# Dental advise



## reccoso (Dec 16, 2010)

*Dental advice*

Hello everyone, I'm a regular user of this message board. I've actually launched my own forum recently as a hobby - it's only really for dental advice - so if any of you have any questions, feel free to post them at:

http://www.smilesavvy.com

Cheers


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## marina628 (Dec 14, 2010)

Looks good where is your practice?I have perfect teeth and have not gone to a dentist in 13 years ,still scarred by a bad experience 34 years ago.If i could pay to get sedated to get my teeth worked on I would lol


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## reccoso (Dec 16, 2010)

marina628 said:


> Looks good where is your practice?I have perfect teeth and have not gone to a dentist in 13 years ,still scarred by a bad experience 34 years ago.If i could pay to get sedated to get my teeth worked on I would lol


Hi Marina, I work in the GTA area in Ontario.

Even if you have perfect teeth, I think it'd be a good idea just to get checked out - plus you're probably overdue to have a thorough cleaning done. 

Speaking of sedation - it's so inexpensive - about a third of my patients are sedated - ranging from laughing gas, to sleeping pills to full blown GA - it all depends on how anxious you are and what's being done.

I see a lot of patients with bad experiences - some of them I still can't believe - like having a dentist put their knees on their chest - don't know how much is fact/fiction. I can tell you though, most of these bad experiences seem to have happened more 10-20 years ago. The most nervous patients seem to be in the 40-50 age range, which says more about the way dentistry was done back then, then about the patients themselves. I think dentistry has become a lot more comfortable now - just have to find the right place and ask the right questions.


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## the-royal-mail (Dec 11, 2009)

Yeah I normally go on word of mouth from close friends (ie. word of mouth or buzz from strangers won't work on me) who actually use a particular dentist, so I can ask questions etc. Although I am quite fearful of dentists (I just had three old silver fillings replaced yesterday) I can say the problem is with me and not with them. They're usually pretty good. No complaints about the dental service I have received through my life.

These days, good teeth are important and I do agree that everyone should at least have a cleaning and x-rays done every 6-9 months. Otherwise your teeth will rot and fall out when you are older. It will be much more uncomfortable dealing with it then, than now. Plus the cost.


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## reccoso (Dec 16, 2010)

the-royal-mail said:


> Yeah I normally go on word of mouth from close friends (ie. word of mouth or buzz from strangers won't work on me) who actually use a particular dentist, so I can ask questions etc. Although I am quite fearful of dentists (I just had three old silver fillings replaced yesterday) I can say the problem is with me and not with them. They're usually pretty good. No complaints about the dental service I have received through my life.
> 
> These days, good teeth are important and I do agree that everyone should at least have a cleaning and x-rays done every 6-9 months. Otherwise your teeth will rot and fall out when you are older. It will be much more uncomfortable dealing with it then, than now. Plus the cost.



You're absolutely right, word of mouth is best. Whatever instills confidence in you in the provider, is the best way get started.

Your last point is accurate as well, people don't realize this, but it's way less expensive to have things addressed when they're small, then when they turn into a much more complex problem. I see people every day with "soft teeth" - the problem is there's no such thing. 

You just have to find someone you trust, someone who will explain things, and someone who can help you along. Btw, you should ask your dentist to give you some light sedation, it always makes the experience a little more comfortable and you can drive home yourself.


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## Jungle (Feb 17, 2010)

One time with my dentist, I negotiated my payment down. I was paying cash.


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## Rico (Jan 27, 2011)

the-royal-mail said:


> Yeah I normally go on word of mouth


If this was the "ban the user above you" thread, I'd ban you for use of a bad pun. Tee hee hee. 

But seriously, my father was very bad about taking care of his teeth since his attitude was "I'll just get dentures". Ugh - he sure was uncomfortable through that process (he was 70-something when he got them) and it just shows how important it is to take could care of the ol' chops.


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## reccoso (Dec 16, 2010)

Jungle said:


> One time with my dentist, I negotiated my payment down. I was paying cash.


That's pretty normal in the US or practices that don't deal with insurance - I wouldn't say you can negotiate in most cases - but some will offer something like a certain percentage off if you pay cash upfront - and that too for big cases.


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## reccoso (Dec 16, 2010)

Rico said:


> If this was the "ban the user above you" thread, I'd ban you for use of a bad pun. Tee hee hee.
> 
> But seriously, my father was very bad about taking care of his teeth since his attitude was "I'll just get dentures". Ugh - he sure was uncomfortable through that process (he was 70-something when he got them) and it just shows how important it is to take could care of the ol' chops.


Dentures are the number one problem treatment for dentists. In fact, many dentist don't even do them any more - not worth the headache. Dentures suck unless they're made with implants supporting them.

Amongst the patients that I see, the ones that care least about their teeth are obviously teenagers, and the ones that care the most are people in the 50+ category - usually those who've already had an issue or two that served as a wake up call.


