Savings on Crowns, Bridges and false teeth costs!!!!!

c4cat

OK when we need lab work to make up Crowns, Bridges and false teeth the mark up charged by our rip off dentists is very high indeed, so much so I almost fell off the dentist chair when I was being quoted the price for one crown and root canal job.

I asked my dentist if he would mind me getting my own lab work done ie getting the crown made up at a lab of my choice, he said no probs if I could find one that would take the work off me!!!,

Well I started calling a few labs and basically it boils down to this, if I could send in at least 3 jobs at once then yes its possible to save a substantial fortune between the three jobs cos the dentist would only charge for his treatment of preparing my teeth and actually fitting the crowns. the total saving is more then the savings made on multiple trips up to NI to have the work up there.

So my question is there anyone here who would like to save some dosh and get their dental lab work done more cheaply then what the dentist will charge? one has to find out from their dentist the actual cost of the actual crown or bridge in a diplomatic way without indicating one is going to get their own dental lab work done, or the dentist will load the lost markup from his dental lab work onto the actual work they do on your teeth,. ~~I can advise how ~I approched this issue. Any opinions ideas lets discuss. Anyone want to discuss privately further can PM me or put questions about any points onto this thread

davo10

C4cat, i have read some interesting posts on this forum but yours is unsurpassed in its stupidity. You are advocating subcontracting/direct labour of your dental treatment.

Any one with the even a shred of common sense would wonder about this: if the dentist has ageed a price for the labour and materials of the crown/bridge/denture preperation and you agree to provide/take responcibility of the crown, why would the dentist give a damn about the fit/shade/strength of the prosthesis or importantly, how long it lasts. You supplied it, if it is not right, tough s**t. What happens if the shade, fit is not right when you attend to have it fitted, you will have to visit dentist again (you would not be charged for this if dentist supplies crown as it is his responcibility), you would most certainly have to pay for extra clinical time under your scheme.

Why go to labs in the North, you could get them made cheaper in China.

Lastly, and this is the part I really love, are you going to go to 3 of your friends and whisper that you know a place where you can have cheap crowns made if they can get their dentist to prepare their teeth. They will think you are a moron and they are right.

c4cat

davo10 wrote: »

C4cat, i have read some interesting posts on this forum but yours is unsurpassed in its stupidity. You are advocating subcontracting/direct labour of your dental treatment.

Any one with the even a shred of common sense would wonder about this: if the dentist has ageed a price for the labour and materials of the crown/bridge/denture preperation and you agree to provide/take responcibility of the crown, why would the dentist give a damn about the fit/shade/strength of the prosthesis or importantly, how long it lasts. You supplied it, if it is not right, tough s**t. What happens if the shade, fit is not right when you attend to have it fitted, you will have to visit dentist again (you would not be charged for this if dentist supplies crown as it is his responcibility), you would most certainly have to pay for extra clinical time under your scheme.

Why go to labs in the North, you could get them made cheaper in China.

Lastly, and this is the part I really love, are you going to go to 3 of your friends and whisper that you know a place where you can have cheap crowns made if they can get their dentist to prepare their teeth. They will think you are a moron and they are right.

OK this is just an Idea as a laymen looking in from outside of the dental system trying to uncover what is a business that does not like to reveal much but in response to your post: is that not what a dentist does, subcontract the making of a crown, bridge to a reputable dental Lab (many of them contracted to overseas labs too) and puts a 500% to 1000% mark up on it, ? If the shade the crown is as the dentist prescribes then the dentist would have to be responsible for revisit and the remaking of the crown is no where near the cost actually charged. If the fitting is not exact then the dentist can make some very minor adjustments to the crown. I have had a look at some xrays of my own inlays and have noticed some tiny spaces filled with dental cement and they have been there 20yrs

As to why would the dentist give a damn about the fit/shade/strength of the prosthesis or importantly, how long it lasts. Well just use the same products that ones dentist would recommend such as Captek or Empress and as to a dentist not giving a dam about the fit, well that would not be a reputable dentist would it? as he/she should care regardless of where the lab work is undertaken, thats their job and thats what he is paid to do

davo10

again your points are ill concieved.

