#16
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Yes, sort of like the stories I heard about people driving south getting stopped for speeding. The Justice of the Peace would fine them exactly how much cash they had in their wallet.
Guess the threat of a chain gang was pretty effective. |
#17
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I tried an implant. I had it for a year, then it failed. $6000 out the window. I had it replaced with a bridge about 10 years ago. Still going strong. I understand that most implants are successful, but I won't place another $6k bet. I think your concern about a permanent bridge might be weighing heavier than it should.
Another consideration: implants are more of a pain to maintain. You have to wrap the floss around the stem of the implant to clear debris. With a bridge you just slide a piece of super floss under it and clean the adjoining teeth. PS: I call it my $10k tooth. First the root canal and crown - $1500. Then, the extraction and implant - $6000. Finally, the bridge: $2500. Ouch. |
#18
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To answer your question, "How is it that serious dental problems aren't medical?" The answer? Because the insurance company says so. I despise insurance companies. We've allowed them to become wayyyyy too powerful. |
#19
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#20
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$10K to perform root canals and crown 8 teeth. Done out of pocket. Three years later, lost 3 crowns and one molar has one broken post. Another has its posts freed form the bone and wants to rise out of the gum. Two of the three lost were re-cemented but separated 3 months later. I have them in a baggy.
Now, this is not unusual, I'm told, to lose crowns 3-5 years from date of completion. What am I doing about it all? Nothing. I'm 63. The remaining teeth are doing a fine job of mastication so I'll tough it out to the end. |
#21
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Nothing wrong with a good bridge. Implants on the other hand have lots of potential issues. Bone grafts won’t take, screws come loose, low grade infection that eventually leads to the whole thing having to be surgically removed, etc. I know lots of people whose implants went bad. The more expensive option isn’t necessarily the best.
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#22
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i dont know, my wife just paid $3500 for for bridge,cap, whatever it is, i had a root canal done once and that junk, it rotted out anyway- got disgusted and didnt want to pay anymore, i had decent insurance and told the dentist rip em out and throw in some dentures, $400 bucks, never looked back and never regretted it
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Fender GDC 200 S Telecaster-(build) Squier 51 Fender Strat Partscaster Ibanez SR400 EQM bass |
#23
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I've been reading this thread over the last couple of weeks, wondering if I should respond (I'm a dentist after all). And I figure I can shed a little bit of light on the subject.
Failures First, every dentist I know hates failure. We are trained to believe that we can fix things. We worked hard to get that degree, we persevered and failure? Well, 'they' never told us that it would happen every day. If you chew enough times, exert too much force, or damage your teeth by neglect, everything will ultimately fail. It's tough defining success. Is it five years? Ten? A lifetime? And can it be guaranteed? Bottom line, your mileage will vary; we do our best to patch you up. Generally what fails is not the dentistry, it's the underlying tooth or bone. Your tooth is at its strongest when it first erupts from age 6-12. But the minute the tooth is damaged by a cavity, by a popcorn kernel, etc, it loses probably 50% of its strength. I use this analogy a lot in my practice: teeth are like trees. They look perfectly solid until one day you are shocked to see the trunk split in two or a branch on the ground. When you look closely, you find that a defect was present where the break occurred. One of my patients, a luthier, liked this explanation: it's all short-grain! It's pretty hard work. A fair number of dentists leave the field early because they can't take the stress. BTW, we know you are stressed and most of us do everything we can to make you more comfortable, but it can be pretty hard to achieve! Fees Most of us try to be fair in what we charge. This varies, of course. Dentists are graduating with $300,000 debts these days (from eight years plus of school). Our overhead is high - about 65%. And our income is limited by how much work we can do in a day - there is a limit. Granted, I do OK, but at age 64, I am still a few years from retirement, gotta pay for a new roof, painting the house, and a wedding next year (and my wife doesn't think I need another guitar). So I am still working at full tilt. And, I can't delegate my work - it's you and me bud! I suspect that if I was really rolling in the dough, I would have already retired and I'd be traveling around the country to guitar shows! I discount a lot of my care. Many of my patients are on a fixed income and they don't have that much extra. I have known many of these folks for all 39 years of my career (and they saw my Dad and\or Grandfather before that). I give out free care too, but I don't shout it from the rooftop. I am not alone as far as that goes - maybe we should be shouting about it. There are ways to phase your treatment and spread out the expense. We inherently know that patching things up is not a real fix and that it costs some $$ to do the job right. Coverage The government has never wanted to incorporate dentistry into Medicare, so care for seniors is ofttimes deficient. Yet, if you are unable to eat your food because of missing or painful teeth, your health will probably suffer. Lots of studies highlight this connection, but our healthcare system is oriented more towards payments and profit than it is healthcare. (Let's leave this topic alone please) Implants Implants have come a long way - they are not perfect, but they have a high success rate. And they don't decay. In a mechanical sense, they simplify the system because they are independent of the other teeth. Our old line treatments of bridges and dentures still work, but they are dependent on other structures for their support. There's always a weak link in the chain. I am happy to have them in the toolbox. Some more observations after all of these years: - Folks under the age of 50 have far better teeth than those over 50. Fluoride has made their teeth harder, braces equalize the forces on the teeth (decreased breakage over time) and most have not smoked. - We try very hard to save teeth, whereas in the old days, we'd just shuck 'em out. - Dental tourism (ie. to Mexico) is nothing new. It has never caught on and there must be some good reasons for it; the greatest likely being, you have no recourse when things don't work out. - Some people take very good care of their teeth and some don't. Guess who we have better luck treating? If you humidify your guitar, you should be brushing and flossing regularly. - If you flossed your teeth every day (or cleaned in between) and brushed twice a day, you would be almost trouble free. - If you do not crunch ice, crack open pistachio nuts, drink soda (essentially bathing the teeth in phosphoric, citric and malic acid) throughout the day, or smoke, you will have much better teeth. - Our Western diet and our constant nibbling has led to many of our tooth problems in the US. - Don't hold your guitar pick with your teeth and don't use your teeth to strip wire. Quite a diatribe on my part. i hope you all find a good doc who communicates well, is gentle and kind. They're out there, sometimes you just have to search a little more. best, Rick PS - I have multiple crowns and root canals. I likely will need two or three implants before I leave this earth, so I've been there and done that. Even though my Dad was a dentist, I loved my sweets and failed to brush well or regularly until the age of 22 when I entered dental school. I also grew up without fluoride in the water.