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## the-royal-mail (Dec 11, 2009)

I must say this is an interesting thread. Thanks reccoso for starting it and participating.

I thought that caring about teeth was a pretty top priority these days. Never knew teenagers didn't care.

I had an implant done in the past couple of years (missing tooth that had to be replaced not due to negligience). They did a good job of it though the surgery was significant. If that can be avoided by better preventative dental work then I'm all for that. I'm considering some sort of whitening process in the future but am concerned that the new tooth won't whiten the same way as my other teeth. Need to look into the whole whitening thing at some point.


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## marina628 (Dec 14, 2010)

We have good insurance ,hubby and kids go twice a year .Maybe when i get my knee operation I can get a dentist to come at same time to clean my teeth lol


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## Jungle (Feb 17, 2010)

Speaking of Dentists on this money forum, check out this recent article on a massive ponzi scheme involving dentists in the GTA:

http://www.thestar.com/news/investigations/article/946896--ponzi-scheme-duped-gta-dentists

Crazy.


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## Kim (Jan 10, 2011)

In the past 5 years I have spent thousands on braces and ortho work. My teeth are much more aesthetically pleasing - thanks to the specialists who did that, but dentists overall give me the creeps. 

I feel that they are only in the business to get your money. The last dentist I went to, "Mr.Macho" was swearing and telling stories about nights on the town to his assistant, while ripping the heck out of my mouth - he was brutal and I really thought about going straight to another dentist as I left that office to document the cuts, bleeding in my mouth. The dentist I had previously seen at that office was nice but had left to go to Vancouver and this was the replacement, I had no idea what I was in for.

The filling he gave me fell out a couple days later. I took aspirin and tylenol till the pain went away ( 3-4 weeks). I don't care if I get 1000 cavities and smile like I did when I was born I am done with dentists.


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## reccoso (Dec 16, 2010)

the-royal-mail said:


> I must say this is an interesting thread. Thanks reccoso for starting it and participating.
> 
> I thought that caring about teeth was a pretty top priority these days. Never knew teenagers didn't care.
> 
> I had an implant done in the past couple of years (missing tooth that had to be replaced not due to negligience). They did a good job of it though the surgery was significant. If that can be avoided by better preventative dental work then I'm all for that. I'm considering some sort of whitening process in the future but am concerned that the new tooth won't whiten the same way as my other teeth. Need to look into the whole whitening thing at some point.


Just a word of advise, whitening will not whiten porcelain, ie your crowns. If it's a back tooth though, you'll barely notice it.


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## reccoso (Dec 16, 2010)

marina628 said:


> We have good insurance ,hubby and kids go twice a year .Maybe when i get my knee operation I can get a dentist to come at same time to clean my teeth lol


I responded to your PM btw. It's funny you mention the knee operation, I used to work as a hospital dentist, and on rare occasions, patients used to actually beg us to work on their teeth while they were getting other surgeries done. I never did it, but I wouldn't write the possibility off. FYI, if you're having knees replaced, you may need antibiotics before any dental appointments.



Jungle said:


> Speaking of Dentists on this money forum, check out this recent article on a massive ponzi scheme involving dentists in the GTA:
> 
> http://www.thestar.com/news/investigations/article/946896--ponzi-scheme-duped-gta-dentists
> 
> Crazy.


I read that, pretty scary. Thankfully, I'm a nothing burger to be the target of any ponzi schemers.



Kim said:


> In the past 5 years I have spent thousands on braces and ortho work. My teeth are much more aesthetically pleasing - thanks to the specialists who did that, but dentists overall give me the creeps.
> 
> I feel that they are only in the business to get your money. The last dentist I went to, "Mr.Macho" was swearing and telling stories about nights on the town to his assistant, while ripping the heck out of my mouth - he was brutal and I really thought about going straight to another dentist as I left that office to document the cuts, bleeding in my mouth. The dentist I had previously seen at that office was nice but had left to go to Vancouver and this was the replacement, I had no idea what I was in for.
> 
> The filling he gave me fell out a couple days later. I took aspirin and tylenol till the pain went away ( 3-4 weeks). I don't care if I get 1000 cavities and smile like I did when I was born I am done with dentists.


I'm sad that you feel that way. You need to understand that most professionals are humans, and the there is a financial incentive. Just like physicians overtreat, and surgeons over-surgerize, so will some dentists. You don't see an OHIP bill, so most people don't care about healthcare costs because they are "free". What you need to do is find somebody you trust, who neither overtreats, nor undertreats. Undertreatment does exist, I've had patients who saw the same dentist for many years with problems overlooked. You depend on the professionals' judgement to decide what is the right amount of treatment. 

Having said that, I also know many people who hate paying a dime for dental treatment. And they tend to fall into the same category as those who over-exaggerate and over-complain about things in general and see a negative motivation in everyone's intentions. 

