Teeth Veneers - ??

[Growin'upDisney]

DH was told by the dentist that he has no enamel on his teeth and he has developed pockets/holes inside his front 6 upper teeth.

There are 2 approaches to fix them.

1) is to have 2 fillings in each teeth to fix the pockets but in the months to come more pockets may develop since there is still no enamel. This would cost us about $200 out of pocket.

2) is to get porcelain teeth veneers on the 6 teeth and this will completely fix the problem. Never have to worry about it again but the insurance won't cover them beacuse accoridng to the insurance veneers are cosmetic. Cost to us $3000

How can something that the dentist tells you that you need to fix a rare problem in your mouth is cosmetic? If he only gets the filings more holes could develop and he could lose his teeth.

Insurances are so frustrating!! This all comes less than a week after we had sat down and laid out a plan to buy a home in 6 months, of course.

I think they call it Murphy's law - Hey Dan do you have anything to do with this??

 

[tiggersmom2]

If I were you, I would get my Dental office to write a letter to the insurance company stating WHY the veneers are necessary. Since the enamel on your husband's teeth has eroded away, they are most definately necessary. I had this same problem because I had chronic GERD and the enamel was eaten away on my maxillary anterior teeth (the upper six). My insurance company paid for 6 porcelain crowns. I have seen many patients need this, and the insurance company has always paid. Most of the time the patient's got full crowns and not veneers.

By the way I'm a dental hygienist and my dad's a dentist

 

[Growin'upDisney]

I just asked my dentist about this and they say that it is just a waste of time and that the insurance won't pay anyway b/c veneers are cosmetic. So can I write a letter myself asking for reimbursement? The dentist is having a small portion of the work charged to the insurance, creative billing I guess, but that still leaves us with $2600 out of pocket.

 

[tiggersmom2]

Yes, you can contact your insurance company yourself. Veneers that are being put on your teeth due to enamel erosion ARE NOT COSMETIC!!! You need to call your insurance company and explain that your husband's maxillary anterior teeth have the enamel eroded off of them and need restoring. Ask your insurance company to send you a dental claim form so you can send in a pre-estimate. You are going to need some dental codes to complete this pre-estimate. After you recieve the form, pm me and I can give you the CDT dental codes to complete the form.


Just a side note - would your husband consider porcelain crowns?
Sometimes if an insurance company won't pay for veneers, they may pay for crowns. (like I said in my previous post, I have never seen an insurance company deny payment for dental erosion.)

BTW it really surprises me that your dental office wouldn't write the insurance company a letter telling them why the procedure isn't cosmetic.

 

[floridafam]

I would get a second opinion. I don't say this because I don't trust the dentist but because I think it is a good idea.

What about bonding? I have bonding on my 6 front teeth that has been there for almost 20 years. My current dentist says she doesn't do much bonding because it doesn't last long. Well, like I said, I've had bonding for 20 years. Sure, it's starting to stain a little from soda drinking but it's still in good shape.

My dentist said she would recommend veneers at $800 a tooth. NO thanks.

 

[tiggersmom2]

Growin'updisney,
Do you know why your husband doesn't have enamel on his front teeth? Does he suck lemons or have a medical condition such as GERD?

 

[Growin'upDisney]

No, I have no idea why the enamel is gone. He does not eat citrus, that would be me What is GERD?

I am starting to get angry about this. I don't understand why they won't try. Mind you I have been with this dentist since I was 5 years old and now I am almost 29. Their service has really gone downhill. But they said DH had to get this done within 2 weeks, so he is in the chair as we speak since today was his only day off and he starts 3 weeks of all day schooling next week.

I know that getting pre-authorization would be the best but I am hoping that something might come of it. I can only try. I will get them to send me the form ASAP.

The 2 options I mentioned were the only ones given. I didn't know that porcelain crowns were an option and obviously the dentist didn't bother telling us that either

I will see what I can do and thanks so much for your help.

 

[floridafam]

Most likely, the insurance company would need a pre-treatment x-ray for the crowns. Ours does before they pay.

Don't you think it is a little strange that you weren't offered this option? Maybe the dentist knows that the insurance company wouldn't pay because he really doesn't need them.

I had a wonderful dentist for many years but have had some issues with our current dentist. I feel like I'm handing over money left and right and can't determine what is right for myself and my family without them telling me what to do.

Good luck with the process.

My Dad had GERD and had terrible problems with his front teeth. It is basically acid coming up from the stomach.

 

[tiggersmom2]

Growin'upDisney,
GERD is Gastric esophogeal reflux disease. To the layperson this is just REAL BAD heart burn on a daily basis. The problem with this is that it leaves acid in your mouth - acid erodes teeth.

Let me know if there is anything I can do to help!

 

[Growin'upDisney]

Nope, no GERD. But I just got off the phone with his insurance rep at the union he works for. They said to have the dentist send it in to insurance with a note stating it was medically necessary. I am going to insist they do this. The rep said that she did not know if they would pay or not but that it was worth the effort.

 

[KimR]

I would keep pushing the matter. I had veneers put on my teeth as well as gum surgery. I had both procedures done for cosmetic reasons, although I had enamel erosion as well. Surprisingly enough, both procedures were covered by insurance. I had expected the veneers to be covered due to the enamel erosion, but I had no idea they would cover the crown lengthening (gum surgery) as well!

One word of warning, though. The fact that he has enamel erosion leads me to believe that he may be grinding his teeth at night. That was the case with me and if he is grinding his teeth and gets veneers he will also have to wear a night guard when he sleeps to keep from damaging the veneers. The night guard is an additional $850.00 (which might be covered, I'm not sure). Also, I was told that wearing a night guard can aggravate gingivitis...I do seem to have more trouble with my gums now. Just some things to think about that your dentinst may not have told you. Having said that, I am very happy with my veneers and have never regretted my decision!

 

[Growin'upDisney]

Aha!! Finally some light shed on this. He does grind his teeth and already has a night guard - that he does not wear. This will be a good kick in the butt to get him to wear it. I hope it will still fit after the veneers. Thanks for your info. This has really helped and I will be persistent with both the dentist and the insurance. One bad thing is that is dental coverage is only $2000 per calendar year so no matter what we would have to pay some, but every bit off helps.

 

[binny]

sorry about that I hate dentist problems.. I love my dentist but that doent mean I dont fear him lol

Pardon me for highjacking your thread but, Kim, how was the gum surgery? Im supposed to have that next month on the area around two bottom side teeth.
How was it for you? did you have a lot of pain with it? they also want to take out of my wisdom teeth while theyre in the area.

I know it can be pricey but I have to do it before I get braces and double

 

[tiggersmom2]

binny,
I'm not Kim, but I can tell you that All of my patients tell me that gum surgery is NOT bad, the alternative is MUCH worse! They (the Periodontist) will give you a shot (just like at the dentist for a filling) and start to work. you won't feel anything and your teeth and gums will be in much better shape! And don't worry about the wisdom teeth, while you're numb you won't feel a thing!!! Trust me, this is the best time to get them out! You may feel alot of pressure when the wisdom teeth are being pulled, but you shouldn't feel any pain!

 

[binny]

ok thanks I appreciate that!


Im a little nervous about it to be honest, it sounds so well... invasive, you know?

 

[nuke]

My husband has to have some cosmetic work done on his four front top teeth. The options were to remove the old bonding that is yellowing and replace it. The dentist thinks the insurance will cover it because of the materials he will use. Even if insurance doesn't cover it the cost is around $1000. Or they could do veneers at $700 a tooth!

He has decided to have the bonding replaced. I hope our insurance covers it but if not we have the money put aside.

 

[KimR]

binny, the gum surgery was not bad at all. I was very nervous, but the periodontist gave me gas (first time I ever had it), and I just zoned out. I didn't feel a thing after the shot, just pressure, but no pain. I was a little sore afterwards, but I had pain pills for that. Getting the stitches out was worse than the surgery itself and the results are so worth it! Don't worry, you'll be fine!

Oh, and GrowinupDisney, I sent you a pm.