Dental Bills

[ilovemygirl]

Long story short, I can't delay fixing my teeth any longer. I have an infection in my gums and jaw where they need to pull out 4-6 teeth and some of the jaw bone to get the infection out. I've had a second and third and fourth opinion over the years and they all say the same thing. To save money, I'm just going to get a partial denture instead of a bridge or implants but it's still a really expensive surgery and my dental insurance barely covers any of it.

I'm putting this in finances because I'm wondering if anyone who has btdt with serious dental issues, way beyond cosmetic or cavity problems has any advice as to how to get some of it covered. Since this is technically jaw surgery, I'm really scared to go to a dental school. As it is, I'm not pleased with the quality of the dentist and periodontist that my insurance has me going to. Is there a supplemental insurance I can buy on the side maybe? I've never done one of those tax free medical spending accounts. Does dental count in those? Since the reason I can't wait any longer is because I keep getting sick from the infection do you think I could try to get my medical insurance to cover it? 

I know I'm kind of grasping at straws here. But we just paid off our credit card debt. The thought of putting 6-10k of dental bills back on them is just so depressing. 

[mnnice]

Are you sure the getting the teeth pulled and the bone graft part is expensive?

In 2007 and 2008 I had a tooth extracted and a single implant done.  The whole process was pretty spendy with x-rays at a couple of different points, the implant itself and then a crown.  The actually pulling of the offending tooth and the bone graft was only about $200.  My insurance paid about half and I paid the other half. 

I didn't have coverage for the implant and the crown and I did use flexible spending.  The whole process took quite awhile because the bone graft had to heal, the implant had to heal, I had to have impressions made two different times, and then have the crown put in.  Anyway it would take months if I had been in a hurry and it took a year and half because I put money in flex specifically for my implant before I had it done. For both the implant and the crown I got a discount because I paid in full before hand.

Honestly, I would get the offending teeth out of there and figure out my strategy afterward (can you tell I was in mega pain) 

[ilovemygirl]

Thanks for replying. Pulling the teeth isn't that costly but the problem isn't really the teeth. I guess it's kind of hard to explain. I've had an infection that got deep into the gums and jaw years ago. It's caused advanced periodontitis. Most of my gum, part of my teeth and some of the jaw bone that holds the teeth in have literally been eaten away by the bacteria. So they need to get into my jaw and sort of flush it out with anitbiotics, remove any affected bone & tissue and then replace that bone and tissue so there is no space for the infection to return to. They say it's a two hour surgery that I'll need IV anesthesia which is also costly.

I've gone to a few different dentists and periodontists over the years and they all say the same thing and the cheapest I've been quoted is the current place for a little over 6k for the whole thing. My insurance is covering about 2k so it really costs 8k. 

The problem now is that the infection must be spreading or something because I've had a low grade fever and flu like symptoms for over a month now while my gums have really been hurting more than normal. I've seen my primary doctor and taken two antibiotics but it hasn't helped a bit. 

I'm pretty pissed about it because if this was any other part of my body it would be fully covered by medical. If I cut my finger and it got so infected that it was eating away the skin and bone of my hand and spreading in my system to the point that I was sick all the time no one would blink an eye about fixing it. 

[Ellien C]

I'm so sorry you are going through this. I don't have any advice except to tell you to PLEASE get the teeth pulled and the bone/infection scraped as soon as you can. I don't know why teeth are so different than the rest of the body for insurance. Probably the only answer is because insurance companies can do it. Jaw infections can carry into the heart and then you will be in real trouble.

I do understand "deferred maintenance" on the mouth. I, too, had a tooth infection - but only one, that was discovered after I gave birth (on x-ray at the dentist). Since I was nursing I didn't want to get that treated right away and as far as I was concerned it had been there for at least a year and didn't hurt. When baby was about 8 months old it really did get more infected and started to hurt. So I took a round of ABX and scheduled the extraction. I was a bit more comfortable since we had started solids. The tooth is out - it's fine. My insurance paid for the extraction and I opted just for a local anesthesia, which was covered. General would have been more and a bigger hassle in my opinon. I have a few months before I figure out the implant route. In my case, I spanned 2 plan years - the extraction in 1 and the implant in the other. I have a $1000/year limit on any covered work - so that helped a little.

