Is my Dentist Ripping me off?

[MissManda]

So, I haven't had to get any fillings for quite a long time. Then, when I went for my last cleaning I told him I was having trouble with a particular tooth. It turns out that an old filling was coming out. So, he said it needed to be replaced. He also recommended replacing another one on the tooth next to it. These fillings were between the teeth and the two he wants to replaced are essentially side by side. They were put in at the same time, have the same wear and tear, and if one was bad it seems logical that the other one should be replaced as well.

So, I get my estimate. My dentist is charging $251 per filling. The fillings are described as Resin-2 surface, posterior by my dentist. Of that, my insurance (who my dentist participates with) only allows for $85/filling. They will pay 80% of the $85 and I have to pay 20% less a $50 deductible plus the difference that is not allowed.

Holy heck, that is a lot of money!!! Like I said, I haven't needed a filling for a long time and so I'm curious if the amount my dentist is charging is outrageous or does my insurance just suck???? I hate to leave my dentist because I really do like him and I really like my hygienist. But if I'm being overcharged, I may have to look elsewhere.

 

[NewRVLady]

I find mine very expensive..its like $125 a tooth

 

[mnrose]

I don't find that charge outrageous. Dentistry is a profession, requiring an advanced degree. I think your insurance paying 85 a filling (and then only 80%) is pretty cheap. I think you'd be hard pressed in my area to find a dentist willing to do the work for 85...at least any dentist I'd be willing to have DO the work. LOL!

Is your dentist willing to accept less than the stated charge? Sometimes, they will give you a small courtesy discount.

This link provides you averages by zipcode for various dental procedures.

https://www.guardiananytime.com/dceapp/DentalCostEstimatorWeb/dentalCostEstimator.process#

In my area, the charge for a two surface posterior filling using white is 198-271 per tooth. Your charge is on the high end of that, but not out of line by any means. Since it is a posterior tooth, you might consider getting a silver (amalgam) filling as this is less expensive than resin. In the rear, it doesn't show (as much).

 

[PrncessA]

I love love love my dentist. Totally trust her and her office staff. This year DH's company went with their parent company's (Caterpillar) insurance and it is great! I had 3 fillings about a month ago, 2 of them very deep, with an old filling removed, and I only paid $25. Looking at the bill that my insurance paid, the TOTAL cost for all three fillings was $253. $90/$90/$73, so personally I fine $251 per tooth a little high. But all dentists are different.

 

[ronandannette]

So, I haven't had to get any fillings for quite a long time. Then, when I went for my last cleaning I told him I was having trouble with a particular tooth. It turns out that an old filling was coming out. So, he said it needed to be replaced. He also recommended replacing another one on the tooth next to it. These fillings were between the teeth and the two he wants to replaced are essentially side by side. They were put in at the same time, have the same wear and tear, and if one was bad it seems logical that the other one should be replaced as well.

So, I get my estimate. My dentist is charging $251 per filling. The fillings are described as Resin-2 surface, posterior by my dentist. Of that, my insurance (who my dentist participates with) only allows for $85/filling. They will pay 80% of the $85 and I have to pay 20% less a $50 deductible plus the difference that is not allowed.

Holy heck, that is a lot of money!!! Like I said, I haven't needed a filling for a long time and so I'm curious if the amount my dentist is charging is outrageous or does my insurance just suck???? I hate to leave my dentist because I really do like him and I really like my hygienist. But if I'm being overcharged, I may have to look elsewhere.

Most insurance carriers have their own fee schedule for procedures but dentist's price their services based on what the market will bear. If you haven't "shopped around" you might find that your guy's prices are very consistent with others in your area. Check some other dentists, although it might be hard to get a price without the Dr. seeing you to know what (s)he's dealing with, which would require you paying for an examination. My insurance policy will only pay for a "new patient" exam once per year.

FWIW I find dental fees to be OUTRAGEOUS I had a root canal with a temporary crown done on Monday and the bill was over $1,600.00. My insurance covered about $1,000 for the root canal and $200 for the crown. I'm OOPS for the rest.

 

[lizzi6692]

Honestly dental insurance sucks and is pretty much pointless. My suggestion is to ask your dentist if they offer a cash discount for people who either don't have insurance or who choose not to use it. My dentist actually offers a discount plan to cash pay patients where you pay 75 dollars a year and you get 25% off of all treatments. As someone who had the cards stacked against them teeth wise(inherited my mom's bad teeth and on medication for 5 years that basically rot my teeth from the inside out) it works out way better than any dental insurance plan available.

 

[mombrontrent]

It's been my experience and most other people I know that all dentists are a "rip-off". If they can't find a new tooth to fix they fix an "old filling". Once the dentist told my DH to come get a cavity filled on the bottom right. He came back a month later and was confused that they were fixing a tooth on the top left. He was frozen and they were working on the tooth so he didn't say anything until they were done. It turns out the one that was supposed to be worked on was just fine, no cavity after all He still has no clue what they "fixed" that day. Luckily we have good insurance and usually only have to pay a few dollars out of pocket but it still sucks not really knowing if the dental work you are getting done is really necessary.

