Posts Tagged ‘Crowns’

A Personal Story: A Year and a Half of Pain – Paula, South Royalton

Thursday, March 15th, 2012

When Paula moved to South Royalton, Vermont, because she had no job she was on Medicaid. She had a cap on her left rear molar which had cracked, but Medicaid did not cover any dental for her, even what seemed to her to be an emergency. She had to wait until she got a job, and then she had to wait nine months before the insurance kicked in to go get her tooth looked at. The first appointment was just an assessment, and she was referred to a different dentist where she had to wait again to get an appointment. “We were probably about a year and a half out where I was going with nothing on that tooth, dealing with the pain and the hot/cold sensitivity. When I finally got it taken care of by the dentist he said the gum was really worn down and damaged because it didn’t have the tooth protecting it and the surface there. So he actually had a difficult time and it was not the ideal crown that he put on…. It wasn’t a perfect fit.”

With the dental insurance from her new job, Paula could now afford dental care, but still found it difficult to get the care she needed because there were so few dentists, she still could not get on a regular six month schedule. It seemed like she could never schedule an appointment when she wasn’t working.

After she had her baby and wasn’t working, Paula called around to quite a few dentists because she was having pain in her lower left molar again. She found a dentist who was able to see her in the weeks before her insurance from her job ran out. Unfortunately, he ended up canceling the appointment, so although she got her teeth cleaned, Paula was not able to get her other concerns addressed. So now it’s been over a year since Paula has been to the dentist, she has no dental insurance and can’t afford to pay out of pocket.

A Personal Story: Insurance Doesn’t Help Much – John, Lebanon

Thursday, March 15th, 2012

John, 41, lives in Lebanon, New Hampshire, and has two cracked teeth that need crowns. He has dental insurance but it does not cover very much of the work. The estimated out of pocket cost for John is about $1,000 per crown. He has a regular dentist, but has to wait until he has the money to get the work done. “The dentists that I’ve seen, they have a set fee that they charge. There is no write-off the way there is for health insurance.” John explains that with doctors and hospitals, if insurance covers 80% of the charge, they call that good enough, but dentists don’t work that way. Whatever dental charge insurance doesn’t cover, the patient must make up the difference. This is what makes dental work so unaffordable. It’s a frustrating situation. “I’ve got dental insurance, it just isn’t very useful.”

A Personal Story: Dipping Into Retirement for Teeth – Danielle, West Hartford

Sunday, November 13th, 2011

Danielle and her husband are both self-employed and living in West Hartford, Vermont. The only dental insurance available to them pays for cleanings but doesn’t cover the bigger work that she needs to get done. Whenever she goes to the dentist, the dentist will usually find something big and give Danielle a proposal of how and when the work should be done. It usually involves more than one tooth and costs two to three thousand dollars. “It’s a little overwhelming,” says Danielle. She usually puts the work on a payment plan with zero percent interest, but “it still feels like you’re going into debt for your teeth.” At times she has cashed in her retirement money to pay for dental work.

Over the past ten years, Danielle guesses she has spent over ten thousand dollars on dental work. In fact, there was one tooth alone that probably cost that much: She had a root canal, another procedure, ended up having the tooth pulled, two bridges made, and finally ended up with an implant with a crown. At one point, her sister remarked to her: “You can get dentures a lot cheaper.”

Right now Danielle’s husband has a cracked tooth that he has delayed work on for the past year. He’s mindful of it when he eats, but it will probably cost four thousand dollars for an implant if the tooth breaks off. Danielle’s husband also needs to get hearing aids, and they have decided that his hearing is more important than the tooth at the moment. But it’s a difficult decision: “How do you choose between hearing aids and a cracked tooth?”

Illustration by Dennis Pacheco.

