Am I being ripped off ??

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