 

[ronandannette]

Honestly dental insurance sucks and is pretty much pointless. My suggestion is to ask your dentist if they offer a cash discount for people who either don't have insurance or who choose not to use it. My dentist actually offers a discount plan to cash pay patients where you pay 75 dollars a year and you get 25% off of all treatments. As someone who had the cards stacked against them teeth wise(inherited my mom's bad teeth and on medication for 5 years that basically rot my teeth from the inside out) it works out way better than any dental insurance plan available.

This wouldn't work for me. Paying cash at 25% off would have left me with a balance of $1,200 instead of the $400 I paid, which was the combined total of the shortfall in my insurance company's fee schedule and my co-pay. I've had 3 root canals in the past year and I simply couldn't have gotten that care if I'd have had to come up with the cash. My dental insurance is part of my benefit package at work and I'm grateful for it.

 

[lovin'fl]

Last dentist recommended we put sealants on my 2 DDs' teeth. We had to pay a nice chunk. We did it and the next cleaning they had, the dentist again recommends sealants after. I remind them that they did sealants the last time...where did they go? They tell me they must have fell out. I ask them if they'll put in new ones at no cost and they tell me no. We switch dentists.

New dentist has done 2 cavities on me. Lower near gum. Not pleasant getting filled, especially one that dentist must have hit nerve when giving me needle because horrendous pain shot up my face and into my eye. They were done about 2 years ago and now they're telling me I need cavities filled and showing me the same teeth they filled 2 years ago...same spots (it's dark there again). I am not happy.

 

[HM]

I just had a crown put in. It was supposed to be a filling but turned out to be more of a problem than anticipated. I got a temp filling before they could start the actual procedure. The Temp Filling (had for two weeks) cost me $185. The insurance said they'd pay $95, but I had a $50 deductible. So, I'm pretty much in line with what your dentist and insurance are saying.

The crown is $1650. I haven't heard from the insurance on what they're paying of that, but I know it won't be much.

 

[mjkacmom]

It's been my experience and most other people I know that all dentists are a "rip-off". If they can't find a new tooth to fix they fix an "old filling". Once the dentist told my DH to come get a cavity filled on the bottom right. He came back a month later and was confused that they were fixing a tooth on the top left. He was frozen and they were working on the tooth so he didn't say anything until they were done. It turns out the one that was supposed to be worked on was just fine, no cavity after all He still has no clue what they "fixed" that day. Luckily we have good insurance and usually only have to pay a few dollars out of pocket but it still sucks not really knowing if the dental work you are getting done is really necessary.

I love my dentist. In the 18 years I've been going, he has replaced 2 fillings (I go twice a year). DH has needed a crown, and out of all 5 kids, there have been 3 cavities.

 

[lizzi6692]

This wouldn't work for me. Paying cash at 25% off would have left me with a balance of $1,200 instead of the $400 I paid, which was the combined total of the shortfall in my insurance company's fee schedule and my co-pay. I've had 3 root canals in the past year and I simply couldn't have gotten that care if I'd have had to come up with the cash. My dental insurance is part of my benefit package at work and I'm grateful for it.

Your insurance may be better since it's through work, but the options available if you don't get it through your job are not that good. We looked at dental insurance and the best plan paid at most 35% and that was only on certain procedures and only after having it for a year. Prior to that the maximum they paid was 15%. We even asked around at dentist's offices that I went to and they said that was pretty much standard.

 

[mombrontrent]

I love my dentist. In the 18 years I've been going, he has replaced 2 fillings (I go twice a year). DH has needed a crown, and out of all 5 kids, there have been 3 cavities.

I agree that it all depends on the dentist. We have been going to this one for 13 years (since he opened). In that time his office has been upgraded multiple times with all the new fancy equipment, it very high-tech in there. I assume business is going well for him. Our insurance covers every 3 month cleaning and of course he highly recommends we take advantage of that but I usually only go once every 6 months. I feel like since we have good insurance he can "milk" it since we are not paying out of pocket but I still hate going and getting unnecessary work done. We are moving next month and will need to find a new dentist. My current dentist told me he hoped we would continue using him and 3 hours wasn't to far to commute for a good dentist I laughed and told him it was indeed to far to drive for dentist visits, but good try anyways

 

[Bree]

That price sounds about right for a composite (white) filling. Amalgam (silver) will be much cheaper. You are lucky that they are even paying anything on a back tooth for composite. The last two companies my husband has worked for did not cover composite on back teeth. He works for Bose and you think a company that has a huge profit margin like they do would cover composite on the back teeth.

 

[apirateslifeforme]

My (former) dentist tried to have 2 perfectly healthy teeth drilled and filled at $210 each (insurance wouldn't pay because it was unnecessary). I cancelled that appointment and haven't been back since.

I had been going to this particular practice since I was 5 years old, in 1979. My first (and only) dentist and his partner were of the opinion "If it ain't broke, don't fix it." I never had ANY problems with my teeth.

