Is dentistry too expensive for you?

This week, I conducted an informal poll on Facebook to find out why people don’t routinely go to the dentist.  In this week’s blog, I will discuss one of the results, as well as explanations and solutions to this problem.

Dentistry Costs Too Much

This was at least part of the reason given by the majority of people polled. Many of the people answering did not have dental insurance and felt that dentistry was too expensive, especially for a whole family. However, what I found astounding is the huge number of respondents who haven’t been to the dentist in 5-10+ years because of costs! So, let me break this down a bit, and try to relate the costs of regular, maintenance dental care to other routine expenses we have in our lives.

Who decided how often we should go to the dentist?

The appropriate time period to visit a dentist used to be every six months when I was growing up.  Why that period of time?  It was manufactured by dental insurance companies when they started offering service in the 1970’s as a way to standardize their yearly benefit offering to patients. Six months actually has zero relationship to how often anyone should visit the dentist for either a check-up or a cleaning!  The same can be said for dental x-rays as well, with some insurance companies only reimbursing for x-rays at intervals of 1-2 years.

With recent research comes a great deal of information on how often each person should have their teeth cleaned…and the answer is…it depends on each person! We have adult patients in our practice who really do not build plaque or stain on their teeth, with healthy gums that never bleed when brushed or flossed, and who DO brush and floss daily.  These patients can have longer intervals between cleaning appointments and still be healthy!  Having said this, the “rule of thumb” in our office is patients should come in for dental cleaning appointments just before the plaque and calculus begins to build, just before the gums start to bleed.  How do we know the time interval? We test it out with each patient by having slightly longer intervals between cleaning appointments each time to find out the break point for that patient. Our adult patients come in every 3 months to every 12 months, and all times in between. A little bit of elbow grease, medical conditions, medications, hormonal factors and a lot of genetic luck are the factors involved for each patient, and as these factors change the dental hygiene needs may change as well.

So what if my gums bleed when I brush or floss?  They always have!

Wow…read that line again!  Brushing and flossing is just the way we clean our teeth.  Imagine if you were taking a shower in the morning and washing your hair, really rubbing the shampoo in the way you were taught…and your scalp started to bleed.  What would you do? Run screaming, wet and maybe even with only a bathrobe, right to the emergency room! Because a bleeding scalp would tell you there is something very wrong..wait…so do bleeding gums! Bleeding gums are a signal from your body that you have an infection around your teeth. Once the infection has already started, simple brushing and flossing will not be enough to rid your body of the infection; rather, you will need help from a dental hygienist.  She can flush out the bacteria from the pockets of gum around each tooth in ways you cannot do at home.

What about the dentist check-up?

The “six month recall visit” was invented by dental insurance companies, and there is no real reason for that standardized period of time.  However, most dental licensing agencies (like the Royal College of Dental Surgeons in Ontario-RCDSO) require a dentist do a check-up exam once every 12 months to give permission to a dentist hygienist (like writing a prescription) to clean your teeth.  This is because only a dentist can diagnose the type of periodontal condition of each patient as well as other dental and oral diseases. For example, in every office an oral cancer screening should be part of the yearly check up exam.  So, in our office if a patient is coming in every 3 or 4 months to see the hygienist, I only do my exam once per year (unless of course the patient has a specific concern).

I haven’t been to the dentist in a while. What can I expect?

Every new patient to our office has a comprehensive examination. This includes the necessary x-rays to diagnose whatever we can see on those x-rays, like cavities, tooth infection, gum disease, or sometimes even cancer. We also take digital photographs of your teeth so we have a visual record of your dental condition and so we can teach you what you need to know to be as healthy as possible.  A full dental examination is done, listing all of the teeth and describing their condition, various measurements of the teeth and the bite, and the gums are also assessed and scored as to health.  Then we talk with each patient and explain in regular-talk what we’ve found and make recommendations for what to do about it. Sometimes little treatment is needed, sometimes lots of treatment is recommended, but in the end it is the patient’s choice to decide what to do with our recommendations.  We can arrange to have your teeth cleaned at that first visit, or a later visit, as preferred by the patient. This appointment usually takes about 1 1/2 hours. If it has been quite some time since your last dental visit, and if your gums show signs of disease, the dental hygienist will usually want to see you back three months after she first cleans your teeth to see how well your gums respond to treatment.  The she can tweak her recommendations for what to do at home, as well as how often to return to maintain a very healthy state.

OK, so what does this all cost?

Fees will certainly differ from office to office all over the world, but this is what you can expect in our office at this time.  A new patient exam as described above with cleaning and x-rays will cost between $350-$500 In our dental practice, depending on the condition of the gums and how many x-rays are determined to be needed. However, future appointments for cleaning only are usually between $100-150, and the yearly dental exam is $40. So…in a given year an established patient can expect to pay between $150-$500, depending on the effort at home and the other factors mentioned earlier (like medical conditions and medications, for example).

I promised I would relate the costs of maintaining your oral health to other regular expenses you may have.  Just a few months ago, I purchased a cell phone for my middle teen-child. The yearly cost for my son to have this phone with no data will be about $750 this year, including all of the start-up costs, and in future years will cost around $550. If I check right now on last-minute beach holidays, the cost for a trip in the next month to anywhere warm would be at least $1000 for myself and my husband, but not our three kids. Dinner out in Kanata to a nicer chain-style restaurant plus a movie for two would likely set me back over $100 without trying too hard. And the last time I took my cat to the veterinarian for a checkup and shots it cost $175 (and I have two cats), but when he needed his teeth cleaned it cost close to $1000 with sedation, boarding, and the procedure!

Please don’t misunderstand…I am not judging the decision about how to distribute limited funds. I am just aware of the incredible importance of your dental health on the rest of your body. Poor dental health has been shown in research to affect diabetes, heart disease, and cancer. Everything we eat and drink, the air we breathe, the words we say, the kisses we give to those we love…all of that has the potential to be unhealthy or healthy…and I feel very strongly that we owe it to ourselves and our loved ones to stay as healthy as possible in every way possible. If your funds truly are so limited that investing between $150-$500 per year on your dental health and that of your family, then please consider treatment at your local dental school, dental hygiene school, or dental assisting school.  The fees are nominal, the care is very carefully monitored, and you’ll be doing what you can afford to do at this time to stay as healthy as you deserve to be. And everyone reading this deserves to be dentally healthy…especially you.

Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer!