Ouch! How Much Does Your Dental Work Hurt (Your Wallet)?
Years ago, when I told people that I was a part-time ski instructor at Snowshoe, West Virginia, they often told me how lucky I was to be that good a skier.
I told them I wasn’t. In truth, I was an intermediate skier at best. I shrugged off their compliments by joking that all you needed in order to be hired at a ski resort in rural West Virginia was a full set of teeth.
After moving to Colorado, I would visit a friend who lived in Idaho Springs, a mining town in foothills of the Rockies only about a half-hour from Denver. A superb story-teller, when describing her new home she’d say, “Here in Idaho Springs, we have two kinds of people. Them with teeth and them with no teeth.”
It’s hardly a joke. Teeth are important professional markers. Both the New York Times and the Washington Post have recently written articles about that the skyrocketing cost of dentistry and how they are making yet another contribution to the widening gap between the haves and the have-nots in America society.
Costs are reported to have risen about 5% a year for two decades. I contend it’s been appreciably higher in any larger city.
I became aware of the escalation when I was advised to use a mouth guard while sleeping (an attractive accompaniment to my sleeping mask and probably a contributing factor to most of my past boyfriends being at least moderate drinkers.) My bill for the upper-jaw-only plastic mold was over $600.
A Mexican whom I dated later, a guy with an amazing, brilliant smile (the first thing I noticed about him) paid $80 for one in Mexico.
This year, while in Denver to have my yearly meeting with my C.P.A., my lower-back teeth began to radiate pain and tenderness. Thinking it was probably another cavity, I went in to see a dentist only to find I would need a root canal (and at least $1,500)
I thanked the gods-of-all-things-holy that I would be returning to Mexico soon, where I could get the work done for probably less than half of that. A legion of Mexican friends with beautiful smiles stood waiting with their periodontist referrals.
Dental work in Mexico costs anywhere from a third to half of what the cost for the same procedure would be in the U.S., even with all the same technological features.
Then I thought of all those people in West Virginia and Idaho Springs who aren’t going to Mexico. The ones who don’t have the money, can’t live with the pain and have to actually get the tooth pulled.
When I was a child growing up in rural Oklahoma, my mother would get me out from under her feet by giving me twenty-five cents to go buy penny candy at a store a mile away. I still remember the candy necklaces.
Imagine her chagrin when her eight-year old’s first dental appointment revealed cavities in almost every single baby tooth, all of which she dutifully had filled with silver on a social worker’s salary.
I was very lucky, unlike the West Virginian girlfriend of an ex of mine who lost all her teeth before she was thirty.
This really happens. And poor dentistry isn’t just an obvious indication of economic hardship. It’s a gateway to various other health problems, such as respiratory infections, diabetes, even dementia.
What is particularly annoying about all of this is that, like setting a cast for a broken arm, the basic technique of medically necessary dental work hasn’t changed in decades.
The advances of the last 25 years have been largely in the level of patient comfort and types of materials used, especially as related to cosmetic dentistry, which has taken off as wealthier Americans spend millions on veneers and whitening.
For those who need critical work like wisdom teeth extraction, fillings, crowns and root canals, the field of dentistry provides a wonderful example of how technology works to the disadvantage of people on a tight budget.
No reputable dentist would not use one of those saliva extraction devices. But how much more do they cost the dentist than that porcelain bowl we used to spit into?
Dentists’ frequent unwillingness to pass along x-rays if you get a new dentist or a specialist and their insistence on unnecessary annual x-rays are other ways costs are jacked up.
Some questionable business practices, the cost of the technology people expect in a dental office, along with high student debt that dentists in other countries don’t have are main factors in American dentistry’s high rates. Dental insurance has always been a poor value. You practically have to have major surgery for it to have been worth purchasing and we're all optimists.
Predictably, overall utilization of dental services has been going down in the United States for 10 years. The industry seems genuinely puzzled about this. Fewer people having routine work done will only incentivize increasing fees more for remaining patients.
No one plans to go back to silver fillings, and when I had a cavity replaced in Mazatlán two years ago, I noted with some alarm the porcelain saliva bowl of my early adulthood in the dentist’s office.
The new filling was fine. The visit, with a cleaning, cost less than $50.
Most recent: As wonderful as Mexico is, you still need to be aware of scams, especially medical ones.
Kerry Baker is the author of the "Interactive Guide to Learning Spanish Free Online," a curation of the best tools on the web to learn Spanish free, all organized into lesson plans that keep learning interesting, and you motivated.
She is also the author of "If I Only Had a Place," a guide to renting luxurously in Mexico.