The day OHIP starts giving people an invoice out the hospital doors, people will realize how on par or cheaper dental care is compared to many medical appointments. I realize dentistry is expensive, but so are many other services that we pay more for that have a much lesser impact on our health and quality of life. What it comes down to is how much you value the service. If you don't see any value in your oral health and dentistry, you'll want to pay that much closer to zero. If you do value your health, you will pay a reasonable amount.


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## Jungle (Feb 17, 2010)

In my teens and early twenties, I neglected my teeth and wound up with too many cavities. Now I really value the service and benefit that dentists and their helpers give to me. I floss and lysterine every day and strive to have a perfect check up. I thank them every time they clean my teeth or fix a problem. I always ask for questions and advice. 

THANK A DENTIST lol


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## Taxsaver (Jun 7, 2009)

Dentists are my heros! Thanks for existing!

I was at the dentist today, and he found out that I have a broken tooth. He will put a crown on it. My group insurance covers 50% of the cost. I will include the non-covered part in my 2010 tax return.

I've had that partial denture for a few years, until I lost it somewhere. I found it again three weeks later, and found out with horror that it no longer fit! My teeth apparently had shifted when I was not wearing them. The denturolog told me I needed a new one. So $1300 wasted! Not covered by my group plan, unfortunately, because the teeth were missing before I got the coverage... A denture should be either in your mouth or in an easy to spot countainer so you don't stress out a whole night looking for it behind the furniture just to discover that it was in your shirt pocket all along...


The dentist told me I may want to have a bridge instead. It would cost me around $10K. It seems that it has to be set up properly, or else you will have problems. It could even cost you a replacement bridge. Would not it be better for me to have artificial teeth (sorry, can't remember the real term) screwed on? I have 5 of them. What would be the cost of that?

I've had dentists with their knee of my chest, but that was in the 70's. He pulling, pulling, pulling... A bit of swearing, and the tooth was finally out!


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## Taxsaver (Jun 7, 2009)

the-royal-mail said:


> I just had three old silver fillings replaced yesterday)


So you invested in silver? How much would it be worth on the market?


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## m3s (Apr 3, 2010)

I always looked after my teeth and once as a teenage a dentist was about to do a bunch of fillings all of a sudden with out asking or anything, it just seemed wrong and I walked out.

Went to another dentist and he said my teeth were perfectly fine, and that he knew of other dentists scamming the insurance system, filling people's mouths with metal for no reason. I also find it odd that 95% of kids nowadays require $$$$ orthodontics

By the way I still have no fillings.. looking after your teeth is the best dental advise I can give


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## cautiousone (Jun 9, 2009)

Thanks for this thread.

My dentist of 25 years recently retired. He performed the scaling and cleaning every nine months. The dentist who's assumed his practice has hired a hygienist who's insisting on quarterly appointments. She's checked to see what my benefits cover and, I guess, wants to take advantage of my utilizing my full annual coverage. 

On my first visit, she told me that my gums were red and awollen. That was news to me and, in fact, was not true; I know because I went for a second opinion.

At the last visit, I asserted that I will, from now on, be coming in only every six months. After some questioning, she reluctantly agreed. 

I realize that it's a business but I'm not feeling that my best interest is always foremost. This hygienist wants to be in control.

On the positive side, she educates more than my previous dentist. I now know the correct technique for my sulcra brush! 

How do hygienists position themselves within the industry? I'm interested in your perspective.


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## the-royal-mail (Dec 11, 2009)

*implants*



Taxsaver said:


> Would not it be better for me to have artificial teeth (sorry, can't remember the real term) screwed on? I have 5 of them. What would be the cost of that?


That's a dental implant. I got one of those a couple of years ago. Cost me about $5000 and my plan paid about $700. That included wisdom teeth removal. You need to see a specialist/dental surgeon to have the implant installed. It's quite a procedure, you need someone to drive you and sit in the office and wait for you and then drive you home after. They put you completely under and then you have a bloody mouth for the rest of the day. Takes a few months to heal, you go back to your dentist to get impressions taken of your mouth, then another specialist makes up a new tooth that your dentist later attaches to the implant added earlier. The whole process took about 6 months, plus the advance time. Most dental plans won't cover this type of major surgery, or they'll only cover a portion of it. So you want to plan out and coordinate your benefits to do the various things in the correct calendar years so you get as much from your plan as possible. I used tier 2 money to pay for this, and most places demand a credit card or cash payment at the time of surgery. No direct billing.

The good thing about an implant is that it is totally permanent, the tooth is matched to your others and you never have to fuss with it again for the rest of your life. It's there for good. Solid.


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## the-royal-mail (Dec 11, 2009)

taxsaver said:


> so you invested in silver? How much would it be worth on the market?


lol!


