Tuesday, December 16, 2008

Why Is Dentistry So Expensive?

Many people are shocked by the cost of dentistry, especially if they need extensive work done. There are many reasons why it costs so much. First, dental school is expensive. The tuition alone for USC Dental School, for example, is $65,000 per year, and that's for three years. And before your first meal or your first book.

The dental office also requires much more equipment than the average medical office. X-ray machines, special chairs, a variety of handpieces, and then water, vacuum (for suction), electricity, computer cables and sometimes nitrous oxide all have to be set up for each room and each chair. The cabinetry is very involved, and then each dentist's office requires a lab and a sterilization area. And that's just a basic office. Many offices have a variety of new technologies to make your dental experience go better and faster and to improve the quality of the dentistry done.

But most of all, the goal of dentistry is to restore your mouth to its optimum level, which means straight, healthy teeth and gums. Dentists deal with a combination of both extremely soft tissue (gums) and the hardest bone in the body, tooth enamel. Imagine how challenging that is. And they need to be very precise in how they repair teeth, dealing in fractions of a millimeter, so that there will be no openings that allow the tooth to decay below the crown, for example.

Think of how much teeth have to endure. The jaw muscles are extremely powerful, and put tremendous pressure on the teeth from multiple angles. This means whatever a dentist does has to be stong and last a long time. There are few things in life that you could repair that would last twenty years or longer, but dentists do that kind of work every day.

Lastly, dentistry seems expensive because even if you have dental insurance, it doesn't really cover much most of the time. It's designed to cover basic care, and the insurance companies are very slow to add new treatments and procedures that they will cover, even if they are found to improve the patient's health. So many times the patient is the one making up the difference in cost in order to get the kind of dentistry that lasts.

And no matter what you'll be doing twenty years from now, I guarantee you'll be eating. And you'll no doubt want to do it with your own teeth. So if it seems expensive, think about the other things that you spend money on. Do they give you a twenty year value? Will you still be using them every day during those 20 years? So in the end, taking care of your teeth is an extremely good value. It may seem expensive, but for the use you get out of your teeth, and the lasting quality of good dentistry, it's probably more than worth the money. In, fact, I think it's one of the best investments you can make.


purpletiger said...

Yes, dentistry is so expensive that some middle income and the wealthy can afford to keep their teeth healthy these days. I live in America and at 57 years old, I can't afford to get my teeth crowned or root canals done to the point that I’ve lost 5 teeth in 3 years. These are front and back teeth and am about to lose the 6th and 7th teeth in the back and won’t be able to chew my food on either side. I’m being told that dentures are my best bet because they’re cheaper then crowns and root canals, however, this only covers my upper jaw (approx. $800.00+) – what about the lower jaw? And how do we complain about the shoddy work that dentists do, which is true in my situation and how do I come up with more money to fix those mistakes? I didn't set how much money it cost to be a dentist, why should people on disability, social security or who can't get any more credit all have to suffer without teeth? Where are the dentists that have been in practice for over 15 years, isn't that enough time to pay back all loans? When will more of them be ready to take Medicaid or give 30% or more in discounts? And people can not regulate what the insurance companies pay for. As Americans, we take pride in stepping forward to help other Americans who have less, so what's it going to take to have more dentists and specialists such as endodontics, step forward and help out?

Jerry said...

I understand about the cost of school
and the cost of equipment and running a dental office.Insurance is part of the problem. They have forced the rates up and do not want to pay the increase.

Some dentists will not pull teeth and will farm out the patients.
Some dentists will not take payments.Some dentists are selective on the insurance they will accept.

There needs to be some laws to make dentistry more cost worthy
to all patients who need it.

I am forced to get dentures because of the failure or unwilling attitude of dentistry
to change so all can get good care.

different kids said...

Both my boyfriend and I are 2 years short of Medicare and don't qualify for Medicaid and neither has dental insurance anyway. We're in the same boat as the woman from 1/19 except that he hasn't lost teeth yet. I have an upper denture. Why isn't there someplace with a sliding scale or something like that, like NYU School of Dentistry but with a sliding scale of fees instead of fixed fees?

Fred Joyal said...

It is difficult to find high quality dentistry at a low cost. The reality is that dentistry is not regarded as normal health care (which is why health insurance doesn't cover it), so it's much more like a commodity in that you get what you pay for.

Dental schools are one way to go, but obviously the dentists are still learning and the institution does not exist primarily to offer low cost dental care, but to educate. They treat patients, usually at a fixed low cost, because they need to have the students practice on real teeth.

Getting dentists to donate their time is really a personal issue. I know many dentists who do discount their work in extreme cases, but they don't make a regular thing out of it or people would assume that their dentistry is free, just like a county hospital. No one is giving the dentist any money to treat the underprivileged, so it's up to him what level of generosity he's willing to go to. Just like the rest of Americans, some are generous, and some are not. But it's not likely that anyone is ever going to require dentists to do a lot of "pro bono" dentistry.

There are clinics in most areas that offer low cost dentistry. But many times it is still not that cheap. But for businesses to exist, they have to make money. The support from states varies widely also, and so some people are more fortunate to live in states like California, where state dental aid is pretty good.

No matter how you approach it, cheap dentistry is never going to be top quality dentistry. And socializing it would only decrease the average quality, not increase it.