Am I being ripped off ??

decko11

Hi -- 2 questions

I have recently had a root canal (all well ) and have returned to my referring dentist some 3.5 months later

He examined today and said i would need a re-filling - fine. He didnt offer to do it on the spot but said he would do a scaling and polish today -- i assumed he had back to back appointments - but the appointment book suggested otherwise (it was left on counter)

I was charged 90 for this - question 1 - is this odd - why didnt he do the filling on the spot (top tooth and just a re-filing etc)

question 2

he read the letter from endonitist - seemed to suggest not measuring straightaway for crown but firstly putting a new filling on - then waiting 3 months and going for crown -

I have already waited and lasted 3 months with the temp the endo did

does this make sense ? -- I am wondering in this tough market is there an element of filling the appointment book here etc

as this tooth is bottom it will mean another appointment for the second temp filling

thanks
D

btkm8unsl0w5r4

Hi Decko, not to be smart these are questions only your dentist can answer. Best to ask him or her. Nobody on here can make an informed decision on your treatment sequence without all the info.

decko11

Savanna Slimy Officer wrote: »

Hi Decko, not to be smart these are questions only your dentist can answer. Best to ask him or her. Nobody on here can make an informed decision on your treatment sequence without all the info.

Thanks for reply

my first post might have been a bit ambiguous.

There are 2 problem teeth - a lower one - with first class root canal done and a top one with a need for a new filing today.

I didn't think my first question was inappropriate for a forum such as this. eg - Is it normal for a dentist to do an exam and then do a polish and clean rather and send the patient away rather than also doing a filling? - this point is as much to do with my time and effort in having an extra visit rather as whether there could be extra cost

Is 90 euro OTT for check up /polish and scale? (I had been with the dentist in December so I had had a recent check up notwithstanding an extra filing was detected and he referred me to endodontist in December).

It was in Dublin 2 where I imagine costs are higher than elsewhere.

I appreciate my second question is perhaps too technical (but at the same time many technical question are dealt with here).

eg is there (or could there be) an endodontic / dental reason for going from a temp filing to a normal filing for 3 months and then to a crown (esp. given I have had the temp filing for 3 months)

Whilst I havent posted here before I have read many threads and appreciate your valued input on the queries raised by other posters.

I value the relationship I have with my current dentist and would be very very slow to change. However, I would not bring the fees matter up with that dentist ; like many Irish people I would simply complain with my feet and go elsewhere once the current "In process" work is dealt with.

I have no problem paying my current dentist a reasonable premium for good work ; and in general I believe dentists here in Ireland are good value -- unlike say GPs they cannot get through say 5 or 6 patients an hour (at €55 ago) , they have far more expensive equipment, they need a qualified nurse, I assume higher PI cover, way more expenditure on materials and yet by my maths gross per hour about 40% less than a busy GP. Which means way less on a NETT basis c. 60% less.

I would also interpret a lack of comment/defence etc by the contributing dentists on this site as meaning yes something is odd here (given the - in my view wholly justified- correction of many myths about Irish dentists and pricing when issues are raised by other posters

I am very happy to provide any further info

ballsymchugh

hi decko,
it may have just come down to time constraints.
some dentists may feel that they can't do an adequate exam unless the teeth are cleaned. so by the time that was done, there wasn't sufficient time to do the filling.
it's doubtful you'd be more out of pocket as regards your final bill, as treatment is usually fee per item, not for the time taken.

the reason for not firing ahead with the crown... maybe the dentist wanted to make sure the root filling was ok.

Dianthus

In all fairness, give people a chance to reply, you only posted at lunchtime today!
Yes, it's a bit odd to have a checkup only 4 months after your last one.
Are there any other factors to take into account (high sugar diet, general health issues, poor oral hygiene, heavily restored dentition, ect) that would make you more prone to dental problems?
One possiblity is if a patient has bleeding gums, a filling is deferred until the gums are healthier, so that blood won't constantly ooze into the newly cleaned cavity whilst it's being filled, & contaminate it. Hence why a scale and polish would have been done first.
Or maybe your dentist had spent a long time with you at todays' appointment, and needed a break himself if he wasn't at his best, or figured you might need one after having your mouth open for so long?
Or maybe he didn't have a patient after you, but had a prior appointment elsewhere?
Or maybe he was shortstaffed& had no nurse to assist him for that time?
Who knows, it could be none of the above, you'd really have to ask him.

