Why is dental work so expensive? One dentist charges his crown 1000$ and another 1500$. Why such a big difference in price?
And why does my next door neighbour need a full mouth rehab? His treatments are costing 40K! Where did he go wrong?
Dental care is not a commodity. It’s not laundry detergent or breakfast cereal or wireless minutes. Dentistry is a professional service that’s both art and a science. Yes, there are excellent dentists and not-so-great dentists. Often, you get what you pay for. Yet even great dentists have bad days. “I consider myself an awesome dentist,” Dr. W. told me. “And I’ve had failures.”
Overhead costs are huge. Anywhere from 60% to 80% of what a patient pays goes toward the expense of running a modern dental practice. Dentists pay for rent or mortgage payments on their office space, payroll for hygienists, office managers and receptionists, health insurance, taxes, supplies, business insurance and technology — just to name a few. “A lot of people would be surprised to know how tight the profit margins are,” Dr. W. says. And many dentists are still paying student loans from dental school.
Labs differ in the quality of the products they produce. We all want our dentists to be using high-quality labs for things like crowns and dentures. Should we have to ask about the labs? No. We should trust our dentists to select a good one. “In my view, you always want to use a good lab,” Dr. M. said, “because if the crown breaks, I’m the one stuck redoing the thing for another hour and a half for free. It’s important to make sure I’m putting good stuff in people’s mouths, because the last thing anyone wants to deal with is a redo. It doesn’t make me look good, the patients get angry, insurance doesn’t cover it, and it’s a waste of time. You want to do a good job.” Dr. M. has invested in a $100,000 machine that lets him make the crowns himself and cement them in one visit. He says patients love it and it allows him to control the process and do a better job. His fee, however, is higher than many in the area.
Insurance isn’t really insurance. Dental insurance, the dentists told me, is nothing like health insurance or auto insurance. It’s a maintenance plan that will cover cleanings and x-rays, maybe half the cost of a crown. It will not protect you if you need a lot of work done. The maximum annual benefits, $1,000 to $1,500, haven’t changed in the 50 years since dental insurance became available. “It’s a minor cost assistance, and there’s a widening divide between patients’ expectations of their dental insurance coverage and the actual coverage that’s provided,” says Dr. W.
Dental insurance drives docs nuts and they wish they didn’t have to use it. “The number one most complicated aspect of running a dental office, bar none, is dealing with dental insurance. You wouldn’t believe how long it takes to get through to a rep, make sure the patient does have benefits, calculate a copay,” says Dr. M. And the largest insurance plans in the country discount most dentists’ fees by 10% to 20%. If you’re paying out of pocket, ask for a discount. (You might discover the dentist is giving you one already.)
Dentists wish patients would value their teeth more. Teeth are a crucial part of health and appearance. Untreated gum disease, for instance, is linked to heart disease. (Would you choose a cardiologist based on price?) “With time, you will come to realize that shopping price is a minor concern when it comes to your health,” says Dr. W. “Any minor cost differences amortized out over a lifetime will become insignificant. You will get the best results and have the most long-term satisfaction getting care from someone you trust.