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## reccoso (Dec 16, 2010)

mode3sour said:


> I always looked after my teeth and once as a teenage a dentist was about to do a bunch of fillings all of a sudden with out asking or anything, it just seemed wrong and I walked out.
> 
> Went to another dentist and he said my teeth were perfectly fine, and that he knew of other dentists scamming the insurance system, filling people's mouths with metal for no reason. I also find it odd that 95% of kids nowadays require $$$$ orthodontics
> 
> By the way I still have no fillings.. looking after your teeth is the best dental advise I can give


Couple of things:
1 - always get a second opinion if you're not sure; and ask the dentist to show you on a monitor what a cavity looks like. Most progressive dentists have a camera that they can see the bigger cavities on. Cavities on your biting surfaces develop like pyramids. The part that you and the dentist see is the tip of the pyramid, they're always bigger as you open that tip up. You rely on experience and judgement to know when to watch it and when to do something about it. Dental school is not a technical school, there's a lot of studies that go into this sort of thing and you have to rely science. Pain or swelling are not a good indicator of a cavity, it usually means its too late for just a filling.

2 - You can show the same tooth to different dentists and some will say it needs a filling and some will say it doesn't. Now they can both be right. You cannot see a cavity on a biting surface on an x-ray unless it's already eaten away at 30-50% of the mineral content of your tooth - by then you're getting awfully close to the nerve and the possibility of a root canal. Someone like me, if I see the top of a tooth, and I see a deep stained groove, I'll clean it up and put a little filling. This tooth can stay like this now for a long time. If there's no staining, despite deep grooves, I'll just keep an eye and inform the patient to brush well. I do fillings day in and out, and it never seizes to amaze me how what seemslike a small cavity turns it a big one once you open it up. This happens mostly in the under 20-30 age category, but can happen at any age.

A lot of old school dentists may not even clean up the stained groove, and that's where you get all the stories of people saying how they always need a root canal or an extraction. All these "keep an eye on" situations eventually blow up. It's a lot easier to be proactive and get fillings, then try to leave things until they hurt or get really bad. All of this assumes good judgement and honesty on the part of the dentist, and good communication to you. I find a LOT of the mistrust that exists is b/c many dentists are often rushed and don't explain things well.

3 - Most kids get ortho b/c parents want straight teeth. Not many people need braces for functional reasons, some do though. But I'd say about 2/3 or more people getting braces get it for esthetic reasons. As a benefit though, straight teeth are less likely to get gum disease cavities around them then crooked teeth due to the elimination of food traps that crowded teeth create. 



cautiousone said:


> Thanks for this thread.
> 
> My dentist of 25 years recently retired. He performed the scaling and cleaning every nine months. The dentist who's assumed his practice has hired a hygienist who's insisting on quarterly appointments. She's checked to see what my benefits cover and, I guess, wants to take advantage of my utilizing my full annual coverage.
> 
> ...


Most dentists don't do the cleanings, they will hire a hygienist. Hygienists should not be the one telling you how often you should come, unless they're reiterating what the dentist said. Hygienists are not allowed to communicate a diagnosis, this is by law - ie they shouldn't be telling you have a cavity or gum disease unless it's been diagnosed by a dentist. As an aside, they get about 1.5 years of college education after high school, while most dentists have about 7-8 years of formal university training.

The frequency issue is pretty straight forward, if you've got good gums and good hygiene, every 9-12 months is sufficient. 
If you don't floss everyday or have the best hygiene or have mild gum disease, it's every 6 months.
Anyone with active gum disease needs to go every 3 months. I'm no just saying this, both my parents are on this regimen. All of this is tempered by how quickly you build up plaque and tartar as well. The more quickly you get it, the more often you should go. 



the-royal-mail said:


> That's a dental implant. I got one of those a couple of years ago. Cost me about $5000 and my plan paid about $700. That included wisdom teeth removal. You need to see a specialist/dental surgeon to have the implant installed. It's quite a procedure, you need someone to drive you and sit in the office and wait for you and then drive you home after. They put you completely under and then you have a bloody mouth for the rest of the day. Takes a few months to heal, you go back to your dentist to get impressions taken of your mouth, then another specialist makes up a new tooth that your dentist later attaches to the implant added earlier. The whole process took about 6 months, plus the advance time. Most dental plans won't cover this type of major surgery, or they'll only cover a portion of it. So you want to plan out and coordinate your benefits to do the various things in the correct calendar years so you get as much from your plan as possible. I used tier 2 money to pay for this, and most places demand a credit card or cash payment at the time of surgery. No direct billing.
> 
> The good thing about an implant is that it is totally permanent, the tooth is matched to your others and you never have to fuss with it again for the rest of your life. It's there for good. Solid.


Just as an FYI, some highly trained general dentists place implants as well. It's often a bit better than an extraction. You don't need to be sedated for it, but it helps. Most insurance plans won't cover any part of it. It's a great option if you're the right candidate. As an aside, a lot of general dentists are becoming highly trained in specific procedures and often you don't need to go to a different doctor to get specific treatments done. It's a case by case issue.