If the root canal treatment was tricky/you had a lot of infection, it's sensible to wait a few months before crowning the tooth....nothing worse that a tooth flaring up and trying to cut through a crown to access it all over again:eek:However, it's usually the permanent filling that should have been in place for these last 3 months, as opposed to the temporary one (to minimise the risk of leakage/reinfection of the root canal). Maybe the dentist wanted to phone the endodontist to inform him that the permanent filling was only being placed now, 3.5months later, and was that ok? Or to check did the endodontist want to see you before the crown to review your tooth or not?
Again, it's all supposition....this has answered nothing for you really, only your dentist can do that, but there are some of the possibilities.

decko11

Dianthus wrote: »

In all fairness, give people a chance to reply, you only posted at lunchtime today!
Yes, it's a bit odd to have a checkup only 4 months after your last one.
Are there any other factors to take into account (high sugar diet, general health issues, poor oral hygiene, heavily restored dentition, ect) that would make you more prone to dental problems?
One possiblity is if a patient has bleeding gums, a filling is deferred until the gums are healthier, so that blood won't constantly ooze into the newly cleaned cavity whilst it's being filled, & contaminate it. Hence why a scale and polish would have been done first.
Or maybe your dentist had spent a long time with you at todays' appointment, and needed a break himself if he wasn't at his best, or figured you might need one after having your mouth open for so long?
Or maybe he didn't have a patient after you, but had a prior appointment elsewhere?
Or maybe he was shortstaffed& had no nurse to assist him for that time?
Who knows, it could be none of the above, you'd really have to ask him.

If the root canal treatment was tricky/you had a lot of infection, it's sensible to wait a few months before crowning the tooth....nothing worse that a tooth flaring up and trying to cut through a crown to access it all over again:eek:However, it's usually the permanent filling that should have been in place for these last 3 months, as opposed to the temporary one (to minimise the risk of leakage/reinfection of the root canal). Maybe the dentist wanted to phone the endodontist to inform him that the permanent filling was only being placed now, 3.5months later, and was that ok? Or to check did the endodontist want to see you before the crown to review your tooth or not?
Again, it's all supposition....this has answered nothing for you really, only your dentist can do that, but there are some of the possibilities.

thank you very much for your reasoned reply - it has actually answered a few things so thanks again; - firstly my second post was in reaction to the first reply which didnt address the issues raised -- I fully appreciate that the time of the dentists who helpfully post here is a very valuable service etc and contributes greatly to the general publics understanding of dental issues

on the first point; thankfully no issue - I have a few routine filings over my 40 years on this earth , and one crown, December was the first time I had root canal - no other issues etc ,none of the other possibilities apply (he told me at the start he would just do a scale and clean (he did one also in December) and it lasted max 15 -20 mins

-- but I can and will give the benefit of the doubt that he had an appointment elsewhere

on the second point -- there was miscommunication between the endodontist and me -- he booked an appointment for last week (April) in Jan with me - he never told me (or if he did it didnt register) to go back to the referring dentist in the meantime. That mix-up was clear when the endodontist was surprised etc when i returned and had the same temp filling in.

However he examined me, told me to make an appointment with referring dentist and that he wouldnt need to see me again. I fully understand why (thanks to your informed post) he didnt want to go direct to crown (although the performance etc of the endodontist was never at issue - it was going 3 month with temp, 3 months now with permanent and then finally crown).

I will maybe give the endodontist a direct call and see can I go now direct to crown ( the referring dentist should have worked this out - as I asked when the letter was dated (mid Jan) from endodontist - and I suggested the 3 months wait was over - but he zoned in on the type of material in a newer temp filing.

assuming endodontist agrees no material reason to go straight to crown its hard for me to regain full confidence in regular dentist. He is BDS NUI (and he didnt go to Cork!) so he is very experienced etc.