Work out a payment plan with you dentist if you can. If not, this IS what CC are for, in my opinion. I would also not use a dentist I felt "iffy" about. My experience is that dental practice standards vary WIDELY - much more than medical tx.

[stormborn]

Check with your medical plan. I have blue cross and they consider it 'medical' rather than 'dental' once an oral surgeon is involved.

If not then try CareCredit. It's a credit card for medical expenses that gives you a fairly long interest free period; I think I went with the one year plan but there are different options. Not all providers take it but definately worth a try. 

[umsami]

Yes, flexible spending accounts do work for dental work--but it sounds like this needs to happen ASAP, not in 5-10 months.

First thing I'd do is call either your dentist or primary care physician and have them call you in a Rx for an antibiotic.  With your infection spreading, you need to be on something now.

I would then strongly urge you to consider your local dental school--if insurance is accepted there.  Work of this nature would most definitely be done in conjunction with an attending--and depending on the severity, the attending might end up doing everything, with the fellow doing very little.  It's possible that if it is true jaw surgery, that your regular health insurance might cover a portion.  I know that DH, when he was in an ophthalmology residency, worked with an MD ophthalmologist who had also completed an fellowship in maxillofacial surgery.  

I agree with the previous poster in putting this on credit cards, if necessary.  If you've recently paid down some debt than now is the time to negotiate a lower interest rate that you could use for this.  In general, the medical loan people charge super-high interest rates... well into the upper 20%.  

Forgot to add that I don't think any sort of supplemental insurance would help you as this is a pre-existing condition.  Sorry. :(

[mamaofprincesses]

FWIW, my mom had a lot of complicated dental work done at a dental school (in MD) and it was fine. Saved her some cash, got the work done. It was time consuming, because the student dentist really took his time and had to have everything checked by a supervisor, but it worked out well. I wouldn't rule it out until I had at least had a consult.

[zebra15]

When I had some dental work done 2 years ago (no where to the level you need though) I paid cash and got about a 50% discount.  I know they recently changed the parameters for HSA.

When I had oral surgery many many years ago that was billed to dental insurance not medial insurance.

I would not let anyone do dental work that I was not 100% comfortable with.  Whatever you decide you need to get this taken care of asap, it sounds like you are quite sick.

[Sharon, RN]

I'm so sorry you are sick.  :-(  I agree w/the pp, you do really need to get this fixed asap.  Find out if the extent of work being done qualifies under your medical insurance now.  Otherwise, I took my mother to a dental school for dentures.  However, they deemed her to be too complicated for the students (decades with no teeth had really affected her jaw) and she was worked on by an attending for a great discount over a private dentist.  So, a dental school may still be an option for you.  Good luck!

[SleeplessMommy]

Get it fixed ASAP. As others have mentioned, this is very very serious. (especially if you become pregnant.)

In your situation, I think a dental school would be worth the risk. Maybe they could even get you implants. Get the surgery done ASAP (2011 insurance year) then get the denture or prosthesis installed in 2012. (this would slightly stretch out the normal healing time for implants.

The biggest thing about dental school work is it will take longer than regular work, as there is supervision. On the other hand, you will be blissfully asleep. You are taking a HUGE risk with the delay.

One option is carecredit. "You can get a No Interest* payment plan if paid in full within 6, 12, 18 or 24 months on purchases with your CareCredit card."

http://www.carecredit.com/index.html

[weliveintheforest]

Originally Posted by stormborn 

Check with your medical plan. I have blue cross and they consider it 'medical' rather than 'dental' once an oral surgeon is involved.

I was thinking this too.  I know people who were able to have teeth pulled at the hospital and not pay out of pocket, because it became a medical issue not just dental. It definitely sounds like your issue is not in the dental category anymore!