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Old 07-01-2008, 04:07 PM
 
9,138 posts, read 9,926,596 times
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Quote:
Originally Posted by Rick Lee View Post
On your recommendation I just went to one of these guys. I realize that, as a new patient, it might take a little longer. But I was there for 90 min. before my cleaning began. They'd faxed me the paperwork last week and I brought it with me all completed. Taking my blood pressure and x-rays was almost an hour. And this was the first time I was seen by the dentist before the cleaning. He used that fiber optic probe to take color photos of my fillings while telling me it was time to have them all replaced with those white fillings. He even left them on the computer monitor for me to stare at for 20 min. while I waited for the hygienist to arrive. Dr. said he'd have an estimate waiting for me when I was done.

Once done I went to settle up and the billing lady explained to me that because of my insurance, they had special rates on all these filling replacements and my out of pocket would only be $174.

I dunno, but in going to my last dentist in DC for 15 yrs., she always told me my fillings looked fine and would hold out for many more years. I haven't had a filling in 26 yrs. and some of them are over 30 yrs. old. I wish I could fly back to DC for my dentist appts.
I went to a dentist. I had to get fillings. I asked him when they would need to be replaced and he said 10-15 years. I don't know who to trust. Your fillings are probably fine. I would wait or get a second opinion from a dentist who doesn't look like he is raking it in. I know dental replacement fillings are a big scam for a lot of dentists and it's an easy way for them to make a lot of money. That dentist sounded shady to me. I would see a couple of more dentists before I came to any conclusions.
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Old 07-03-2008, 01:29 AM
 
19 posts, read 44,254 times
Reputation: 15
There is debate as to whether silver (amalgan) fillings need to be replaced. Many dentists will not place amalgan fillings in adults due to the controversy about mercury. Children may receive them in baby teeht since they will fall out eventually.

That's generally not the issue. Teeth with silver fillings often have large fillings. If these have to be replaced because they are craking or leaking the dentist drills away more tooth structure - and in many cases it's too much for the tooth. If it's filled again, the tooth breaks much more easily and then you have an even bigger problem. Most dentists will suggest these teeth be crowned. The success of the crown is often higher than a fllling.

The patient may say - wow a filling is only $130 - a crown is $800+. The crown however will last a very long time. If you fill it and it then requires a crown - you don't get a filling credit - you just pay the extra for the crown crown. And by filling it - and having it fail may create a higher need for a root canal.... add $500-$800 depending on the tooth and whether a general dentist can do it or it requires a specialist.

The advise to seek 3 opinions .....wow. Who has that kind of time? If I took off time to see 3 dentists over one tooth I'd be able to pay for a lot more than one crown. Add to time off work - each dentist will require a exam $50-$90 and need to see your x-rays - where you'll pay a copy fee .from the original doctor. If you plan to have a number of implants, or lots of cosmetic work where you will be spending thousands - a second opinion is smart. For one tooth .....any dentist can do a crown. And many insurance policies discount these crowns to $600 or so.

Most dentists put the patient's interest first They have a standard of care that they must meet in every instance. These people have gone throgh extensive and expensive education and training. Equipment is expensive - etc, etc. This is your health. Find a dentist that somenone you know uses and likes. Hopefully that person is a educated consumer of health services. They get regular dental cleanings and maintain their mouths. Don't ask an opinion of someone who only goes when it breaks or hurts. These are not educated consumers of health services - they are only consumers in emergencies. Patients who have a relationship with their provider will be better referral sources.