Oral Surgeon

decko11 wrote: »

He is BDS NUI (and he didnt go to Cork!) so he is very experienced etc.

What is this supposed to mean and where do you think he went to college?

ballsymchugh

Oral Surgeon wrote: »

What is this supposed to mean and where do you think he went to college?

ucd dental grad.

Oral Surgeon

ballsymchugh wrote: »

ucd dental grad.

Aaahhh, there's your problem right there....:D;)

fatfacee

Yes you are being ripped off.. The charges for dentistry are way too expensive here and I found it hard to get a good dentist. I booked myself on a plane to Poland two months ago. Got everything I needed done in 3 days for less than half the price here.

Oral Surgeon

fatfacee wrote: »

Yes you are being ripped off.. The charges for dentistry are way too expensive here and I found it hard to get a good dentist. I booked myself on a plane to Poland two months ago. Got everything I needed done in 3 days for less than half the price here.

Thats great, don't think the op's scale and polish and filling justify return flights and 3 nights accommodation in Poland. The crown would involve a longer stay as good crowns take time for a lab to make...

decko11

Oral Surgeon wrote: »

What is this supposed to mean and where do you think he went to college?

my understanding is that UCD dental school merged into Trinity in and around 1980

So any dentist that qualified after 1980 and DID NOT go to Cork - cannot be a BDS NUI

there was no malice intended- sorry if i offended - it was just another way of saying he/she must be qualified 30 years plus

fatfacee

Oral Surgeon wrote: »

Thats great, don't think the op's scale and polish and filling justify return flights and 3 nights accommodation in Poland. The crown would involve a longer stay as good crowns take time for a lab to make...

That's true Oral although I was quite lucky because my friend is living there at the moment. She helped me out in regards to accommodation and organizing the Dentist. Can be arranged over ph though and flights only cost €40 to and back. Wouldn't even fill my petrol tank for my car here:D

Oral Surgeon

fatfacee wrote: »

only cost €40 to and back. Wouldn't even fill my petrol tank for my car here:D

Doubt you'd fill your tank anywhere for that....:D
http://www.drive-alive.co.uk/fuel_prices_europe.html

fatfacee

Oral Surgeon wrote: »

Doubt you'd fill your tank anywhere for that....:D
http://www.drive-alive.co.uk/fuel_prices_europe.html

I would in the US:D

ballsymchugh

decko11 wrote: »

my understanding is that UCD dental school merged into Trinity in and around 1980

So any dentist that qualified after 1980 and DID NOT go to Cork - cannot be a BDS NUI

there was no malice intended- sorry if i offended - it was just another way of saying he/she must be qualified 30 years plus

hmmm... your lack of clarity on the gender would make me think i have figured out who your dentist is!

decko11

ballsymchugh wrote: »

hmmm... your lack of clarity on the gender would make me think i have figured out who your dentist is!

what ! - not intended ! - i would have assumend the UCD dental school produced many male and female dentists pre the merger ??

Dianthus

More variables?! If the practice has computors, maybe a computor error re fee.
Or a human error- dentist may have genuinely forgotten a checkup was done only a few months prior.
You say you also had a checkup& scale and polish in December- were you charged the same then as today?
No practice wants to lose loyal patients in "the current economic climate", and I've reservations that your dentist would have jeopardised providing you with a crown, for the cost of a checkup/cleaning. However, equally, I would respectfully suggest that you get a written quotation for your crown, so that everyone is quite clear about the sequence& cost.
I'm sure you're in the best of hands! Good luck:)

Oral Surgeon

ballsymchugh wrote: »

hmmm... your lack of clarity on the gender would make me think i have figured out who your dentist is!

decko11 wrote: »

what ! - not intended ! - i would have assumend the UCD dental school produced many male and female dentists pre the merger ??

