Some 4 or so years ago I finally had my last two wisdom teeth removed. The lower two were impacted (crowns facing forward, not up) and I’d been told since I was 18 “When they bother you, have them removed.” Well, they never bothered me enough. Just try to come in a bit more, then stop. Once every year or two. Eventually, on of them started to have decay. Out they came.
Well, about a year ago, seems the tooth that one of the wisdom teeth had been pressing against had gotten some kind of defect in the enamel on the backside where nobody noticed (or the process of removal and nobody noticed) and decay had proceeded “back to front” under a nice crown (put in some many many years ago). OK, it was basically slicing the top off of the roots, so “not repairable”.
Silver Nitrate & Fluoride
As a new procedure had been approved by the California Dental Weenies In Charge Of Gate Keeping, that of applying Silver Nitrate to decay in non-repairable places, my Dentist and I decided to see if it would do any good. I thought that was almost a year ago, but the time stamp on the article is 17 months ago… I think I need to check with my dentist just how much life extension the treatment gave and how much after the article my tooth was treated.
The result of 2 applications of silver nitrate solution and a fluoride varnish seems to have been about a 3 month extension on expected tooth life. Nice for scheduling, not so good for cure… Perhaps a more frequent, quarterly?, schedule would help more in such severe cases. But at least we learned something. Silver Nitrate as a treatment for minor surface defects might well work longer term, for an already significant decay process, not so much. But it does slow things.
Information gained, we now reached the “time to go” point for the tooth. It was starting to show signs of forming an abscess on the root / tooth body interface as the decay reached the pulp and headed down the roots. One interesting sidebar: It didn’t hurt. Perhaps a side effect of the silver. Perhaps the nerve was just shot early and insensate. Whatever. Everyone kept commenting on “You sure that doesn’t hurt?” in a slightly incredulous tone.
It’s the lower left rear molar. #18.
So my dentist doesn’t “do” extractions anymore. He just likes doing repairs. I’m given a referral to have the tooth pulled. That’s it.
The Doctor Of Dental Surgery & Upselling
So I go to my referral appointment to have the tooth pulled. I’m seen by a nurse / dental tech / don’t really know. Nice cute gal in a blue surgical suit. I’m in the chair, and we are talking. After about 10 minutes, I figure out I’m being sold an “implant”. “Did your Dentist talk to you about implants? No? Oh, well, here’s why you want one” kind of stuff. Maybe 20 minutes in, I’ve been told that to properly figure out where the nerve is in the jaw so that I can still taste food and not have a rubber lip the rest of my live, they would really really like to do a “CAT scan”. (Nice little head only sized unit that looks at your teeth.)
Well, I’m all for that, even after being told insurance doesn’t cover it for “just an extraction”, which is all I really need… But I go for it anyway.
KA CHING! $250 out of pocket.
Back in the chair some time later, the continued sell on an implant proceeds. Oh, look at that (on the CAT scan), Dr. Foo will be able to tell if we can do the implant NOW or have to just do a bone graft now and later do the implant. Along the way, I mention that we’ve talked about everything possible other than “What is the Cost?”
More hemming an hawing about well you know everyone is different and it depends on this and that and the other thing and I’ve decided to push it.
“I’m not going to hold you to it, but I need some idea of if we are talking $50, $500 or $5000.” After more beating around the bush, I figure it’s about $2500, all up, if they can do the implant then, and insurance covers the extraction. Maybe.
Dear Dr. Foo comes in, looks at the X-ray / CAT Scan and says need to do a bone graft first, for the implant to work and not hit the nerve. (Never stated, but I suspect, a simple extraction and waiting a year would have the bone recovered more than enough, given how the bone looks where my wisdom teeth had been…) But, what the heck, I just want the damn thing gone and us to “get on with it”, so I suggest we just do the extraction and bone graft, as they suggested, and I get on my way.
Well…. Turns out “Oh, not today, today is just a ‘Consultation’ visit”… meaning today was the Sales Job Day. OK… Would have been nice to know that FIRST, so I’d not brought the spouse along as Designated Driver… BUT, someone else had cancelled, so I got scheduled for the next day…
THEN, and ONLY THEN, I was taken to the quote room and given the papers with the actual estimates for all this.
Frankly, I was very tempted to just cancel the whole thing right there just based on my fundamental rules of:
1) NEVER accept an “upsell”
2) Unless you know the cost FIRST, never set an appointment
3) Negative Surprises mean “Walk away, just walk away”
But this Dear Dr. had been referred by my family dentist who we’ve used for about 30 years+ now and is GREAT. And maybe he ought to have told me this was going to be a sales appointment with selling me an implant… not just a “yank and go”.