Disclaimer: all of the above is just my opinion, please see a dentist in your locality for specific advice.


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## the-royal-mail (Dec 11, 2009)

Thanks for posting more info!

I wanted to be fully sedated for that surgery. I was terrified just going, so that worked for me. They were on top of their game. They did everything well, were sharp and quick and knew what they were doing. I couldn't stand the missing tooth any longer. My smile is so much better now, judging from photos I can see where I was actually trying to hide the missing tooth in my smile. Now I can laugh and smile properly and no one will see a gap any longer. It was worth the money.

Good teeth are socially important these days. It's not just in hollywood anymore.


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## reccoso (Dec 16, 2010)

the-royal-mail said:


> Thanks for posting more info!
> 
> I wanted to be fully sedated for that surgery. I was terrified just going, so that worked for me. They were on top of their game. They did everything well, were sharp and quick and knew what they were doing. I couldn't stand the missing tooth any longer. My smile is so much better now, judging from photos I can see where I was actually trying to hide the missing tooth in my smile. Now I can laugh and smile properly and no one will see a gap any longer. It was worth the money.
> 
> Good teeth are socially important these days. It's not just in hollywood anymore.


No worries. Btw, I don't know if teeth were ever not important. I think hundreds if not thousands of years ago, they were using tree barks to clean teeth - the primitive tooth brush. And back then, people died from dental infections, thankfully, much of that has been taken care of through modern dentistry.

Btw, I hate to plug this, but I'd love for all of you to go to my website http://smilesavvy.com and ask some questions there. I feel lonely being the only one there 

Also, I'd love for some ideas regarding what most of you are interested about. You all seem like a pretty dentally experienced bunch, it'd be great to hear your ideas.


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## Toronto.gal (Jan 8, 2010)

cautiousone said:


> The dentist who's assumed his practice has hired a hygienist who's insisting on quarterly appointments. She's checked to see what my benefits cover and, I guess, wants to take advantage of my utilizing my full annual coverage.
> 
> On the positive side, she educates more than my previous dentist. I now know the correct technique for my sulcra brush!


By what you have said, yes, it does sound that the 4x a year cleaning routine was being promoted & abused because they knew that if you have coverage, that the insurance company would cover the charges x 4. 

How dentists get around this, is by performing different treatments & hence submitting the claims using different dental procedure codes and of course this is perfectly legitimate for patients who require additional care & many do, but abuse [on the part of dentists & sometimes patients too] results in insurance companies increasing premiums, which makes it difficult for those without non-contributory plans. 

Depending on the insurance plan, *basic cleaning* is eligible every 6 or 9 months, so the 1st claim would be submitted using the codes that would fall under *dental 1 services.* 

The following quarter, the treatment performed would be *periodontal scaling/root planing,* which does not have a visit, but rather, a unit [time] limit per year, this service falls under *dental 2 services.* Essentially the treatment performed is similar as above, except the scaling involves going beneath the gum, but excludes brushing instruction, fluoride treatment, polishing & other services performed only under dental 1, so as far as being educated by the person cleaning your teeth, there is a fee within the dental code procedure for this too! 

3rd quarter they would charge for basic cleaning & 4th quarter for periodontal scaling, for a total of 4 cleanings within 12 months.

Periodontal scaling limits varies with plan, but typically 8/12/16 units per year are common; some years ago this procedure had no limit, but after recognizing the abuse, unit limitations were implemented by insurance companies.

1 unit = 15 minutes, 2 units = 30 minutes and so on [unless the Dental Fee Guide has revised this]. I would imagine that no more than 3/4 units maximum per sitting would be physically tolerable for a patient, but I have heard of dentists charging in excess of 10 units per visit.

4341*1* = 1 unit [perio. scaling lasted 15 minutes].
4341*2* = 2 units [perio. scaling lasted 30 minutes] and so on. Codes get updated/revised, so these may be outdated, but you'll get the idea.

So this is how a person can get reimbursed for 4 cleanings per year by using limits under each of dental 1 and dental 2 & as most plans consider dental 1 & 2 as basic services, reimbursement is usually 100%, hence the usage & abuse.

As far as negotiating payments with dentists, it is pretty standard here too [not just in the US], to give patients without insurance a discount; I believe most give 10%.

I have had 3 dentists all my life and all are/were wonderful; one moved to the US, another retired and my 3rd is close to retirement and don't even want to think about looking for a 4th one. Some time ago when I needed a root canal, I was pleasantly surprised when my dentist called me at home to make sure I was alright, it's nice not just being a number.

Good oral health is not just for beauty, but also for good health as research indicates that poor oral health is connected to some diseases, such as heart disease.  Also, it is said that nice teeth can make you look up to 10 years younger, lol.