I'm not a dentist - I work with many health care providers. I understand this field. For the most part - once you've gotten through the rigors of medical/dental school, paid for a practive, pay your staff to the tune of $300-$500K per year, add rent and equipment .... you've weeded out most of the bad apples. I'd look for an office that is modern ( new equipment says your doctor is up to date on newer procedures and techniques - few put new equipmemt in old beat up infrastructure ..., so yes you may see a nice waiting room - it's about pride of services - not money) and clean (critical! if they are impecably clean they generally pay attention to other details). I prefer owner operated practices - I think they are more concerend with patient care and are in it for the long run. I would never look for the cheapest provider. Why would a dentist do a crown for $400 when everyone else is getting twice that? He's cutting cost somewhere - poorly trained staff....cheaper supplies... or just desperate to have someone in the chair because there aren't patients coming in .....very bad sign. I want a provider who is out of school for at least 4 years. Anything under that and they are still seeing and learning new things - on the job training - let them learn on someone else. They will say they saw it all in school....perhaps - with an experienced doctor looking over their shoulders - it's not the same.

For those seeking 1/2 price dentistry and who don't have insurance try Az School of Dentistry & Oral Heealth in Mesa. They have student dentists who will perform supervised dentistry for half price. Plan to be there a L O N G time. student dentists are very slow. Midwestern Univeristy in Gendale will be treating dental patients in 2 - 3 years - also at a discount.

Just some ideas on finding a care provider.
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Old 07-03-2008, 09:06 AM
 
Location: Cave Creek, AZ USA
1,712 posts, read 3,755,981 times
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Thank you and I appreciate your taking the time to explain all that. I know about the delicate balance between messing with old fillings and risking more trouble with newer ones. If I need to have work done, I can accept and afford it. That's not the issue. It's just that the last time I shopped for a dentist was before there was an Internet. And earlier in this thread a lot of folks mentioned getting a hard sales pitch from new dentists. I'd never heard that before, but it's exactly what I got when going to this dentist. Add that to the 90 min. I was in that chair before the cleaning even began and I came away with a, shall we say, bad taste in my mouth. I will certainly get a second opinion before spending any of my own out of pocket $$ with this new dentist.
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Old 07-08-2008, 07:23 PM
 
21 posts, read 110,536 times
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Can anyone recommend a good dentist in North Phoenix near Union Hills and 34th street?
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Old 07-08-2008, 08:12 PM
 
9,138 posts, read 9,926,596 times
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Healthcaresafety is obviously a dentist and I can tell by his response that he is clearly a dentist. My very best friend is a dentist. He is close to my age. I work out with him daily and we discuss our practices. I know a lot of inside information that he wouldn't want me to share but I'll share it with you.

-Most dentists finish school with 100-300K in debt. Many of the private schools charge over 40K in tuition per year alone.

-Most young dentists purchase dental practices. Unlike medicine, there are a lot of solo dentists that eventually sell their practice off when they retire. With physicians, they are usually members of groups so they sell their share back to the practice they are leaving. So just because you see a young dentist with a huge patient following, don't assume he built that from scratch. These practices usually cost anywhere from 250K to up to a 1 million but most go for around 300-400K. So keep in mind, these dentists are already in debt for 300K + 200K or around $500K. Banks will bend over backwards to give you a loan if you are doctor or dentist. Any guy graduating from dental school can walk into any bank and ask for a practice loan and it's done, no questions asked.

-Yes, these dentists pay around 500K for their staff and expenses but guess how much they gross. Many dentists in private practice who are somewhat popular will gross over a 1 million dollars. Overhead for most dentists accounts for 60% of their total gross. So don't think these dentists are not making money when it's all said and done. The guy I'm friends with grossed 1.1 million and his overhead was 55% so he made close to 500K in net income before taxes. This is not uncommon for a dentist. The famous cosmetic dentists that you read about, gross over 2 million

-The truth is a lot of these dentists have massive debt in addition to a more expensive lifestyle upon graduation (new house, new BMW) so they have every incentive to make sure you don't leave their office with putting some money in their pocket.

-A lot of this new equipment is eye candy. My friend uses the camera puts his work on the LCD in front of the patient and assumes the patient is impressed and thinks more highly of his work or practice. It doesn't mean the dentist is any better at his or her job.