Besides, I really needed the tooth dealt with. I’d cancelled one appointment prior to the one with my dentist where “time to go” and been pronounced, and I was pretty sure it was time to go then. Starting over with a new referral and likely the same process was just not interesting. In a week, I’m booked somewhere and it would NOT be a good time for medical procedures. Sigh. OK, let’s just get this step done.
Seems that a “dental implant” consists of several steps, NOT explained to you up front, but metered out piecemeal. Maybe they figure you won’t notice the Salami Technique on your wallet…
The first step was that CAT scan I’d already done – $250 and dental insurance doesn’t cover it.
The second step is the extraction, covered by insurance. Now you might think $50 like it was 20 years ago, or even $75 as it is at regular dentists now. No, this is a “Surgical Extraction”. $345. But the insurance got that.
Next up, I see on my bill for that day, “Consultation Implant” $109. What? I got to PAY for being SOLD? One hopes the insurance covers that. Since they were rather pushy (forceful? demanding?) that payment was DUE SAME DAY, that they didn’t ask me to pay that says they called my insurance and it was covered.
After the extraction, to make the site more suited to an implant, they wanted to do a “bone graft”. Knowing my bones, I’m pretty sure they would fill in on their own in a year. But I figured, may as well get it done. That’s a key area of the jaw in terms of forces and I’d rather have it stronger sooner and without a hole to fill in.
So, on the day of the extraction and bone graft, I’m showing up bright and early. In hand, the “required before we start” payment in full. A bit shy of $1700. (Not including the $345 for the extraction billed to insurance). The bone graft itself runs about $1k (a bit over). That consists of packing some filler (like ground coral?) into the socket space after cleaning out any infection and / or stuff you don’t like. Then there is about $700 for the ‘closure’ and a “bio mat” with “serum growth factors” on it to promote healing / growth. This is via a blood draw and spinning out the cells, so your own “growth factors” are given back on a bit of gauze stuck on the surgical site. (I suspect some may be blended in with the aragonite filler too).
OK, so were up to a bit over $2000 and I’ve had my tooth pulled…
The Actual Implant Costs?…
Now you wait “4 to 6 months” (I’m likely to make it 8 to 12…) for the actual installation of the “implant”. Turns out this isn’t the whole implant. This is a peg on which the actual tooth is installed.
The quote for THAT, breaks down into 3 parts. A “Surgical Implant Body: Endosteal” (procedure) at about $2250, more “Bio Mat” at about $700, and the actual “implant components” at $200. That is, a little titanium peg with threads I think for $200.
Total? About $3000.
So now were up to about $5000, all up. (Really a couple of hundred over, but who’s picky about $Hundreds…)
But Wait, There’s More!
Talking to my dentist afterward, he points out that to build the tooth that actually goes on the peg is much more complicated than just any old cap, and guesses it will be about $1000. (He’s usually about right on his guesses and he doesn’t play games).
Now, note that the “implant” costs are not covered by my insurance. Some dental plans do, many do not.
All up,l we’re now at about $6000 before I actually get to chew anything on that ONE TOOTH.
Looking on line, I found LOTS of places doing the same hem ‘n haw about actual prices. Lots of song and dance, actual $$$ Price not so much. Prices at one site, for California, said this price was bottom quartile to middle of the pack. Some ran up to $25000 (what are they, solid gold?) but that looked to be for a denture that had many teeth stuck onto two implanted posts.
Here’s one such site:
CostHelper > Health & Personal Care > Dentistry & Orthodontics > Dental Implants
Dental Implants Cost
How Much Do Dental Implants Cost?
average cost Single Dental Implant Average Cost: $2,488 high cost Abutment, Implant and Crown Average Cost: $4,263
A dental implant functions as an artificial root to anchor a replacement tooth or teeth. A small titanium post is surgically implanted in the jawbone, and as part of the healing process it bonds with the bone. A metal abutment is connected to the implant, and then a crown, bridge or denture is attached to the abutment. The work is typically done in stages, often with separate prices for the implant surgery, the abutment placement and the replacement tooth or teeth. There may also be a charge for a temporary “flipper” tooth while the jaw heals after surgery.
A single implant typically costs $2,400-$3,000, but can be $4,000-$10,000 or more if additional procedures like extractions, bone grafts, tissue grafts or a sinus lift are needed. CostHelper readers report paying $1,000-$5,000 for an implant with an average cost of $2,488.
Placing an abutment and a dental crown on a single implant typically adds $500-$3,000 to the cost of just the implant, for a total of $1,500-$13,000 or more. CostHelper readers report paying $1,750-$8,270 for an implant, flipper tooth, abutment, crown and all needed procedures, with an average cost of $4,263.
Two to six implants topped with a partial or full-mouth dental bridge can cost $3,500-$30,000 or more, depending on the number of implants, bridge size and materials, and any other needed procedures. CostHelper readers report paying $4,000-$16,000 for a three- or four-tooth bridge on two implants, with an average price of $8,486.
