Question:
I am a long time lurker in this newsgroup. About 7 months ago, I had
a Maryland bridge come loose from my upper front tooth (#9), and my
dentist suggested an implant. I have been with my Dentist for two
years, and I do not have dental insurance (I understand from reading
in this group, it wouldn't help much with an implant anyways) .
I thought about it a bit, read up on the net about it (lots of great
sites out there on it), and talked to my dentist about the procedure
and costs. At the time I was told it would be about $500 to remove
the bridge, and make a "flippy" tooth with a retainer on it (I have
already paid for this), and then it would cost about $500 to later on
crown it. I was quoted $700 for a new bridge. I agreed to the implant
thinking it is a more of a long term fix.
I am referred to an Oral Surgeon, who does the actual implant, I pay a
total of $1950 for this portion of it. I paid in full even before the
actual surgery. Surgery went well, didn't hurt more than a filling.
Now six months later:
I just had the abutment screwed into the implant, and I went in today
to see my dentist to have my flipper tooth adjusted after the
abutment. In two weeks (need time for gums to heal up), I am to have
the impressions for the crown, and I ask for the amount that I am to
be charged for this and the next two visits. I am presented with an
invoice of $1200 for the crown. I ask why the high cost, and I am
told that it is because the crown is a special Titanium crown. I have
paid $400 of this bill without putting up too much of a fuss - at the
time I really didn't want to argue with my dentist while I am having
this procedure done. How should I deal with this situation? Should I
seek out a different dentist, and get everything in writing? Are
these costs reasonable? Hans should I fly to Sweden for my dental
work?
Answer:
Well within ballpark. I know my restorative for an anterior crown cost alone
me ~$600-700.00. This includes parts and lab costs only.
Parts:
1.anterior abutment~ $150-200,
2.impression coping ~$20,
3.gold hex screw ~$50,
4.lab analog ~$20-25,
5.polishing protector ~$15,
Lab costs:
1.final crown ~$250-350,
2.provisional crown and parts ~$100 to develop soft tissue contours once
implant is uncovered (usually very important in the anterior corridor).
This does not include office time and overhead. However if planned and
performed well, a single tooth implant should outlast both aesthetically and
functionally your MD bridge.
A couple thoughts. Was any thought given to using your failing MD. Bridge as
the provisional during the integration time? Was costs and treatment sequence
discussed in advance? Implants can be confusing to a patient because it often
involves multiple appointments over a long period of time in different offices.
I find a flow sheet with proposed appointments helps patients understand the
timing and procedures involved.
I should have asked a few more questions in the begining of the
procedure. I got a bit of "sticker shock" with the last bill. Your
advise did help reassure me about this.
Well, I didn't ask about using the failing bridge and my dentist did
not bring it up. The MD was ten years old (Uncle Sam put it in while
I was in the Air Force), and I did have a small amount of decay behind
the bridge. Also, the color no longer matched (I guess I am getting
older. I do floss my teeth daily, and the biggest reason I opted for
the implant was that it should be easier to floss. I lost the tooth
as an injury when I was 15, so I have been wearing flippy tooths, and
later the MD for over 15 years.
A flow sheet like you mentioned would be helpful - next time I need a
major procedure done (hopefully not for many years) I will take more
time up front and discuss it in more detail.
I have about another month before I get the crown done.
I did ask my Oral Sugeon "can the crown that is screwed into the
implant be replaced -ie if it needs replacement" He said that "it is
tricky" How does one unscrew a tooth that is cemented into an
implant? Not that I want a diamond studded tooth put in later :-)