-Why does one dentist charge less? Why does one doctor see 20 patients a day and another see 60 in the same time period? Phoenix has a short supply of both doctors and dentists. It's easy to get patients here. Getting patients is cake. It comes down to how you choose to practice. Some professionals are willing to make less money(although still great money) to practice ethically. Some people are not comfortable ripping off patients while others could care less and are greedy. I see this with some of my physician colleagues. They spend 10 minutes on a new patient visit and bill a level 4 or 5 visit whereas others spend 25-45 minutes and bill the same amount. It comes down to integrity and there are many dentists just like doctors that have a very expensive lifestyle they are paying for and need to trump up extra procedures in order to pay for that. I know I'm not being PC but people need to know this.
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Old 07-08-2008, 08:32 PM
 
488 posts, read 844,379 times
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Quote:
Originally Posted by azriverfan. View Post
Why does one doctor see 20 patients a day and another see 60 in the same time period? Phoenix has a short supply of both doctors and dentists. It's easy to get patients here. Getting patients is cake. It comes down to how you choose to practice. Some professionals are willing to make less money(although still great money) to practice ethically. Some people are not comfortable ripping off patients while others could care less and are greedy. I see this with some of my physician colleagues. They spend 10 minutes on a new patient visit and bill a level 4 or 5 visit whereas others spend 25-45 minutes and bill the same amount. It comes down to integrity and there are many dentists just like doctors that have a very expensive lifestyle they are paying for and need to trump up extra procedures in order to pay for that. I know I'm not being PC but people need to know this.
You're not being PC, but you're really accurate. I'm amazed at other physicians I've worked with in the past who just order a seemingly random series of tests because they'll get paid for it, and especially because it's a lot easier than sitting with the patient for an extra 15 minutes trying to figure out what tests might actually tell you the diagnosis and lead to a treatment. It's frustrating, and a major problem with the current medical system.
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Old 07-09-2008, 02:27 AM
 
9,138 posts, read 9,926,596 times
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Quote:
Originally Posted by synapse View Post
You're not being PC, but you're really accurate. I'm amazed at other physicians I've worked with in the past who just order a seemingly random series of tests because they'll get paid for it, and especially because it's a lot easier than sitting with the patient for an extra 15 minutes trying to figure out what tests might actually tell you the diagnosis and lead to a treatment. It's frustrating, and a major problem with the current medical system.
To be fair, physicians don't make money on the labs since they are done at Sonora Quest and other labs. Sure they get paid a $15 lab drawing fee but that's about it. The reason they order these labs is to practice what we call CYA medicine or "Cover Your A$%#" medicine. We know the patient has a most likely diagnosis but we still need to order the labs in case he or she has a 1 in a million diagnosis because if we fail to order that test and the patient gets a disease, we can get sued and trust me, we will get sued.
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Old 07-09-2008, 12:12 PM
 
Location: Goodyear, Arizona
697 posts, read 1,367,178 times
Reputation: 252
Quote:
Originally Posted by Finger Laker View Post
my wife goes to Dr Ahrens off of 75th and thunderbird and likes him

i went to litchfield dental - honestly in the past I haven't gone to the dentist like I should have, mainly because of what's been said here - just got tired off the hassle and exagerations, at my own detriment

i knew I had one cavity and maybe another - they said I had 2 on each side, but actually backed it up with level of severity - also made the least pushy wisdom tooth extraction case I've ever heard - basically said it was 100% my option and wouldn't cause major options if left in, but the cavities I did have were probably made worse by having food get caught back there and difficulty of flossing/brushing that area - i also bite my cheeks a lot (which I didn't mention) but he noticed and said that would probably be reduced as well (which it has)


in two visits they pulled my wisdom teeth, filled the 4 cavaties and gave me the super duper you haven't been here in a while cleaning - instead of drawing work out like my prior dentists

