in there thanks to a swing from an angry client in 98. My breathing is too obstructed with the mouth guard and the self preservation takes over in my sleep. Anyway Im about to get it all fixed. Can't wait

I remember my mother telling me me that as a child there was no such thing as novocaine. She used to go to the dentist for a filling and the dentist had a pedal operated drill. I used to ask her how she dealt with the pain. She just said "what choice did I have? I dealt with it."

[SoulBiter]

Like Lorin, I have a mouth full of root canals and crowns. I grew up on "well water" which of course has no flouride, and we didn't have anything like insurance. When I got my first real job with insurance, I had them all fixed. After getting these done, you MUST get regular dental checkups. Since they killed the nerves, you can have a major cavity develop and not know (because no pain) it until too late to save whats left. So the X-rays will show when you are developing any issues under the crown, above the gum-line.

I also grind my teeth at night and have to wear a bruxism guard. One other thing, if you have crowns, bridges, etc etc... the porcelain is stronger than your regular teeth and your real teeth don't stand a chance when you grind them against porcelain at night.

[aliantha]

I've got my share of crowns and root canals, too.

I wonder why dental coverage isn't more widespread. Tooth problems can create overall health issues, and vice versa. Yet we have this two-tier system -- for both this and mental health (which is a whole 'nother can o' worms). They all ought to be covered under the same insurance plan.

[SoulBiter]

Agreed Ali. And its changed a lot over the years. When I had most of mine fixed (about 1986) it was 80% covered. Now I'm lucky if anything except preventive is 40% covered.