1. Does lidl display all the costs involved in the manufacture of a pair of runners?, does the price tag read:
Labour =
fabric=
stitching=
rubber soles =
transport=
insurance=
electricity=.

no silly, they display the cost and you make your mind up whether you buy or not.

2. The mark up on a crown is no where near 500-1000% that I know of, particularly for a top quality cosmetic crown which these days everybody wants. I know some charges make even me blush but I have not heard of any dentist charging € 2000 per crown. However if you are not concerned about materials/cosmetics/fit but just price alone (you said you rang around so price is your thing) then sure if a crown is €50, I do charge more than € 500 for a crown. silly idea.

3. If you supply the crown then you are responcible for the shade and the quality of the crown, not the dentist. If it is of poor qaulity/fit/shade why should the dentist look after you. If you buy a suit and pay someone to help you put it on, its not that persons fault if it doesnt fit/looks crap/falls apart.

4. A lab is as good as the work it does. All dentists know the good ones and the bad ones. I use different labs for crown work, bridgework, implants because i know that each one is fantastic for that particular work. I pay alot for the lab work but I know it always fits and looks completely natural. If it isnt right in any way, i ring them and they correct it immediately. They know that if they dont, i will not send work to them and i will not recommed them. You on the other hand will have to fend for yourself if the crown is not right. Do you think the lab will care if you do not recommed them?.

5. why should the dentist adjust YOUR crown at no extra cost?

6. Of course there is a narrow gap silly between the inlay and the tooth, there has to be to allow a film of cement between them, they are not friction fit. What you do not want is big gaps at the margins.

7. why not buy dental drills on ebay, try to prepare the tooth yourself and get the lab to fit the crown, you will save a fortune, maybe you can do the same for your 3 friends.

c4cat

davo10 wrote: »

again your points are ill concieved.

1. Does lidl display all the costs involved in the manufacture of a pair of runners?, does the price tag read:
Labour =
fabric=
stitching=
rubber soles =
transport=
insurance=
electricity=.

You are comparing apples with oranges, but then why not, lets do with dentistry what has been done to airlines and bring in lower cost dentist charges cos some people are having to buy pliers to pull their own teeth out
anyway.

When I visit a Doctor he/she does not sell me medication but prescribes what I need, then I can go to the pharmacy of my choice, why can I not choose the dental lab of my choice to make up the crowns too?


[/QUOTE]
no silly, they display the cost and you make your mind up whether you buy or not.
[/QUOTE]

Well as you compare apples with oranges I will do the same, try buying a ticket on Ryanair cost is broken down in the low cost airline industry lets do it with dentists too and reveal the true costs and give us more choice


2. The mark up on a crown is no where near 500-1000% that I know of, particularly for a top quality cosmetic crown which these days everybody wants. I know some charges make even me blush but I have not heard of any dentist charging € 2000 per crown. However if you are not concerned about materials/cosmetics/fit but just price alone (you said you rang around so price is your thing) then sure if a crown is €50, I do charge more than € 500 for a crown. silly idea.
[/QUOTE]

Well tell me how much would you quote me for a gold crown on a moler excluding tooth prep and fitting and i will then tell you what I have been quoted to have one made up and where too

[/QUOTE]
3. If you supply the crown then you are responcible for the shade and the quality of the crown, not the dentist. If it is of poor qaulity/fit/shade why should the dentist look after you. If you buy a suit and pay someone to help you put it on, its not that persons fault if it doesnt fit/looks crap/falls apart.
[/QUOTE]

What if the dentist screws up the order it would be very easy to see which has screwed up the dentist or the lab

[/QUOTE]
4. A lab is as good as the work it does. All dentists know the good ones and the bad ones.
[/QUOTE]

So are Dentist


[/QUOTE]
5. why should the dentist adjust YOUR crown at no extra cost?
[/QUOTE]

Cos he might not have got the order quite right in the first place and many of them do need a tiny slight adjustment any way, also I am paying him to fit the crown but not to buy it in for me

[/QUOTE]
6. Of course there is a narrow gap silly between the inlay and the tooth, there has to be to allow a film of cement between them, they are not friction fit. What you do not want is big gaps at the margins.
[/QUOTE]

Also one can use dental cement to compensate for adjustment

[/QUOTE]
7. why not buy dental drills on ebay, try to prepare the tooth yourself and get the lab to fit the crown, you will save a fortune, maybe you can do the same for your 3 friends.[/QUOTE]

I never have and do not advocated this, I only advocated making ones own choice of dental lab to use to have ones own crowns made up.

It seems that you are dead set against this idea of mine, and you make me out to be a moron not because its stupid but cos dentist like you would lose at least 50% of your income
and the problem with dentistry its run in a way that I believe is extortionate to the customers. in other services charges have come down over the years, but not in dentistry where charges are just beyond reach for many people. something akin to whats happened in other services such as airlines needs to happen to dentistry

davo10

C4cat, try booking an airline ticket then ring ryanair and ask them if they can do it cheaper if you bring your own seat.

cement does not make up for deficiencies in the crown, it is hydrophillic and would dissolve over time leaving gaps. The aim is to foem a seal at the crown/tooth margin with minimal cement exposure in this area.

When ordering crowns I instruct the Lab in type of crown, shade, characterization, margin type, i take a photo of you and your teeth and email it to the lab, if it isnt right, i dont fit it. If you are supplting the crown and i am only doing the manual work then you are responcible for these instructions, you cant have it both ways.

I charge € 650 for a posterior gold crown, lab costs vary as the price of gold is constantly changing. When i get the bill from the lab it will have labour costs and then the amount of gold used and its costs. Usually approx €250-300.

The reason most dentists do not display a price list is because it is a service rather than a fixed cost treatment. For example if i advertised a charge of say € 60 for an amalgam filling then is it fair that someone you has a small filling on the occusal surface should pay the same as someone who has a large filling covering a number of surfaces and takes 4 times as long to put in.
Also, and the Government accepted this point, if every treatment was itemised like you suggested, then it would make treatments MORE expensive. Take for example a check up, scale and polish and 2 x rays, I charge € 70 for this, but if i priced each part individually how many people would object to paying € 30 for just an examination. € 40 for just a scale and polish and € 20 just for x rays. I gaurantee you that most people are being charged considerably more for having their teeth cleaned, but you add these up and it comes to €90, more than what i charge for an unitemised treatment.
If you take a crown, the itemisation of costs could read:
1. labour,
2. topical anaesthetic,
3. anaesthetic injection,
4. impression trays,
5. retraction material,
6. impression material,
7. temporary crown material,
8. placement of temporary crown and ajustment.
9.temporary cement.
10. administrative costs.
11. postage costs.
12. telephone costs.
13.broadband costs.
14. nursing costs,
15. electricity costs,
16. rental costs.
17. xray costs.
18. equipment leasing costs.
19.water charges.
20. rates costs.
21. insurance costs.
22. indemnity costs.
23. heating costs etc, etc, etc.

Were you foolish enough to think that we have no other expense in providing a crown than the lab costs, welcome to the real world
3

davo10

Sorry, i forgot to add one more cost on to list, the tax man will take over 40% of the net cost of treatment after lab expense is deducted.

c4cat

davo10 wrote: »

C4cat, try booking an airline ticket then ring ryanair and ask them if they can do it cheaper if you bring your own seat.

maybe Ryanair will consider your Idea

[/QUOTE]
cement does not make up for deficiencies in the crown, it is hydrophillic and would dissolve over time leaving gaps. The aim is to foem a seal at the crown/tooth margin with minimal cement exposure in this area.
[/QUOTE]

Well my inlays with tiny gaps are still solid after 20yrs even after falling out of a dentist chair with shock

[/QUOTE]
When ordering crowns I instruct the Lab in type of crown, shade, characterization, margin type, i take a photo of you and your teeth and email it to the lab, if it isnt right, i dont fit it. If you are supplting the crown and i am only doing the manual work then you are responcible for these instructions, you cant have it both ways.
[/QUOTE]
In that case I would not let you near my teeth in the first place if you would not be willing to work with a lab of my choice