i'm actually not insanely skeptical about heading back for my next cleaning
Did Litchfield Dental require that you come in for an eval or were you able to schedule a cleaning/exam, thus requiring only one appointment? I've been looking for a dentist and have found that many want to turn a cleaning into two appointments. So far, I've refused to go. I had never heard of that until moving here. My husband went to a dentist on McDowell in Goodyear that required that he go for an eval before they would schedule the cleaning. They gave him a paper with his "treatment plan" that benefitted them financially and listed things such as a deep cleaning and tooth whitening. He refused the whitening and several other items, but we still ended up paying several hundred dollars. I don't think he will go back since our dental insurance pays 100% of cleanings/exams and they obviously exceeded what was necessary. I feel confident that he didn't need this extra work since he has seen a dentist every 6 months since a child and no dentist has ever made the suggestions that this place made. I may give Litchfield Dental a call. I want to find a place that provides honest care and doesn't make it sound imperative that one gets cosmetic/excessive work done.
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Old 07-09-2008, 12:13 PM
 
Location: Goodyear, Arizona
697 posts, read 1,367,178 times
Reputation: 252
I remembered a couple of the additional charges: Irrigation and oral cancer screening.
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Old 07-09-2008, 02:15 PM
 
9,138 posts, read 9,926,596 times
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Quote:
Originally Posted by military spouse View Post
Did Litchfield Dental require that you come in for an eval or were you able to schedule a cleaning/exam, thus requiring only one appointment? I've been looking for a dentist and have found that many want to turn a cleaning into two appointments. So far, I've refused to go. I had never heard of that until moving here. My husband went to a dentist on McDowell in Goodyear that required that he go for an eval before they would schedule the cleaning. They gave him a paper with his "treatment plan" that benefitted them financially and listed things such as a deep cleaning and tooth whitening. He refused the whitening and several other items, but we still ended up paying several hundred dollars. I don't think he will go back since our dental insurance pays 100% of cleanings/exams and they obviously exceeded what was necessary. I feel confident that he didn't need this extra work since he has seen a dentist every 6 months since a child and no dentist has ever made the suggestions that this place made. I may give Litchfield Dental a call. I want to find a place that provides honest care and doesn't make it sound imperative that one gets cosmetic/excessive work done.
Great response and I'm glad you brought this up. Many people are intimidated by their doctor or dentist. Don't be! A clinician should inform you of any procedures that you will have to pay out of pocket that your insurance does not cover. Physicians are usually better about this than dentists because most patients don't usually pay anything outside of their co-pay so a physician knows a patient will flip out if they are suddenly suprised to have a $200 upon leaving since it's not normal. That dentist was unethical. He should have informed you those extra procedures would cost you several hundred dollars outside of your insurance coverage. Tell them, you are only going to get what is covered under your dental insurance. Sometimes, for a big job, your insurance will only cover75-80% but ask specifically what those extra charges are. I would also get 2 or 3 estimates before going to one dentist. Many dentists work on Saturdays so you don't always have to take time off of work in every case.

And no, you absolutely do not need to see a dentist who requires two visits for a cleaning. This is just a scam to make more money. They are trying to imitate doctors. Physicians will need to schedule two visits to get something done because you may not need to get a procedure done. For example, I saw an allergist because I thought I may need to get a skin test. I saw the allergist and doctor spent 20 minutes doing a history and physical. The doctor determined I didn't need a skin test and gave me samples of allergy meds. If I needed a skin test, they would have scheduled a second visit. With a dental clearning, no History or Physical will preclude you from getting a cleaning since two cleanings are required per year regardless of your health. So dentists are trying to imitate physicians by creating some fake exam and trying to do an History and Physical and do an "oral cancer" screen before they schedule you for a cleaning on the second visit. It's a complete scam and you should not make an appointment with that dentist.

Whenever you see a doctor or a dentist, always ask them in advance of what's entailed in the procedure and if you have to pay anything out of pocket. If they respond with: "Well, we won't know until he looks" that's fine but when the dentist approaches you, just tell him that you want to be informed of any procedures that you would have to pay for out-of-pocket before he does them. You can refuse that additional treatment. If he has issues with that idea, get out of that chair and leave. Get a different doctor because that guy is obviously just trying to make money off you.

Last edited by azriverfan.; 07-09-2008 at 02:30 PM..
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