Being a dental cripple is expensive

Dental work gets expensive, fast. Learn from my mistakes so that you don't become a dental cripple with ongoing expensive maintenance …

(This post was originally published on August 30th, 2013, and has been updated.)

At a dental checkup circa 2003, the dentist lectured me as if I were in second grade after looking at my x-rays. I was thirty-one.

Something like:

“Well, well, well, boys and girls. Someone hasn't been taking care of their teeth, have they?”

I distinctly remember the phrase boys and girls. He used it twice. —CRINGE—

After the work was done on my mouth, I never went there again.

Extensive dental work is …

That day, that dental practice saw probably $50k walk out the door.

It was clear that Dr. Boys And Girls wasn't the owner. Otherwise, he would have been smart enough not to berate me like that. It was a bonehead business move on his part because I'm exactly the kind of patient they would want: someone with bad teeth and money.

It's really too late for someone who needs extensive dental work to do anything except … have extensive dental work done. I'd need to get it done somewhere.

It just wouldn't be with him or any of his colleagues.

Because expensive is just one letter off from extensive:

One day in the life of a dental cripple

The dentist also used the term dental cripple in his little lecture to me.

Condescending attitude notwithstanding, he was spot on this point.

There's no true replacement for real teeth.  Decay, fillings, crowns, etc., are crippling to teeth, and once the integrity of the enamel is breached, everything done to fix it just isn't as good.

One night in 2013, I was chewing on a Life Saver. Shortly after that, I was trying to eat porcelain. A good chunk of one of my crowns, that was covering a tooth that underwent a root canal, cracked off.

I went to the dentist shortly afterwards. After looking at the x-rays, he referred me to a endodontist to check out a dark spot in the x-ray before re-crowning the tooth.

The dentist told me that this shouldn't have happened, but I chalked it up to “things don't last forever and this was the time for it to fail.”  He didn't disagree with me.

My daughter (then eight) asked to look inside my mouth. I handed her a flashlight and let her get a good look at all of the dental work (as well as the still-cracked crown).

I told her: “Keep taking care of your teeth. You don't want this to happen to yours. It's very expensive.”

Dental work only gets more expensive with time

Fast forward to 2020. I'm with my family on a short vacation, and it feels weird when I brush my teeth in the upper left of my mouth.

I think it was the same tooth that the crown broke off of seven years prior.

So I go to our current dentist — someone who just takes my money without berating me, haha! — and he sees dark around the roots on the x-rays. Likely an infection, so he prescribes some antibiotics and refers me to an endodontist.

This time, the news from the endodontist wasn't good. Re-doing the root canal would be a waste of money, he told me. The tooth would need to come out.

So, now I've ventured into an entirely new tier of dental expenses. Just taking the tooth out was over $600. Now I have a hole in my smile. Sometime after the beginning of the year, I'll experience the sticker shock of either an implant or a bridge, depending on how my jaw heals.

Bad teeth are ongoing, lifelong, ever-increasing expenses

My experience is that it doesn't get cheaper. Ever.

Nothing ever is as strong as the teeth you start with.

Here's how it goes down.

First you get cavities, and have to get fillings.

Then over time the margins of those feelings start to develop cracks, which gives pockets for bacteria to live in, causing tooth decay around the cracks. This results, at best, in the need for bigger fillings. Larger fillings cost more because they involve more surfaces of the tooth.

Once the fillings get so deep that the pulp of the tooth is impinged with decay, there's little choice but to get a root canal, which kills the tooth. (I had my first root canal in my mid twenties.)

Following the root canal, the tooth needs to be ground down to a post and then stabilized with a cap or crown. These procedures are a lot more expensive several times over than fillings, and more time-consuming as well. Regular health insurance generally doesn’t cover any of these kinds of restorations; supplemental dental insurance is needed, which is another extra cost.

Over time, these crowns can fail from further tooth decay. If you're fortunate, the crown can be replaced. If the tooth gets infected around the roots, then it may be possible to redo the root canal once more, but not always.

If it’s not worth redoing the root canal, then there is little choice left except to extract the tooth. Extractions are neither cheap nor fun. My extraction was around half an hour of twisting and pulling, and I paid several hundred dollars — after the insurance paid its portion — for the privilege.

And that just removes the tooth!

The nature of these dental expenses

Next, after about three months of the hole in my jaw healing, I’m looking at either an implant or a bridge which is … more money and more time in the dentist’s chair. If I don’t remedy the gap in my smile, the nearby teeth will lean toward the hole over time, hastening their demise.

It never gets cheaper.

They're escalating expenses in a number of ways:

The cost of the dental work

A six-month checkup is a bit like changing the oil in your car. (Come to think of it, Dr. Boys And Girls did call getting the checkup “every 6,000 miles.”)

If things stay that way, that's great. Regular health insurance also is generally happy to cover these.

But more extensive dental procedures get more expensive: sealants, then fillings, then crowns, then root canals, then bridges, then implants.

The cost of insurance

Basic health insurance usually only covers preventive care and minor restorations: dental prophylaxis, sealants, and fillings.

It does not cover most of the stuff beyond this. To cover any of these more advanced procedures, you'll need supplemental dental insurance, which is more money. (Note: Even if your dentist says they take your insurance, make sure that it kicks in for what you need. It may not.)

The cost of time

All of these extra procedures take time. Time off of work to travel and sit in the dentist's chair.

When I had my crown replaced in 2013, I needed four appointments: the consultation with the dentist, the evaluation from the endodontist, another appointment to fit the crown, and a fourth to install it. So four times off work, and about six hours just driving.

The cost of all of the intangibles

Some things may not cost money but they're there nonetheless. Things like discomfort, inability to eat certain foods, lost sleep, lost self-esteem because of a broken smile, and so forth.

What I should have been doing all along

I chalk my dental problems to being a slow learner. I learned eventually but had I been doing the following all along I know I'd be in far better shape:

• Brushing and flossing regularly. The basics, full stop.
• Going into the dentist regularly. Somewhere along the line I had a bad experience with a dentist and stayed away. (It was before I went to Dr. Boys And Girls.) That gave my dental problems more time to get worse.
• Getting problems checked out quickly. I had several weeks' notice prior to getting my first root canal that something was wrong. I felt a piece of my tooth missing, but I went in only when it started to hurt. Bad move. Now, at least, I don't wait for things to hurt before going in. That's saved me a few serious problems over recent years.