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## reccoso (Dec 16, 2010)

Toronto.gal said:


> By what you have said, yes, it does sound that the 4x a year cleaning routine was being promoted & abused because they knew that if you have coverage, that the insurance company would cover the charges x 4.
> 
> Not at all! You've totally misread what I said. It doesn't hurt to get a cleaning more than twice a year, but it's not needed if you have impeccable hygiene.
> 
> ...


aaa


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## the-royal-mail (Dec 11, 2009)

BTW thanks for the link and for creating a website. I took a quick look earlier and will take a little more time to read up on it later on. As I think everyone here is saying, we appreciate what you do to make us look great. Despite all my fear of dentists, I really appreciate what you guys do. My ex was a hygienist and said that some people were bothered by the fear people have and the comments like "I hope not to see you again soon" and such (usually said in a friendly, joking manner) wore some people down. And there usually isn't much time for discussion, so let me use this chance to say 'thanks'.


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## Toronto.gal (Jan 8, 2010)

recosso: if you check my post again, you'll see that I was *not* responding to your post, but that of cautiousone, who said:

*"The dentist who's assumed his practice has hired a hygienist who's insisting on quarterly appointments. She's checked to see what my benefits cover and, I guess, wants to take advantage of my utilizing my full annual coverage. On my first visit, she told me that my gums were red and swollen. That was news to me and, in fact, was not true; I know because I went for a second opinion."* 

Yes, I was describing fraud because of my interpretation of the above statement. I have seen numerous programs, W5 & others, which clearly showed the false & excessive filing of *all* kinds of claims & the problem only gets worse.

My dentist offers 10% discount and I know of at least 2 more that do, so I thought it was pretty standard.


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## Taxsaver (Jun 7, 2009)

the-royal-mail said:


> That's a dental implant. I got one of those a couple of years ago. Cost me about $5000 and my plan paid about $700.


I think I'm gonna wait... These are my teeth ===>


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## cautiousone (Jun 9, 2009)

Thanks so much for providing all the information recosso and Toronto.gal. You've given great perspective.


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## reccoso (Dec 16, 2010)

Toronto.gal said:


> recosso: if you check my post again, you'll see that I was *not* responding to your post, but that of cautiousone, who said:
> 
> *"The dentist who's assumed his practice has hired a hygienist who's insisting on quarterly appointments. She's checked to see what my benefits cover and, I guess, wants to take advantage of my utilizing my full annual coverage. On my first visit, she told me that my gums were red and swollen. That was news to me and, in fact, was not true; I know because I went for a second opinion."*
> 
> Yes, I was describing fraud because of my interpretation of the above statement. I have seen numerous programs, W5 & others, which clearly showed the false & excessive filing of *all* kinds of claims & the problem only gets worse.


And I appreciate that, but I just want to inform others reading of what my opinion is on this issue. The kind of thing that you're describing is pretty rare and may not even be possible in 2011: 1 - b/c those codes don't exist 2 - root planing is not as you described a cleaning below the gums. A regular cleaning involves "debriding" or cleaning both above and below the gums. In certain individuals with advanced gum disease, enough bone and gums have receded that they develop plaque and tarter on their roots - this involves more work to remove b/c it's deeper, more tenacious and more surface area to debride and smooth- thus it's called root planing. An 18 year old getting a root planing is not even possible in 99% of cases (some rare exceptions do exist).

Plus the post that you're responding to was more concerned about the right frequency of check ups, and not how the ins and outs of coding works. These coding games have existed for ever, and exist even in our OHIP system. 

For cautiousone, to ask how often you should get a cleaning is like asking how often you should brush - obviously, the more the better (to a point). It becomes an issue when you have to pay each time to brush, so what you want to figure out is what's the optimum amount - this is something you should discuss with your dentist, and understand why you need to follow a certain regimen. Don't ever let anyone push you to do something you don't understand. As dentists we're trained to diagnose patients and their conditions, not their insurance policies. I present the same options to a plumber and a software millionaire - I let them decide what suits them - I'm just happy they came to see me, and trust me, and I try do the best I can. 

Plus, I want to re-iterate, if you're not sure about how things work, please ask. The vast majority of dental offices would be more than happy to explain how these things work, and if they don't, find another one. This isn't rocket science, or some major conspiracy, it only becomes one once we all start assuming things and come to our own conclusions.

Here's a good explanation of dental insurance by the Ontario Dental Association:
http://oda.on.ca/dental-benefits-explained.html

Btw, I really appreciate the positive tone of this thread and how appreciative many of you are of your dentists. It's great to hear such things. I'm just a young dentist and it's great hearing all the different perspectives. As always, if you have any questions, I'd be more than happy to hear them.


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## Toronto.gal (Jan 8, 2010)

reccoso said:


> Btw, I really appreciate the positive tone of this thread and how appreciative many of you are of your dentists. It's great to hear such things. I'm just a young dentist and it's great hearing all the different perspectives. As always, if you have any questions, I'd be more than happy to hear them.