Don't worry about it op, you'll never figure out what Ballsy is on about.....;)

ballsymchugh

Oral Surgeon wrote: »

Don't worry about it op, you'll never figure out what Ballsy is on about.....;)

was def a ucd dental grad too!!

decko11

Dianthus wrote: »

More variables?! If the practice has computors, maybe a computor error re fee.
Or a human error- dentist may have genuinely forgotten a checkup was done only a few months prior.
You say you also had a checkup& scale and polish in December- were you charged the same then as today?
No practice wants to lose loyal patients in "the current economic climate", and I've reservations that your dentist would have jeopardised providing you with a crown, for the cost of a checkup/cleaning. However, equally, I would respectfully suggest that you get a written quotation for your crown, so that everyone is quite clear about the sequence& cost.
I'm sure you're in the best of hands! Good luck:)

Thanks Dianthus

I cant remember what I was charged in December - I will check credit card etc --

I wont "walk with my feet" until the current work is done (including crown and top filing not done today).

Im just disappointed .... its not the price - as I said I am happy to pay a premium for good work and an expensive rent location etc - its more the principal and repeat visits... maybe he felt he was missing out on a filing due to the misunderstanding between me and the endodontist...maybe he felt I purposely didnt show back for 3 months...either way i have a confidence issue which lets face it is the most important item in any relationship with a professional

Oral Surgeon

decko11 wrote: »

Thanks Dianthus

I cant remember what I was charged in December - I will check credit card etc --

I wont "walk with my feet" until the current work is done (including crown and top filing not done today).

Im just disappointed .... its not the price - as I said I am happy to pay a premium for good work and an expensive rent location etc - its more the principal and repeat visits... maybe he felt he was missing out on a filing due to the misunderstanding between me and the endodontist...maybe he felt I purposely didnt show back for 3 months...either way i have a confidence issue which lets face it is the most important item in any relationship with a professional

Maybe you just needed another scale and polish before other treatment. I've seen patients come back to me a week after a scaling with crap all over them.....

ballsymchugh

OP i had a patient like you a few weeks ago who complained to me because i asked them to come back. when they asked if i would do all the work in one go, i refused. i said i'd do it right or not at all, and they haven't been back since. i'm much better off if they want to go and bug someone else as long as i'm not going to be rushed and can do things at a pace i'm happy with.

maybe your dentist just does things methodically and in a way which he's comfortable with.

Lippy C

You are been ripped off...I always return to my dentist (private) in uk..£25 for hygienist and clean..I also paid £250 in total for x-rays and root canal and that included follow up to check all was well:)

ballsymchugh

Lippy C wrote: »

You are been ripped off...I always return to my dentist (private) in uk..£25 for hygienist and clean..I also paid £250 in total for x-rays and root canal and that included follow up to check all was well:)

i work in the UK. there is a world of difference in the costs of running a dental surgery here compared to dublin. anyway, you didn't have a specialist root filling at that price.
prices with the specialist we refer to start at £500stg.

decko11

ballsymchugh wrote: »

OP i had a patient like you a few weeks ago who complained to me because i asked them to come back. when they asked if i would do all the work in one go, i refused. i said i'd do it right or not at all, and they haven't been back since. i'm much better off if they want to go and bug someone else as long as i'm not going to be rushed and can do things at a pace i'm happy with.

maybe your dentist just does things methodically and in a way which he's comfortable with.

thank you

I wouldnt have thought that one upper tooth re filing along with a scale and clean was too much in one visit ?

to answer Oral Surgeon -- if condition was so bad to merit not doing a filing bad surely he/she should have communicated this (i dont think condition was bad at all)

Lippy C

ballsymchugh wrote: »

i work in the UK. there is a world of difference in the costs of running a dental surgery here compared to dublin. anyway, you didn't have a specialist root filling at that price.
prices with the specialist we refer to start at £500stg.

I am not disputing what you said just saying that what treatment I had was a fraction of what it would cost in Irl for what I had in UK so to me x-rays and root canal plus aftercare was great price.

ballsymchugh

Lippy C wrote: »

I am not disputing what you said just saying that what treatment I had was a fraction of what it would cost in Irl for what I had in UK so to me x-rays and root canal plus aftercare was great price.

you didn't compare like for like though. specialist treatment is more or less the same price in UK and Ireland.
you didn't have that, while the OP did.

Dianthus

OP, a friend of mine has a saying, and it is as follows- "Assumption is the source of all f###ups". You assume one thing, the other person assumes something else, and there's just misunderstanding and tension all around.