A Personal Story: Extraction the Only Option – Phil, Vershire

Thursday, November 3rd, 2011

In 1997, Phil was self employed and making good money. He had a tooth that needed a root canal and a crown, and he paid $1,200 to get the work done. After five or six years, the tooth went bad and Phil needed to get it fixed. However this time he was unemployed and “basically homeless”, and he could not find anyone willing to do the work. Fortunately, Phil lives in Vermont and had VHAP and went to the local free clinic where he got a voucher for an extraction. “It was really messed up because it was really hurting for awhile and I was babying it and babying it, until it finally finished cracking apart and I went in there. It was really awful, I really had a horrible toothache for like two weeks. Getting them to see me was just almost impossible.” But Phil finally convinced them to move up his appointment, and he had the tooth extracted. “That was one of the best things that ever really happened.”

But it’s frustrating for Phil, because he used to have health and dental insurance coverage through his job, and dentists were also more affordable. Now he feels like his only option is the clinic where he can only be seen for an extraction. “If there’s no real problem with your teeth, they’re not going to do much of anything. You basically have to wait until they’re extractable, which is really awful, and then just have all your teeth pulled out…That’s how our system is working now…Just like it was ages ago…from the 13-1400s until now. If you can’t afford whatever it costs to have someone look at your teeth and get the dental work done, they wait until they’re extractable and then, boom, out they go.”

Illustration by Dennis Pacheco.

A Personal Story: Won’t Take Teeth for Granted – Sarah, Topsham

Friday, September 30th, 2011

Sarah feels really lucky about her family’s dental care. Living in Vermont, her children have been covered by Dr. Dynasaur since they were young, “I feel like we got in with a really good dentist… and then I started hearing about this shortage.” Sarah used to see the same dentist as her children, but she had a lapse where she didn’t go for three years. When she tried to go back and re-establish regular care, they weren’t accepting new patients, so she had to find another dentist. The lapse in care occurred because Sarah herself was uninsured and paying out of pocket for her care: “Fortunately, one of my wisdom teeth was impacted so I got medical insurance coverage for that.”

Sarah had a few complications from her wisdom teeth removal: some of her soft tissue healed in such a way that it formed a pocket next to her molar, making it very difficult to clean. She got a crown on her molar because of the decay. Sarah was able to pay out of pocket for her crown, and sees this kind of dental work as an inevitable part of growing older. “I have older friends who said, oh – my partner didn’t take care of his dental situation when he was in middle age and now it’s really giving him problems… I’ve had friends telling me, get your teeth taken care of now, because it just gets worse if you leave it.”

Sarah and her family used to qualify for VHAP and Dr. Dynasaur, but now they don’t and now they pay for all dental care out of pocket, which Sarah doesn’t mind: “I really feel like my teeth are worth investing in. I feel really lucky that I inherited these genetically strong teeth and it would be really foolish not to just continue to take care of them. I can’t take them for granted.”

A Personal Story: One at a Time – Dottie, Strafford

Friday, September 30th, 2011

Dottie and her husband Stan live in Strafford, Vermont, and have no dental insurance. Dottie is currently scheduled to have three cleanings a year, because she is on the edge of periodontal disease. She can afford to pay for her cleanings, but in the last ten years she has also had five crowns and two root canals which were more difficult to find the money for. One year she had two crowns and a root canal, Stan had a crown, and the couple’s total dental bill that year was $8,500. Fortunately their dentist offered them a loan at 0% interest if it could be paid within the year, which they did, but it wiped out their savings. They thought, “Well we’ve paid off our dentist but we have no money. It’s crazy…Luckily nothing else happened that we needed to access some quick cash.”

Currently Dottie has a mouth full of old fillings, all of which will eventually need to be crowned. She thinks she should probably get her teeth done one at a time, one a year, but she knows she’ll have a hard time paying for a second crown if one of her other teeth happens to break.

Dottie has considered a local free dental clinic but isn’t sure if she’d qualify because her family’s income wavers between qualifying for VHAP and not. She has also heard that you can go to Boston and let Tufts medical students practice putting crowns in, which seems like a good option for her when she considers the number of crowns she still needs. Dottie has a friend who opted to have a tooth extracted rather than pay $2,500 for a crown and root canal that was recommended by her dentist. “Now she has this hole back there and I’m like, yeah, but aren’t all of your teeth going to shift?… That’s like, whoa, you start pulling out your teeth because you can’t afford to fix them? I mean, I suppose that’s what we all do in the end, and we end up with false teeth.”

A Personal Story: In Debt for Dental – Emme, Strafford

Sunday, September 25th, 2011

Emme is 58 with two grown children. She lives in Strafford, Vermont. She has dental work that she needs done, but can’t afford it. She has repeatedly gone into debt to try to pay her dental bills. Here is her story:

Sometimes we had Medicaid, sometimes not, but I have only once used a Medicaid dentist, as I trust my own so much, and he does not take Medicaid. Most of the time we just put it on the credit card, as we don’t have enough money to pay cash. We have lots of credit card debt. My dentist knows our situation, so whenever he can, he gives us a break . . . like for an emergency visit for my husband, but we still had to pay the “extractor” with a credit card. The boys were always covered by Medicaid, until they got older. Now they don’t go as often as they should. They will go for years (without seeing a dentist.) I have work that needs to be done, but cannot do it and it is just too much to put on the card… deep scaling and planing, (my husband too) and a crown. I will have to wait until my stepfather dies and then use my inheritance. In the past, like 18 years ago, I didn’t go unless it was an emergency. I had several teeth pulled out because it was cheaper than a root canal. The only time I had a big job done was after my father died and I inherited some money. I needed a crown, and so I could pay for it then.

A Personal Story: Teeth are a Good Investment – Susan, Chelsea

Tuesday, September 20th, 2011

Susan and her husband Phil and their family live in Chelsea, Vermont, and have had dental insurance through her teaching job for the past eighteen years. Although they’ve never had high incomes, Susan and Phil and their children always made sure to get regular dental care: “I’ve always felt like taking care of your teeth was a priority, even when we felt like we had no money.” The dental insurance they had paid for cleanings and most of the cost of the two crowns Susan had to have. One of the crowns was five years ago and the other was two years ago, and Susan was able to pay off what the insurance did not cover in two or three payments on a payment plan. Susan and Phil’s two children are both grown now and no longer covered on the family dental insurance plan. They both pay out-of-pocket for their cleanings, but still make sure to get their teeth cleaned at least once a year. “Our whole family has just put a really big emphasis on healthy teeth…it seems like a good investment.”

A Personal Story: Crowns vs Food? – Martha, Sharon

Wednesday, September 14th, 2011

Martha moved with her family to Sharon, Vermont, from overseas three years ago. She went to the dentist for a full work up, and the dentist told her she would need several procedures done over the next five years. Martha and her family do not have dental insurance so she is paying out of pocket for all the work. Martha got one crown done for $1,200 and then changed dentists because she found one who would do the work for less money. However the new dentist has since raised his rates, so his crowns are over a thousand dollars as well. Last summer she had a second crown done with money from the family’s tax rebate. Although the crown had been intended for one tooth, it was put on another when the filling cracked and half the tooth fell out.

Martha still needs three more crowns and she has not scheduled the work because she can’t afford it. She’s not sure when she will be able to: “I’ve got lots of dental work to do and I’m not doing it because I haven’t got the funds right now.” She has thought about taking out loans for the work, but with a fixed salary, her family can’t afford the payments: “By the time you’ve taken out loans for health care, dental care, and everything else you need to take out loans for, you’ve got no food. So we can’t really do that.”

A Personal Story: Can It Wait? – Beth, Strafford

Tuesday, September 13th, 2011

Beth is 49, lives in Strafford, Vermont, and has a job in health care. She feels fortunate that she and her family have dental insurance and have always gone to the dentist regularly. She and her husband have started needing to get their teeth crowned, as their old fillings deteriorate: “As a matter of fact, I felt a little twinge of something yesterday.” Because their insurance covers half the cost, Beth and her husband take turns getting their teeth crowned in order to afford their dental work. Then they use a payment plan with a monthly payment to pay off the work.

Still, Beth and her husband tend to put off dental work as long as they possibly can. Whenever the dentist tells her there is more work to be done, Beth says, “I ask, ‘Do I have to do it now?’ because there are always other pressing needs.” Beth knows it can be dangerous to delay care: “An abcess can kill you if it goes to your brain…some things happen really fast.” But, she admits, even with dental insurance, most people can’t afford to do all their necessary dental work at once.