[/QUOTE]
I charge € 650 for a posterior gold crown, lab costs vary as the price of gold is constantly changing. When i get the bill from the lab it will have labour costs and then the amount of gold used and its costs. Usually approx €250-300.
[/QUOTE]

I have been quoted USD110 from a lab in Singapore which is E84 why can I not choose to have my gold crown made up in the Lab in Singapore. You still instruct the Lab in type of crown, shade, characterization, margin type,take a photo of me and my teeth and email it to the lab, if it isnt right, you dont fit it

[/QUOTE]
The reason most dentists do not display a price list is because it is a service rather than a fixed cost treatment. For example if i advertised a charge of say € 60 for an amalgam filling then is it fair that someone you has a small filling on the occusal surface should pay the same as someone who has a large filling covering a number of surfaces and takes 4 times as long to put in.
Also, and the Government accepted this point, if every treatment was itemised like you suggested, then it would make treatments MORE expensive. Take for example a check up, scale and polish and 2 x rays, I charge € 70 for this, but if i priced each part individually how many people would object to paying € 30 for just an examination. € 40 for just a scale and polish and € 20 just for x rays. I gaurantee you that most people are being charged considerably more for having their teeth cleaned, but you add these up and it comes to €90, more than what i charge for an unitemised treatment.
If you take a crown, the itemisation of costs could read:
1. labour,
2. topical anaesthetic,
3. anaesthetic injection,
4. impression trays,
5. retraction material,
6. impression material,
7. temporary crown material,
8. placement of temporary crown and ajustment.
9.temporary cement.
10. administrative costs.
11. postage costs.
12. telephone costs.
13.broadband costs.
14. nursing costs,
15. electricity costs,
16. rental costs.
17. xray costs.
18. equipment leasing costs.
19.water charges.
20. rates costs.
21. insurance costs.
22. indemnity costs.
23. heating costs etc, etc, etc.
[/QUOTE]

My subject matter is savings on the actual cost of a crown I do not argue about any other treatments that you charge for (which are the some of the highest charges in europe anyway) You have validated what I have said about the cost of a gold crown and this is what you refer to me as a stupid moron about

[/QUOTE]
Were you foolish enough to think that we have no other expense in providing a crown than the lab costs, welcome to the real world
[/QUOTE]
I think its you who should come into the real world where costs are real

So what you are saying is that you do not add an extra markup on the actual cost of the crown as You pay your lab E250 to 350 for a gold crown. Correct? that means I would be paying E350 to cover your fees and expenses
Then why are you against me choosing the lab of my choice saving me E170 to E270 per crown by your quoted prices and without you even losing 1 cent of your Fees or expenses cos I am not asking for any reduction in fees to cover your long list of business expenses for preping my tooth and fitting the crown. you would not have the lab cost to pay for would you? Is it because I am just a moren that questions why I should pay through the nose? for Lab work

c4cat

davo10 wrote: »

Sorry, i forgot to add one more cost on to list, the tax man will take over 40% of the net cost of treatment after lab expense is deducted.

yes Tax is something we all have to pay, my heart bleeds

c4cat

davo10 wrote: »

Sorry, i forgot to add one more cost on to list, the tax man will take over 40% of the net cost of treatment after lab expense is deducted.

and why not form into a company then that would reduce to 25% But using my method the actual cost of the crown would not be included in the bet cost of treatment anyway

davo10

Of course the costs of providing treatment is some of the highest in Europe, are you the only person in Ireland who does not know that operating costs here are higher than almost anywhere else, have you heard of a company called Dell recently.

You referred to the rip off mark up on crowns not just the cost of the crown alone, these costs are the reason why we charge more than the just the actual cost of the Lab alone.

we are not talking about tiny gaps in crowns, i referred to problems with fit, you think that deficiencies can be overcome by the dentist adjusting the crown to fit hence larger areas of cement would be exposed. It sounds like you had a good inlay fitted 20 years ago.