Honestly, 11 hours of your life (and maybe just a bit of the rest of ours too!:rolleyes:) has been spent on secondguessing what the story here is. Why not just go directly to the source, not in a confrontational way or anything, and say "Look, I've always been very happy with your work, and I respect you as a dentist& a professional. But I'm a bit confused as to the fee I was charged when I was here last". Then calmly await the full explanation.

I can guarantee that if you approach this directly& in the right way, versus running away from it/ disappearing into the dead of the night never to be seen in that dental surgery again, you'll have a lot more respect for yourself, and nothing but respect from the dentist in question either. (And who knows...you may even get a refund...?;))

decko11

ballsymchugh wrote: »

you didn't compare like for like though. specialist treatment is more or less the same price in UK and Ireland.
you didn't have that, while the OP did.

true and as OP I would reiterate that I was extremely happy with Dublin based endodontist. As a patient, Endo work is tricky business and i am grateful to have been referred to a top class guy

Lippy C

ballsymchugh wrote: »

you didn't compare like for like though. specialist treatment is more or less the same price in UK and Ireland.
you didn't have that, while the OP did.

No I didnt compare fair enough but my sister needed same treatment I will accept we have different teeth but what a hell of a difference she was quoted 950 euros just stating facts I know with her and myself that we have been quoated

macmurchu

Hey man

I'm a dentist and came across your post.

1) is €90 expensive for a scale&polish?

It's not the most expensive I have heard. It's more than I charge but I know of places where it's €120 for a cleaning alone. Where I work an exam including X-rays is €70 and a cleaning is €70 with a hygienist, so €90 total probably isn't that bad. If you think you were charged a bit much ask! I hate thinking that my patients are unclear over costs and I want to be totally transparent. If asked, the dentist should tell you exactly what was done during your exam. For example, a typical exam will include inspection of teeth and gums, oral cancer screens, records of progression of gum disease, if any, X-rays if they took them. Depending in the dentist (especially if they aren't much of a communicator, which I admit I used to be) they can give the impression they've done sweet FA.

2) why wait before crowning a root canal treated tooth?

If the root canal was done to rid the tooth of a dead pulp/nerve or get rid of an infection/abscess, whether painful or not, dentists sometimes want to be sure the root canal was a success. There are a few issues here:

- root canals are typically 90-95% successful for a variety of reasons (this reflects ALL teeth, some you can say it will be 99%, I don't know your case exactly). We want to be sure that the infection is resolving before putting a crown worth up to €1000 on top of it; if the root canal fails, you may need to take it out. Bye bye money. This is done by taking an X-ray 6 months after completing the root canal and comparing it to the infection from beforehand. If the infection is getting bigger then the root canal has failed, so don't put a crown on, no point. If the infection is the same size or shrinking, crown away!

- the reason crowns are need is to prevent the tooth breaking. A tooth becomes more brittle after doing a root canal. 3 years after completing a root canal 50% of those teeth will have broken. Where that fracture occurs and how deep it goes might end up in losing the tooth. Again, bye bye money.

One viewpoint for a dentist is to crown the tooth as soon as the root canal is finished to prevent fracture. The other is to observe healing and make a decision after 6 months. Personally I make the decision on a case-by-case basis. If it has been a complex root canal and I'm not sure it will be successful, I may wait the 6 months. If I'm pretty sure it's good, or I'm pretty sure the tooth will break if I don't, I'll recommend a crown/onlay.

My own view tends towards crowning in general ASAP. A crowned root treated tooth may fail, a broken tooth runs a greater risk of catastrophic failure, ie extraction.

One thing is certain: the filling needs to be replaced. Why the dentist didn't do it then, who knows? His reasons: a meeting, lazy, sore back, no instruments, God only knows. More likely he was reluctant to charge you for many things all on the one day.

Whatever the reasons for the treatment sequence, communication is important. An informed patient is a happy one. I've been that bad communicator and it leads to problems. I am a good communicator and my patients aren't confused, so they trust me. If you don't understand what's going on, ask.

Hope I've helped and haven't confused you.
Best of luck