As I already mentioned, my personal experiences with all my 3 dentists could not have been better & already dreading when my dentist of 15 years will retire. 

You will find that patient loyalty is easy to get, all you need to do is ensure your patients trust and feel comfortable/at ease with you & of course, have soft hands, but you probably already know that! Despite what some say, no one hates dentists, we just hate the pain and noise. 

Nice to have a dentist on board and thanks for the information you have posted.


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## Taxsaver (Jun 7, 2009)

I call dentists and chiropractors my best friends. However I love my friends, none of them can ease the pain that those experts can.


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## cautiousone (Jun 9, 2009)

Recosso: I did not mean to open such a can of worms on this thread!  It IS great to have a dentist on board. I've benefitted from your perspective and I thank you. 

As I said, working with a dental hygienist is new to me. I will discuss my concerns with both this new dentist and the hygienist. I want my relationship with both to be positive.

I wish you all the best with your practice.


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## the-royal-mail (Dec 11, 2009)

Taxsaver said:


> I think I'm gonna wait... These are my teeth ===>


Is that the colour of your skin, too? 

Seriously, if your teeth look like that you don't need an implant. My reason for getting one was because I had a MISSING tooth and didn't want to fuss with cheaper and less convenient methods like partials and bridges. All of these are to replace missing teeth, not needed if your teeth look like our envious smiley friend. 

With my implant, I can now smile like this  instead of this .


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## Taxsaver (Jun 7, 2009)

the-royal-mail said:


> Is that the colour of your skin, too?
> 
> Seriously, if your teeth look like that you don't need an implant. My reason for getting one was because I had a MISSING tooth and didn't want to fuss with cheaper and less convenient methods like partials and bridges. All of these are to replace missing teeth, not needed if your teeth look like our envious smiley friend.
> 
> With my implant, I can now smile like this  instead of this .


Ah, ah!

One implant is not that bad. But when you want 5 of them... 

I'm wearing a partial denture right now because it prevents my teeth from moving any further. I'm missing 5 teeth. I'm wondering if implents would be enough to fix the problem. If so, how many teeth I would need. I will ask my dentist when I see him in a few weeks.


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## reccoso (Dec 16, 2010)

Taxsaver said:


> Ah, ah!
> 
> One implant is not that bad. But when you want 5 of them...
> 
> I'm wearing a partial denture right now because it prevents my teeth from moving any further. I'm missing 5 teeth. I'm wondering if implents would be enough to fix the problem. If so, how many teeth I would need. I will ask my dentist when I see him in a few weeks.


Hi Taxsaver, there's some creative solutions you can come up with too. You can have one or two implants anchor your denture so it's a lot more sturdy and doesn't move around as much. You'd still have to take it out at night though.

If you're missing five teeth in a row, you don't need an implant for each, you may be only need 3 and a bridge on top. You don't need an implant for each missing tooth, unless the missing teeth are all in different isolated areas.


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## Kim (Jan 10, 2011)

If you don't have an implant in the space where your tooth is missing, isn't it true that the jaw bone in that area deteriorates? I was told that by a dentist.


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## reccoso (Dec 16, 2010)

Kim said:


> If you don't have an implant in the space where your tooth is missing, isn't it true that the jaw bone in that area deteriorates? I was told that by a dentist.


Yes that's accurate, but that's reason enough to place an implant in that spot. You have to see what's going on around that space as well.

There's so many people out their who've been wearing dentures for more than 30 years, and many of them literally have paper thin bone, which is a problem should you ever get knocked on the jaw, it also pretty much rules out the possibility of a denture every fitting well or getting implants.


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## Taxsaver (Jun 7, 2009)

I have an appointment with a periodontist next Wednesday. I'm going there just to get an estimate on how much it would cost me to get dental implants. I have 6 missing teeth, all in the upper part of the mouth, 3 on either side. I want the minimum number of implants so I don't have to wear a partial denture anymore. In about 5 years, I would like to have all the other missing teeth replaced with implants. At least, I will have all the information to take a decision. I will let you know.


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## the-royal-mail (Dec 11, 2009)

Taxsaver said:


> I have an appointment with a periodontist next Wednesday. I'm going there just to get an estimate on how much it would cost me to get dental implants. I have 6 missing teeth, all in the upper part of the mouth, 3 on either side. I want the minimum number of implants so I don't have to wear a partial denture anymore. In about 5 years, I would like to have all the other missing teeth replaced with implants. At least, I will have all the information to take a decision. I will let you know.


Congrats on taking the leap. This will be a good use for your tier 2 money. Hopefully they can do all the work in one visit as this type of surgery can be quite a process. Please do keep us posted.


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## chaudi (Sep 10, 2009)

5 implants lot of money. For that much cash i'd consider thailand, india costarica panama etc. Good quality implant is about $1000 or less. 

But i love my dentist in Toronto. Let's see, can you match this:
she makes her own crowns! has the machine, last one cost $1000 total including some fillings.
she makes her own invsil retainers!
she gives me big discounts and does things for free!
she is really a great people person.


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## John_Michaels (Dec 14, 2009)

Chaudi - by "invisil", do you mean she makes her own "Invisalign" (I own the stock ALGN) retainers?




chaudi said:


> 5 implants lot of money. For that much cash i'd consider thailand, india costarica panama etc. Good quality implant is about $1000 or less.
> 
> But i love my dentist in Toronto. Let's see, can you match this:
> she makes her own crowns! has the machine, last one cost $1000 total including some fillings.
> ...


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## chaudi (Sep 10, 2009)

Yes i see your point probably a good investment as long as no bad press comes out. I think the machine is like this,
http://www.essix.com/orstore/default.aspx
So i assume that some could use it to make a series of trays or at least one by one that could move teeth for a patient.


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## Spidey (May 11, 2009)

One thing I've been curious about -- don't know if anyone knows the answer. Do dentists get any kind of referral commission for referring a patient to a specialist? My current dentist, just seems a little too inclined to refer to specialists.


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## reccoso (Dec 16, 2010)

Spidey said:


> One thing I've been curious about -- don't know if anyone knows the answer. Do dentists get any kind of referral commission for referring a patient to a specialist? My current dentist, just seems a little too inclined to refer to specialists.


Absolutely not. It is against our college's rules and may even be illegal. Some dentists don't do many specialty procedures like extractions or root canals or gum surgery etc due to lack of proficiency or if it's beyond their comfort level, esp older dentists, and thus they are more likely to refer procedures out. Even highly trained dentists aren't jack of all trades and will refer out procedures they don't do enough of or aren't equipped to tackle. You should be glad your dentist wants you to get the most specialized care. I do realize that it may be a pain if you have to travel to distances to see the specialist but it may be the best thing for you. Out of curiosity, what have you been referred to specialists for?



Http://smilesavvy.com


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## chaudi (Sep 10, 2009)

If you need a root canal a specialist is better because they use a microscope to find the roots, a dentist might do it for half price but if goes wrong you'll be in pain.


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## Spidey (May 11, 2009)

reccoso said:


> Absolutely not. It is against our college's rules and may even be illegal. Some dentists don't do many specialty procedures like extractions or root canals or gum surgery etc due to lack of proficiency or if it's beyond their comfort level, esp older dentists, and thus they are more likely to refer procedures out. Even highly trained dentists aren't jack of all trades and will refer out procedures they don't do enough of or aren't equipped to tackle. You should be glad your dentist wants you to get the most specialized care. I do realize that it may be a pain if you have to travel to distances to see the specialist but it may be the best thing for you. Out of curiosity, what have you been referred to specialists for?
> 
> 
> Http://smilesavvy.com


Could be I'm being a little too hard on my dentist. I was sent for dental grafting, which as you will know is removing tissue from the roof of the mouth and grafting it onto the gums. I was told that this procedure would be akin to the severity of a root canal. However, it was much, much worse. 

I guess I'm somewhat questioning the need for the procedure as my teeth weren't bothering me. It must be a fairly new procedure as there seems to be fairly little information about it on the internet. What is your opinion of this procedure?


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## reccoso (Dec 16, 2010)

chaudi said:


> If you need a root canal a specialist is better because they use a microscope to find the roots, a dentist might do it for half price but if goes wrong you'll be in pain.


I wouldn't go that for - short term discomfort is not always a good indication of success or failure. The person using the equipment is a lot more important than the equipment they use. I know several dentists with microscopes and have used one myself, I can assure you, it makes little difference if the operator is not up to par.


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## reccoso (Dec 16, 2010)

Spidey said:


> Could be I'm being a little too hard on my dentist. I was sent for dental grafting, which as you will know is removing tissue from the roof of the mouth and grafting it onto the gums. I was told that this procedure would be akin to the severity of a root canal. However, it was much, much worse.
> 
> I guess I'm somewhat questioning the need for the procedure as my teeth weren't bothering me. It must be a fairly new procedure as there seems to be fairly little information about it on the internet. What is your opinion of this procedure?


The type of grafting you're alluding is very often referred out. I'm not exactly sure if you got a bone graft or a gum graft - I'm assuming it was the latter, there two types - a free gingival graft or a subepithelial connective tissue graft. They're not new procedures but they're also not done as routinely as say a filling. I don't know your specific situation, so I can't comment on the benifit or reason, but I assume you've seen two doctors, so you should've been given specific reasons by them for the graft procedure. I do recommend patients to have the procedure done, but in very specific circumstances. 


Http://smilesavvy.com


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## the-royal-mail (Dec 11, 2009)

reccoso, please note there is a signature feature in the forum. It is not necessary to manually copy-paste every time.

1. User CP

2. Edit Signature

Hope that helps.


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