Two to six implants with a removable denture plate can cost $3,500-$30,000 or more depending on the number and type of implants (mini-implants are less expensive), denture materials (in some cases an existing denture plate can be adapted for use with implants) and any other procedures needed. A full set (upper and lower) of implants and dentures can cost $7,000-$90,000 or more. CostHelper readers report paying $3,800-$27,858 for implants with a single denture plate, at an average cost of $14,226; and $6,549-$80,000 for a full set of implant-supported dentures (upper and lower), for an average expense of $34,119.
Dental insurance typically does not cover implants, because most insurance companies categorize implants as cosmetic procedures. However, some surgical costs might be covered by health insurance.
Gee, a range of $1000 to $90,000 listed. I guess that’s helpful… They do list it by how many teeth are involved, so maybe…
Has a couple of interesting comments:
Dental implant cost
Implants fees can range from as low as $1000 to as high $4000. It depends on a variety of factors that can affect the cost of an implant. Patients should choose the clinician that they feel comfortable with. Sometimes the cost can be secondary to a piece of mind. Implants are the best option in dentistry, outside of your natural teeth.
James Magee, DDS
Altamonte Springs Dentist
Well, I’ve been to Altamonte Springs. It is just north of Orlando. I’m going to be there about the time my jaw has finished healing. $1k to $4k sounds a lot better than $4k + to go.
At this point, I’m pretty sure some “shopping around” can save me a couple of $K on the “drill a hole and stick a screw in it”… and likely the “put a tooth on top of that” too.
The same article raises the point of “Tourism Dentistry”. I’m OK with that, too. Heck, I’d be FINE with spending $2k on a vacation and the next $2k on the tooth at the end of it… Note this posting was put up in 2012, last contact was “5 hours ago” and has 4.8 out of 5 “stars”.
June 6th, 2012
Implants in Mexico
Dear patient,MEXICO does not produce any dental materials or implants, everything its imported from germany,USA,switzerland, the implants are FDA approved, probably you might check some dental vacations,based on what you say,you request several of them.there are several options you will find,for implants and prosthetic restorations,each case its different, and we can give you a more specific answers,and diagnosis.
German Arzate, DDS
4.8 out of 5 stars 17 reviews
01800 565 1424
22 yrs experience 1 offer
Last contacted 5 hours ago
OK, I’ve got 1/2 a year to do some more shopping. I’ve got a very well prepared install site that just needs time to finish bone growth / filling in. I’ve got a $4000 price tag in front of me and it doesn’t look that hard to beat. Makes a fella go Hmmmm….
So I’m finding the idea of “Dental Tourism” very very attractive at the moment. I do need to find out if my insurance covers out of country ( I think it covers the $1k actual crown that goes on the peg.) I also need to decide if I really care enough to finish this process. I’ve, maybe, got 10 more years. I figure about 15 tops. That beats my parents by a lot, and it comes up to about what my Grandad was when he died. He worked his whole life on a farm eating “natural organic food” as that was what it all was then ;-) I’m not in anywhere near his shape.
Just what are the real benefits of a decade of that one tooth, really? Is it worth another $4k? I’m not really seeing it… I’d figure at about the $2k point, I’d likely be interested. $1k for sure… Then $1k and 2 weeks on the beach in Mexico… well, he DID say pain killers as needed ;-)
So I posted this just so folks could have some idea what the steps and costs are in getting a single tooth implant in California. Hopefully it will help other folks to avoid having a “yank the tooth” turn out to be a $109 “Consultation” sales opportunity by surprise…
Do I think this Dental Surgeon was unethical? Not really. Just using common “practice building” and sales tactics. He did a great job on the extraction and bone graft. It’s “day two” and my jaw feels fine. Nerves are fine so taste is fine ;-) Needed minor pain killers yesterday, post op, but really could have skipped them. Less pain than a cap, in some ways.
HOWEVER: I do think ALL the sites I visited looking at “San Jose Dental Implant Cost” indicated the same process and that the entire Implant Industry is playing a “hide the cost and up sell” game. That isn’t really “Customer Friendly”. I also think my dentist could have taken a minute to say “Here’s a referral for the extraction. The first meeting is just a ‘consultation’ and they will talk to you about getting an implant. If you just want it pulled, tell them to skip that step and just pull it. Oh, and implants run from about $2k to $8k for one tooth.” Then again, he knows I’m pretty bright and generally research things, so maybe he just figured I didn’t need the prep talk….
With that, I’m open to suggestions on good places to get a peg in my jaw and a tooth put on it… Or places with $4k of Scotch at the bar instead ;-)
Or $4k yielding 5% would give me $200 / year or about one cheap bottle of whiskey a month forever…
I think I could forget about one tooth for that …