If you came to me or most dentists for that matter and spun this drivel, I would not treat you, I would give you a high estimate and try to get you out as qiuckly as possible with instructions to staff not to make you any futher appointments.

you rang labs in Singapore, it all makes sense now, no reputable lab would take an order from a patient for crown/bridge/implants. By the way, what happens if the crown is crap, wheres your come back.

Again, if you supply the crown, its your baby, why should the dentist give you an opinion on its quality, all you want to do is pay for the labour involved in fitting it.

Ancillary practice costs are not suspended just because you are getting a crown from a sweat shop. How can you be certain materials used are safe ( recent milk scare in China/ reports of lead being used in dental prosthesis in the past).

The fact you think ryanair would consider charging less if passengers brought their own seats betrays the logic of your thinking.

Do you not think the list above are "real" costs, look again, see how many of these particular costs you think have/will come down. None is the answer, infact Vat has gone up and there is an extra 1% on taxation for clinic income.

I am not against you per say doing what you are planning to do, but I think you are a fool for doing it. This is not a pair of shoes or a coat, this is a medical/dental procedure. People who have crowns want to know that it is done right, looks right, is of a high quality etc. They want their dentist to look them in the eye and say this is going to look great, preserve your tooth and last them for a long time. They do not want the dentist to say that the prep was done right but you will have to get the gaurentee from the lab about the crown.

Lastly, and i think this is very important for anyone tempted to contact you, your deal depends on you getting two more people to sign up, this is not for the people reading this information, it is so you can benefit.

c4cat

You really do not do yourself justice, you would get rid of me cos you would find it difficult to overcharge me., seems to me you are more interested in the euro you can get out of your patients. just look at the MI out of the Rep heading north and so long as people like you carry on ripping us off that queue of shoppers with a fistful of euros heading north is just going to get longer. The standards of Health care and dentistry in Singapore are on Par if not higher then here in Ireland, I know cos thats where I had my Inlays that have lasted 20yrs done which you kindly complimented as must be very good, and every dentist that has seen them has been impressed with them too and I think anyone else would be happy to have the same too. What is a reputable lab to you, A lab that will not undermine your profits by dealing with a patient direct? So finally why could you not work with a dentist lab of the patients choice, I put it to you according to the evidence you have posted is that you would lose out financially. I rest my case and leave it to the readers of this thread to judge

davo10 wrote: »

Of course the costs of providing treatment is some of the highest in Europe, are you the only person in Ireland who does not know that operating costs here are higher than almost anywhere else, have you heard of a company called Dell recently.

You referred to the rip off mark up on crowns not just the cost of the crown alone, these costs are the reason why we charge more than the just the actual cost of the Lab alone.

we are not talking about tiny gaps in crowns, i referred to problems with fit, you think that deficiencies can be overcome by the dentist adjusting the crown to fit hence larger areas of cement would be exposed. It sounds like you had a good inlay fitted 20 years ago.

If you came to me or most dentists for that matter and spun this drivel, I would not treat you, I would give you a high estimate and try to get you out as qiuckly as possible with instructions to staff not to make you any futher appointments.

you rang labs in Singapore, it all makes sense now, no reputable lab would take an order from a patient for crown/bridge/implants. By the way, what happens if the crown is crap, wheres your come back.

Again, if you supply the crown, its your baby, why should the dentist give you an opinion on its quality, all you want to do is pay for the labour involved in fitting it.

Ancillary practice costs are not suspended just because you are getting a crown from a sweat shop. How can you be certain materials used are safe ( recent milk scare in China/ reports of lead being used in dental prosthesis in the past).

The fact you think ryanair would consider charging less if passengers brought their own seats betrays the logic of your thinking.

Do you not think the list above are "real" costs, look again, see how many of these particular costs you think have/will come down. None is the answer, infact Vat has gone up and there is an extra 1% on taxation for clinic income.

I am not against you per say doing what you are planning to do, but I think you are a fool for doing it. This is not a pair of shoes or a coat, this is a medical/dental procedure. People who have crowns want to know that it is done right, looks right, is of a high quality etc. They want their dentist to look them in the eye and say this is going to look great, preserve your tooth and last them for a long time. They do not want the dentist to say that the prep was done right but you will have to get the gaurentee from the lab about the crown.

Lastly, and i think this is very important for anyone tempted to contact you, your deal depends on you getting two more people to sign up, this is not for the people reading this information, it is so you can benefit.

davo10

Dentists cannot incorporate, we cannot reclaim vat we pay on materials.

If your crown falls out, who will you blame?, the dentist may feel the crown you provided was of poor quality, the Lab may blame the dentist for poor preperation, or will you blame yourself for being a fool.

If i wanted to maximise my profits, i would use cheapest lab (eg in China/Vietnam etc), but i don't, i use a top quality one and pay a premium for their services.

How would you know whether a lab is good or not?, your only concern is the price. You could get a lead substructure with white plastic on it, but it will look like a tooth.

You are not talking about standards of health care (your reference to Singapore standards), you are talking about price.

A reputable lab is one that provides top quality work, uses top quality materials, uses articulators (mimics jaw movements so bite is correct),works to the dentist's prescription, returns the work on time, is good to deal with and is knowledgeable in new advances. The prosthesis is produced in a clean and hygienic enviornment and is returned in prestine condition.

Your assumption is that you are being overcharged, would you be surprised if i told you that the average profit made by dentists in the North and South on prosthesis is the same. Take a look at the list above of costs associated with the provision of dental services (there are many more not included on the list), now how many of these costs are not cheaper in the North?. In particular look at the big ones like property/rental prices, staff wages, energy costs, equipment costs, vat etc. People are not just heading North for dentistry, they are heading north for everything, but just ask yourself this, is a person in the North or Hungary or Singapore getting paid the same as you for doing the job you are doing, if not are you overpaid?

c4cat

davo10 wrote: »

Dentists cannot incorporate, we cannot reclaim vat we pay on materials.

So you are saying if one is a Dentist then one can not work for a company? or that a company can not provide dental services?

If your crown falls out, who will you blame?, the dentist may feel the crown you provided was of poor quality, the Lab may blame the dentist for poor preperation, or will you blame yourself for being a fool.

I would make sure the crown was say either a CAPTEK or EMPRESS

If i wanted to maximise my profits, i would use cheapest lab (eg in China/Vietnam etc), but i don't, i use a top quality one and pay a premium for their services.

And there are Top quality labs in Singapore too, even better then Irish ones too

How would you know whether a lab is good or not?, your only concern is the price. You could get a lead substructure with white plastic on it, but it will look like a tooth.

Do some research as I have been doing up to now and come to an informed decision, also are you saying that standards in singapore are inferior to Irelands and they would use a lead substructure? I think not, Singapore is a first world country more developed then Ireland in many respects

You are not talking about standards of health care (your reference to Singapore standards), you are talking about price.
I am talking about overall standards including dental lab work


A reputable lab is one that provides top quality work, uses top quality materials, uses articulators (mimics jaw movements so bite is correct),works to the dentist's prescription, returns the work on time, is good to deal with and is knowledgeable in new advances. The prosthesis is produced in a clean and hygienic enviornment and is returned in prestine condition.
Exactly what one would expect from Singapore too, I could not agree with you more on this point, but so far its the only point I can agree with you on

Your assumption is that you are being overcharged, would you be surprised if i told you that the average profit made by dentists in the North and South on prosthesis is the same. Take a look at the list above of costs associated with the provision of dental services (there are many more not included on the list), now how many of these costs are not cheaper in the North?. In particular look at the big ones like property/rental prices, staff wages, energy costs, equipment costs, vat etc. People are not just heading North for dentistry, they are heading north for everything, but just ask yourself this, is a person in the North or Hungary or Singapore getting paid the same as you for doing the job you are doing, if not are you overpaid?[/QUOTE]

Yes I have already checked thankyou, I still do not think your prices are justified, but then I am not undermining your prices, I just want to choose which lab I buy my crown from thats all, quite willing to pay you for everything else

davo10

Dentists cannot incorporate, we cannot form companies for the provision of dentistry, we cannot pay at the lower rate of corporate tax. Accept this as a fact, if you cannot, just email the question to revenue (www.revenue.ie). Dentists can however work for a company like Boots for instance.

captek or empress are brands of crowns, it does not mean it will not fall out.