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#24
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Great perspectives, Rick. I have a whole bunch of tales as a patient--I'm 67 now.
My family dentist also did my orthodontia when I was entering my teens, and it was not a success. I was horribly noncompliant about wearing my rubber bands, because they'd snap off (often as projectiles) at inopportune moments, hurt like hell all the time, and the appliances kept breaking: wires, brackets loosening, bands falling off, etc. Had my braces removed at 20--a week before my wedding. Had some dental work done in the early '70s at the U.of WA dental school across the street from our grad student housing in Seattle. Nobody had ever taught me how to floss before that, not even that I should! I had four crowns, three of which are still in my mouth (the fourth was on a bicuspid that had to be pulled in 1979 after we moved to Chicago because of crowding issues as part of Orthodontia Part Deux preparatory to maxillofacial repositioning that never happened). The porcelain is chipping off one, but the gold is intact. Those crowns are >40 yrs. old. Great dental schools do great dental work--the supervision is strict and the students are the top of the heap. So about that thwarted surgery: we were all set, impressions were taken, calendars cleared. Then my HMO called: they would pay for oral/maxillofacial surgery only if reconstructive after trauma or disease. Not just that: if I were to suffer any side effects or complications, they wouldn't be covered because whatever caused them wasn't. We reluctantly had to cancel the surgery, and after a year of wearing a retainer my teeth slowly "relapsed." Now, about those implants, or Round 3 of orthodontia--how I wish I could have them! We can afford them now, even though my Medicare PartB supplement carrier says no dice. BUT I have osteopenia, diagnosed even before starting aromatase inhibitor (anti-estrogen) therapy to keep my breast cancer from recurring. I can't tolerate oral bone drugs, so I get Prolia shots. But there's a possible side effect: osteonecrosis of the jaw, aka ONJ. It's extremely rare for it to develop spontaneously on Prolia, but anything that involves exposing or stressing dental bone (whether extractions, implants, orthodontia or losing a tooth due to trauma) can increase the chances exponentially. I am not even supposed to gnaw on a rib bone, eat corn on the cob or even an apple except if I first cut it up. I get cleanings 4x/yr now, and my dentist is extremely careful to monitor me for signs of incipient ONJ. I see those Invisalign commercials and then look at my slowly splaying upper incisors and simply sigh. My smile may not be gorgeous, but it least it's healthy...for now. About insurers not considering dental problems to be medical--I used to be an IL Asst. Atty. Gen. in the Welfare Litigation Division. Our state's Medicaid at the time would not cover preventive dental treatment (such as cleanings) or even drilling & filling cavities. It would cover extractions of diseased or abscessed teeth, but not bridgework. It also would not cover eyeglasses (it does now) or hearing aids. Before I transferred to a trial division, General Assistance for the young, childless and nominally able-bodied was discontinued except for a temporary 3-month period during which the recipient had to prove he was looking for work, and at the end of the 3 months, if he hadn't found a job, he was up the creek. We--who could not write the regs, only represent Public Aid when they applied them--used to shake our heads and wonder: how is one supposed to find a job when they're toothless, bumping into walls, and can barely hear?
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Sandy http://www.sandyandina.com ------------------------- Gramann Rapahannock, 7 Taylors, 4 Martins, 2 Gibsons, 2 V-A, Larrivee Parlour, Gretsch Way Out West, Fender P-J Bass & Mustang, Danelectro U2, Peavey fretless bass, 8 dulcimers, 2 autoharps, 2 banjos, 2 mandolins, 3 ukes I cried because I had no shoes.....but then I realized I won’t get blisters. |
#25
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I have to chuckle at the countless AGF threads we generate about string tension, tonewoods, and bracing, when there are so many who need so much more. ---- Quote:
I'm still traumatized from it - 39 years later. Quote:
Ugh - this is not healthcare. Quote:
(Let's call it authentic!) Quote:
Connecticut had a similar schtick (on children no less) - they would pay for the fillings, but not the fluoride because the kids would get cavities anyway. Quote:
My wife was getting a root canal several weeks ago and while I was waiting, I had the joy (?) of listening to Christie Brinkley talk (on the Today Show) about her beauty secrets at age 63 - It's so easy, I don't know how you've missed it!!! Well, today at 11:00, I am going to team up with another doc as we attempt to save some teeth. In this case, this fellow's bone tends to melt away without any warning leaving his implants hanging by a thread. I'm sure that in another 30 years, these issues will be ancient history, but for now, we have to try and save this one. As I said in the prior post, "We hate failure!" Good luck on your dental journey - and come to think of it, maybe the SCGC medium strings do sound a little brighter than the Straight-up Strings...
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