The American consumer is feeling the squeeze in this recession. Families are faced with less income and higher fuel and food prices, and that means fewer discretionary dollars. Family expenses must be scrutinized, and health care costs are included.
I have visited dentists and attended dental conventions all over the world. There is no doubt that dentistry in the US is the best in the world. But nobody claims it’s the cheapest! How can the consumer save money on dental care, without risking sub-standard care? Here are some things you might try!
Utilize teaching institutions for treatment
If you are within a reasonable distance of a dental school, seek treatment there. Treatment by pre-doctoral students averages about 33% of the fees charged by private dentists. Be aware, however, that appointments will be very numerous and very lengthy.
If you live within commuting distance to a college with a dental hygiene program, you may get cleanings and x-rays done at an extremely low price. If you do this, it is always wise to see a regular dentist once a year. While hygiene schools give great cleanings, they sometimes miss decay. Thus, it is prudent to alternate visits between a private dentist and a dental hygiene school. Most hygiene schools forward copies of x-rays to the dentist of your choice.
Choose dentists by reputation, not by advertisement
Anyone can say nearly anything in a yellow pages, radio, or television advertisement. You will find guys that utilize these techniques have high patient turnover rates- for good reason! As with any other professional, choose an individual that has demonstrated honesty and high personal ethics in your community.
Should you start with dentists on some “preferred” insurance list? Probably not, as they often make up the difference in fees by charging for things that are usually included free with a visit. Merely signing up to be a PPO provider involves ethical compromise, as one must agree to charge different groups of patients different fees for the same procedures.
Go easy on the cosmetic dentistry
Have back teeth filled with silver amalgam, instead of resin or porcelain. Not only is silver amalgam safe and less expensive to start with, it lasts far longer than white plastic for back teeth. Silver amalgam has the lowest cost-per-year-of-life than any other filling material. If your dentist has quit using silver amalgam, you need to change dentists!
Smile makeovers can be done more economically with orthodontics than with veneers and crowns. Traditional stainless steel brackets are cheaper and more trouble-free than white brackets. Clear aligner orthodontics is very much more expensive!
Remember that the more aggressive cosmetic treatments that require cutting down teeth also have higher maintenance costs throughout life.
When contemplating tooth bleaching, remember that there is no difference in final result between bleaching teeth by wearing a tray at night, and having it done at the dental office. In-office bleaching is at least twice as expensive, and often creates more sensitivity! By waiting for whiter teeth a few weeks, you may save quite a bit of money.
Whatever you do, avoid practicioners who advertise themselves as “cosmetic dentists.” There is no such recognized specialty, despite public perception. Every general dentist does cosmetic dentistry. You can be certain that self-proclaimed “cosmetic dentists” will recommend significantly more expensive treatment plans!
Take the insurance burden off the dentist, and save!
Consumers can’t imagine the hassle dental offices deal with in getting insurance claims filed and paid. Often a patient can negociate a better fee by offering to pay the dentist up front, then personally filing the claim and being reimbursed. A good idea is to send claims registered mail, to make sure the insurance company can’t say they “lost” the insurance claim! Expect discounts from dentists of 5-10% when you are willing to do this.
Dental insurance is an inefficient way of paying for dental treatment, as administration typically eats 30-35% of every premium dollar. Far better to finance dental care through Health Savings, Cafeteria, of Flex-spending accounts.
Offer to barter for services– If you have any sort of useful skill, perhaps you can barter with the dentist dollar-for dollar. I have traded dentistry for cabinet work, yard work, piano tuning, painting, and roofing, to name a few. Everybody wins in barter!
Don’t use cards to pay.
Dentists pay 2% and more for processing credit card transactions. You are not as likely to receive a prepayment discount if you use a credit card.
Choose less complicated procedures, rather than shopping for the lowest price on a procedure.
Patients often call my office, shopping for the best price on a particular procedure, like a porcelain crown. I understand what they are trying to do, and emphasize with them. However, it is better to seek cheaper procedures. Seeking the cheapest price on a procedure usually means finding someone who takes shortcuts on procedures.
For instance, rather than a porcelain crown on a back tooth, the patient might be satisfied with a crown made out of a non-precious metal like chromium-cobalt, which is more durable anyway. Or to save even more, a large silver filling buildup could be done.
Find a general dentist who does most specialty work
Treatment by specialists is nearly always more expensive, and entails additional drive time. Find a dentist who does most specialty work- root canals, implants, orthodontics, and wisdom tooth extractions in-house. While relatively rarer, such dentists do exist, and usually offer fees 10-30% lower than specialists. They tend to be middle age and older, and are more typically male.
Kim Henry, D.M.D.
October 13, 2008