There may well be top quality labs in Singapore, how do you as a person with no expertise in dentistry know that the one you contacted is one of them?.

You didn't answer my question on the wage comparisons for your job in other countries, if they are paid less, do you feel you are overpaid and that your higher salary is justified?.

Lastly and I think this is most important, please inform us of your answers to these questions?

1. what is your criteria for picking a lab, is it price or quality?
2. if it is quality, how would you personaly know whether the lab does provide quality work considering you have now expertise in the matter?
3. When you recieve the crown, how would you know if it is what you ordered and if it is a good crown?
4. What will you do if the dentist informs you that the crown does not fit/is poor quality?. Now you have to have new impressions if the models are damaged during crown production, the temp crowns have to be put back on, you can expect to be charged extra for another fit appointment and the extra work done.
5. again i ask, who carries the can if the crown fails?, captek/empress/procera etc are types of crowns not gaurentees of good lab work.

c4cat

davo10 wrote: »

Dentists cannot incorporate, .....................

captek or empress are brands of crowns, it does not mean it will not fall out.

There may well be top quality labs in Singapore, how do you as a person with no expertise in dentistry know that the one you contacted is one of them?.

You didn't answer my question on the wage comparisons for your job in other countries, if they are paid less, do you feel you are overpaid and that your higher salary is justified?.

Lastly and I think this is most important, please inform us of your answers to these questions?

1. what is your criteria for picking a lab, is it price or quality?
Both

2. if it is quality, how would you personaly know whether the lab does provide quality work considering you have now expertise in the matter?
I already have a few inlays and 1 gold crown and I know which Lab they came from and as you already said they must be good having lasted 20yrs so far .

3. When you recieve the crown, how would you know if it is what you ordered and if it is a good crown?
I won't but I can rely on past experience of what I already have and an honest dentist would tell me since he is neither making or losing anything from the lab work being done at the lab of my choice which is a reputable one anyway so that issue would never come up anyway but Regarding colour if you get that wrong prescribing incorrectly then its in your court

4. What will you do if the dentist informs you that the crown does not fit/is poor quality?.
Doubt if this would happen with a reputable Lab, so a no issue really
Now you have to have new impressions if the models are damaged during crown production, the temp crowns have to be put back on, you can expect to be charged extra for another fit appointment and the extra work done.
I think it would be best to ask for a backup model in the first place, just like data BACK IT UP

5. again i ask, who carries the can if the crown fails?, captek/empress/procera etc are types of crowns not gaurentees of good lab work.
Well if one uses a good lab that should not happen and how often in your experience does this happen with a reputable lab? again thats a non issue like saying what happens if I crash driving to work, still drive to work anyway

davo10

You are basing your quality assurance on work done 20 years ago, good luck with that. How do you know what the quality is like today?. How do you know what lab made your crowns 20 years ago, is the same lab technician still there? (maybe he remembers your model from the millions he has seen since).

Why should the dentist tell you anything, you are supplying it, it's your responcibility, he is not making anything off the crown himself, he has fulfilled his part of the deal by preping the tooth and fitting the crown you supply.

How can you be certain that the crown you supply will fit?

If you crash on way to work, then it is your responcibilty if no one else is involved.

We choose labs based on our experience, you have none bar some inlays/crowns placed 20 years ago and the reason i am spending so much time on this is that you are trying to encourage others to join you in this rediculous scheme so you can get a cheaper crown. Will you take responcibility for the other peoples crowns based on the fact that you organized the crown production. Now that would be interesting.

