Americans are consciously trimming the extras from their budgets, and, often, dental work is left off the list of necessities, because it is expensive. But proper oral care is more important than some may think. By age 74, roughly 78 million Americans lose all of their permanent teeth. Sometimes tooth loss is due to a lack of personal oral hygiene, other times the cause is bone loss, gum disease or some other underlying medical issue.
Since 90 percent of systemic diseases have oral manifestations — for example a sore jaw, when combined with chest pain, especially in women, can signal a heart attack — dental visits should remain a priority.
Moreover, since one of the outward signs of success in America is having straight teeth and a glistening smile, bad teeth can be a source of stress.
On average, 44 percent of dental fees are paid out-of-pocket. Many Americans would like to visit the dentist more often but may be asking, is dental care affordable?
Insurance and flex
Dental insurance and health insurance are not the same. There are different fee and benefit structures for patients with these insurances. Dentists complain that health insurance makes dental work seem more expensive, when it is not. One big difference in dental insurance is that it typically covers 100 percent of preventive care, such as cleanings and X-rays, but does not cover the more expensive fees like bridges, caps and crowns. When patients need dental work and need to meet a deductible or price quota to receive benefits, they shy away from dental treatment and their problems undoubtedly worsen over time.
“Patients with dental insurance think that care should be free, because the insurance covers cleanings, which can cost between $100 to $300. They get used to not being charged, so when something happens, it feels like it is expensive, and the cost makes them angry at the dentist’s office. Not fair,” said Betsy, a dental hygienist in Brooklyn.
To help pay these extra costs, patients with dental insurance can use their flex benefits — a plan that helps you pay certain specific expenses from your pre-tax, rather than your after-tax, income.
“Patients with dental insurance can combine it with their flex benefits to cover any out-of-pocket costs. We can charge the fees to their flex accounts on a monthly basis for the expensive procedures, if they want to handle the payments that way,” explains Peggy, a dental office manager on Staten Island. “Patients that use their flex dollars, and do not have to pay us directly, are very happy with the arrangement.”
Dental schools
Jonathan Zeichner, a Manhattan periodontist, lends patients a sympathetic ear, excellent periodontal cleanings (according to his reviews) and practical advice. He recommends that patients without insurance get a cleaning every six months at a dental school, as the minimal front line of defense.
“Oral hygiene may not be as out of reach as you would expect,” says Zeichner. “Options for patients who cannot afford these fees are to go get care from clinics at the major dental schools. While procedures are performed by dental students, all of these clinics are supervised by licensed dentists and are a backdoor for patients to obtain quality dental care for little or no cost.”
Because the focus of dental school is on education, services are offered at lower fees than the cost of comparable procedures at most private practices. The NYU College of Dentistry and the Columbia University College of Dental Medicine offer services at great reductions. In addition, dental hygienists in training at Hostos Community College and the New York City College of Technology offer free and reduced rate care to qualifying patients.
Dental tourism
More and more people are investigating tourism as the next best option for getting the treatment that they need. It appears that proper and high-quality dental treatments at low prices are available at beautiful destinations around the world. Clients can get dental work and then vacation before they return home, looking refreshed, not as if they have been under the knife.
“I’m an American living in the Yucatan of Mexico and have had several friends visit in part to get dental work done there,” says author and tattoo artist, Elaine. “They’ve found that they were able to make the trip (including the flight, plus taking a vacation) and get their dental work done for a cost that is significantly less than just the out-of-pocket dental work alone in the U.S.! One friend had work that had been estimated at USD $12,000 and he got it here for literally one-10th of the price!”
Mindy, formerly of New York, agrees that leaving the country for dental care can make it more affordable.
“Go to Mexico. My whole family (parents, sister, her kids and my cousin) all go to a dentist in Tijuana. He recently did a crown for me for $220. Most are educated in the U.S. and some market to U.S. clientele specifically.”
These gals both happened to mention Mexico from personal experience, but there are several tourism agencies promoting dental tourism destinations including Mexico, Australia, India, Budapest, Hungary and others.
If you’re considering this, do your own research in advance. Research the dental provider and his credentials, references or reviews, and the destination itself, to avoid any potential problems or regrets.
In-office dental plan
Higher out-of-pocket costs cause many patients to delay treatment, which can often cause the problem to get more severe. Delayed dental care usually means more expensive care in the long run.
The truth is, many dentists are trying their best to accommodate rising costs (their own operating costs are rising dramatically, as well costs from materials to information technology to infrastructure — though few give them credit for this) and employ various methods for taking care of their under-insured patients.
“My dentist has an in-office plan that includes two hygiene treatments, two exams, and any necessary X-rays each year. Plus, I get reduced fees on practically all other dental procedures. I pay an annual fee and discounted fees for additional family members,” says Ms. Kidd of Manhattan.
Discount dental plans
Dentists in upper middle-class and affluent neighborhoods with big and loyal followings of their practices often do not accept insurance, nor do they offer in-office plans to patients. As an alternative for patients who cannot afford a high-priced dentist, dental discount plans may be an option.
These plans provide access to a network of dental providers who are contracted to deliver services at fixed discounts. A dental plan is not insurance. There is no premium or co-pay collected and there is no maximum on usage. Members are charged a steady monthly or yearly rate, lowering the patient’s out-of-pocket costs from the start.
Dental discount plans often include cosmetic and orthodontic treatments, and since no middleman is involved, the amount of paperwork is reduced for the patient and the dental office. Some plans discount nearly everything except lab fees. Since it has no maximum usage, some people use a discount plan after their regular dental insurance plan has reached its yearly limit. The simple process has few restrictions and could be ideal for seniors.
Do-it-yourself dental
Some people are just plain old afraid to go to the dentist. The thought of going to the dentist conjures up images of a drill-bearing ogre who will chastise you for bad habits, strap you into the chair and cause you to endure excruciating pain the whole time. For those with dental phobias, there is good news: Patients can take responsibility for taking care of their own teeth with good results. Here are some suggestions:
People who drink three or more sugary sodas daily have 62 percent more dental decay, fillings and tooth loss. Drink more water, it’s good for your teeth.
The average person only brushes for 45 to 70 seconds a day, while the recommended amount of time is two to three minutes. Set a timer and brush the four sides of each tooth.
Seventy-three percent of Americans say they would rather go grocery shopping than floss. Yet, flossing daily can extend life expectancy, a fact that is weird, but true. Flossing does two things: it prevents gum disease, and it (not so obvious) prevents heart disease. Preventing both of these together is what adds years to your life.
Thirty-two percent of Americans cite bad breath as the least attractive trait of their co-workers. If you want to have a better time at work, take care of your mouth and teeth.
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How people take care of their mouths and teeth is often a reflection of how they feel about themselves. Everyone deserves to have a healthy mouth. It can change your life and be a reason to smile.
“Did the sun come out, or did you just smile at me?” still might be the greatest pick-up line of all times. Need I say more?
Candi Sparks is the author of children’s books about money: “Can I Have Some Money?,” “Educating Children About Money,” “Max Gets It!” and “Nacho Money.” She lives in Brooklyn, is a mother of two, and is on Facebook and Twitter. Her website is www.candisparks.com.