Then they retired about 5 years ago. The hygienists, all of whom had been there for at least a decade, started dropping like flies. My regular hygienist told me flat out that they didn't like the guy taking over, "he really pushes procedures because they cost so much." That was the last time I saw her. Now they have all new, young girls just out of school who are VERY rough. My mother and I never had problems with cleanings, but now we both were leaving sore and bleeding.

EVERY SINGLE TIME you walk out of there, you have a "treatment plan." They seemingly always find something. And it's different every time, so to me, that means that whatever was recommended wasn't needed.

DH went once for a cleaning. He walked out with a 4-page, $8000 treatment plan. Their idea of a payment plan is to divide the total by 3, and you give them 3 post-dated checks that they keep in their safe and cash on the correct date. You ONLY get the 3 months to pay, no matter how much the final bill is.

My mother needed a crown. First of all, the temporary crown fell off and some mild pain ensued. The dentist refused to put the permanent crown on until the pain went away, so he gave her an antibiotic. The pain never went away, so she went back and insisted on having the crown attached. He grudgingly did it (lo and behold, the pain went away). She had told them that her insurance would only pay for a gold crown, but they ordered white, and then presented her with the bill for it since her insurance wouldn't pay. She refused to pay it. And her bite is "off." Same thing happened to my hairdresser; she has an "off" bite from a crown done by the same dentist. This guy also wants to put a brace on 2 of her "little bit crooked" lower teeth, but refuses to fix his own crooked teeth, telling his wife that she married him like that, so she's keeping him like that.

The final straw for me was when I went in for a cleaning and came out with that "treatment plan" to drill those 2 healthy teeth. First he got mad that I'm in infertility care and am assumed to be pregnant unless proven otherwise, so I could not have x-rays ("I insist on x-rays every year"). Then he said "Infertility treatment and pregnancy are going to ruin your teeth" (must be a lot of women out there with rotten teeth, I guess ). He then poked around, complained about my straight-and-clean wisdom teeth that have never given me issues, turned to the hygienist and said, "She needs to make an appointment to have these 2 teeth drilled, I don't like the grooves in them." I asked why and he said the hook got stuck (it didn't). I said that I'd had grooves in those particular teeth all of my life and never had a problem, Dr. R. never had a problem, etc. He said, "Dr. R. wasn't a very good dentist and let a lot of things go. Those teeth are going to rot from all the food that's going to get stuck in them." I have NEVER, in my entire life, gotten food stuck in those teeth. My insurance wouldn't pay, so I cancelled the appointment and haven't set foot in that office since.

 

[Bnb0627]

Your dentist may be giving you a fair quote but it definitely doesn't hurt to call around. I recently had an issue with my children's dentist. They quoted me a price for nitrous oxide and tooth removal. They have always charged $75 for nitrous and my insurance company didn't cover it . Well after getting the quote I get the new fee schedule from my insurance company and yay now they cover nitrous and that entire visit. So I tell the dental office they need to get the updated fee schedule (because they always try to charge me based on the old). After the visit I get the explanation of benefits from insurance company showing the fees the dentist charged including $75 for nitrous and the insurance covered it. Then I get a bill from dentist showing that the nitrous was $90 and the insurance only covered $75. When I questioned them they said that's the price for nitrous. Well I pulled out the quote they originally gave me with the $75 and they regrettably took it off. It's only $15 but I felt like they were trying to pull a fast one. Especially when they tried to make me pay $500 for the visit before they would do the work even though they knew the insurance company covered the work!

 

[mombrontrent]

I actually saw a news show about this problem. They had the same woman go into several different dentists in several different cities. Every single one gave her a different "treatment" plan. Some ranged from very minor work to extremely expensive and extensive work. Totally unnecessary procedures were recommended for the same woman on totally different "problem areas and teeth". Crazy

 

[lustergirl]

Yea dental insurance doesn't cover anything worth while. I would like to have my bottom teeth pulled and replaced with a plate. Dentists here don't like to do that but want to do implants instead. Implants cost 3,500 dollar a tooth. OUCH!!!

 

[DebbieB]

I would check with your insurance company. If he is participating, he may have to accept what they pay.

 

[sksjasams]

Last dentist recommended we put sealants on my 2 DDs' teeth. We had to pay a nice chunk. We did it and the next cleaning they had, the dentist recommends sealants after. I say that they did them the last time...where did they go. They tell me they must have fell out. I ask them if they'll put in new ones at no cost and they tell me no. We switch dentists.

Actually, sealants can come off if kids eat sticky food liks starburst, taffy, etc. I do feel they are totally worth it though, and would pay to have them put back on my kid's teeth, and have the kid be more careful next time.

That price sounds about right for a composite (white) filling. Amalgam (silver) will be much cheaper. You are lucky that they are even paying anything on a back tooth for composite. The last two companies my husband has worked for did not cover composite on back teeth. He works for Bose and you think a company that has a huge profit margin like they do would cover composite on the back teeth.

We have Delta Dental and find this to be true for us as well. They will only cover Amalgam fillings in the back. They will cover up to the cost of the amalgam filling and then you pay the difference for the composite filling. Our dentist doesn't even do amalgam anymore. I think insurances should update their standards for what is covered, but at least part of it is paid for.