LASTLY, GIVE ME AN OPINION ON YOUR WAGE COMPARISON WITH NORTH/OTHER COUNTRIES AND WHETHER YOU FEEL YOU ARE OVERPAID AND CAN JUSTIFY THE DIFFERENCE IN PAY. Perhaps you could post your job/profession, it is very easy to look up average pay rates for each profession in other countries.

Phil RevaHealth

This is a pretty strange debate I have to say. I'm a strong supporter of letting people make informed choices and in them having a say in decisions to do with their own healthcare.

That said, I don't see how you can't expect a dentist to fit a crown that they can't stand over the quality of. It is a bit like asking the dentist to use a different make of drill that you have supplied on the day - how can they know it works as well as their own drill with no experience of using it?

When a dentist uses a particular lab they are implicitly standing over the quality of the returned end product. When there's a problem with the product the dentist has a relationship with the lab and can get the problem sorted.

I have two suggestions that I would personally like to see:

1st - "Up to" or Service level pricing
By this I mean a price based around (but slightly above) the statistical average price (including mark up) of the completed treatment. The dentist undertakes to complete the full treatment for this amount, even if it works out costing a little more or a little less on a case by case basis. If a dentist is seeing a lot of complicated cases, this price has to go up to reflect that, and vice versa. This might be complicated to work out, but leaves the patient in no doubt as to the most they will pay for any given treatment. It would also give the dentists the option of charging less if the procedure was easier / less complicated than the worst case scenario, giving the patient a nice bonus (I hesitate to use the word discount for obvious reasons). Finally, it gives the patient a good baseline to compare the completed treatment costs of different dentists in their local area.

2nd - Pricing options
This already happens in some dental clinics, but I'd like to see more options in prices for certain treatments. e.g. Two different makes of implant offered. There are more than one reputable quality brand available for most materials used in dentistry. Give the patient the choice of what materials are used.

Both of those would offer greater transparency and choice to the patient, while not affecting the income of the dentist (if done right!).

davo10

Phil, your points are well made, but I would think that most dentists do this already. It would be difficult to list/advertise an "up to" price because potential patients would just use this figure (the most expensive it could be) to compare prices and decide on whether to proceed with treatment.

I do offer different types of crowns with different costs, from standard PJC's up to procera/lava crowns and inform patients of the advantages and disadvantages of each. Unfortunately, a lot of people base their decision solely on price, the dentists carrying out the treatment know this and proceed with the most basic crowns. I have lost count of the number of patients who have attended my clinic with fractured PJC's which were placed on heavily restored teeth or where occlusion should have prohibited their use. But they were the cheapest option and the patient thought they were getting a good deal.

Secondly, the method and equipment required to place implants differ from one system to the next, we tend to hone our skills at placing one type of implant and build up a relationship with that company. There really isn't a price difference between the cost of the components of the well established implant systems such as Straumann,Nobel Biocare,ankylos etc, so to offer a cheap generic alternative we could be staking our reputation on something that may be untried and tested over a suitiable period. When an implant fails it can be very traumatic for the patient, they have undergone implantation/restoration process, then have to go through explantation, recovery/healing, more surgery, possibly bone grafting etc. Quality implants/crowns cost a little more but the difference over a twenty year period is small.

btkm8unsl0w5r4

I think the point has been lost here somewhere......the real problem is that c4ct like a lot of the public think they know a lot cause they can use google but in reality know nothing about the finer points of dental science. They will argue with you all day long (see the above posts) about why they are correct and you are not becuase they know better. I have a practice limited to crown, bridge and imlant dentistry. I do nothing all day but crowns. All I can tell you is that 1. cheap crowns are crap, 2. How would you know which crown to order, 3. Its whats under the crown that counts and how the tooth is prepared, 4. medical devices cannot be ordered legally by non professionals,

I dont know why I am replying really its so silly.

Its really the dentists time you are paying for, not an item like a crown. By supplying the crown yourself you will not really save the dentist much time (and hence much of his running costs) so why would it be much cheaper.

btkm8unsl0w5r4

Have decided to lock this thread its so amazingly dumb, My moderation skills are being questioned by leaving this up.

THREAD LOCKED