Probably because their work is something that an average person can't perform on themselves, except for perhaps removing their own teeth, or the teeth of others.
Thank you for your response. That's a good point, but sometimes I wonder if they take advantage? If you don't have good benefits it seems like it costs a ridiculous amount of money to get your teeth fixed.
Not all of them do. In fact, at least where I live, a lot of them didn't make it through the recession. It's a tough spot to be in. If you think about it, they are doctors. They have gone to medical school. They leave school with a ton of debt- usually a minimum of $200,000 in student loans. Then, they have to find a way to practice, and a lot of them join group practices where they're treated like employees and don't have a say in anything. The ones that start their own practices or buy are usually out about $500,000. So, just to get in, you're looking at a $700,000 career, and many spend over a million. And, they have to have insurance, be licensed, and continue their educations. Don't even get me started on the cost of dental materials.
Most dentists do not make a killing. It takes many many many years before they clear their debts. Some never climb out from them.
If you're looking for cheaper dentistry, try to get insurance or better insurance. Failing that, find someone who runs a solo practice and go to a smaller town instead of the city. Generally speaking, dentists in big cities charge more because they set rates based on others in the area, and city prices are higher, but you can call around and ask. Bear in mind, cheaper isn't always better either. If a dentist is seriously undercutting other dentists, he'd freak me out. Dentistry is not cheap, so if you're getting bargain rates, there's a good chance he's cutting a corner somewhere.
Thank you for the response. Do you know what the options are to have the metal fillings removed from my back teeth? Is it an easy process or is better to leave them in or get the teeth pulled out?
It's an easy process. Most of the time, it's no different than having fillings done. The doctor just goes in and removes the amalgam and then puts the white filling in. Complications almost never arise. I would say the most common issue is when the filling is already huge. In cases like that, there may not be enough natural tooth structure that the dentist feels confident it'll stay strong without a crown. That's something he would diagnose before starting 99.99% of the time. Also, with ultra large or deep amalgams, removal can sometimes irritate the nerve enough that you'd need a root canal. I have never once seen that happen in real life, but it's technically possible.
One other somewhat common issue with old amalgams is that they can leak. Amalgams are put in place differently than the white fillings are. With amalgam, it's not actually bonded to your tooth. The dentist has to cut out a little notch inside the tooth after he has removed the decay. Then, he presses the amalgam into place. When it dries, it's locked in because of the notch. So, over time, people do get stuff leaking under their amalgam fillings, which results in decay. You don't really see that with white fillings because they're actually bonded to the tooth itself. It's "possible" if something goes wrong with the bond, but is pretty rare. If you've got decay brewing under an amalgam filling, it can be hard to see on an x-ray, so it's possible a dentist wouldn't know it was there until he removed the amalgam. Most of the time, even that's still not a problem, but it could make it so the tooth needs extra care, like a root canal or crown.
That's a full and honest assessment, but in all my time and the literally hundreds, if not thousands, of cases I saw, not one of them had an issue beyond being diagnosed as needing a crown from the get-go.
Removing teeth is never a good option when they can be saved. First off, you need them to eat. Secondly, when you don't have roots there anymore, you get bone resorption in the area... it's like your jawbone melts away in that spot. Over time, you'll get "facial collapse," where your mouth puckers inward and makes you look really old. Also, your teeth keep your other teeth where they need to be. Pull out your molars and your other teeth will start to drift around- you'll wind up with funny gaps between your teeth. My mom also has this really odd problem... she's in her 50s and had bottom molars removed in her 30s. The top molars had nothing to bite on for years, so they started coming downward. Now, every time she bites, her top teeth in the back come down and hit the tissue where her bottom teeth should have been. It hurts. The only solution is to extract the top teeth now, but she refuses.
If replacing old amalgams is something you want to do, go in and get an estimate, so you at least know what you're dealing with for sure. From there, you can break up the appointments however much you need to, so it fits in your budget. Most offices are glad to split things up for you, even if that means going in once every couple months to have one done. Your dentist can also talk to you about which ones are more likely to cause trouble or be leaking, so you can address those first before they do need crowns and become more expensive if any are that way at all.
Thank you for the information. I've been saving money to really fix all my dental issues. Aside from the old fillings on the back teeth from when I was a child I also have some crowding on my front teeth now. I will have to go to the orthodontist and start procedures to straighten my teeth nicely. I'm not sure if it's the back teeth that are causing the crowding? A long , long time ago I had my wisdom teeth removed and they told me that should fix any crowding, but it didn't. Anyway, I'm just wondering if I should get those fillings removed first or go to the orthodontist first? What's going to work the best to fix crowding? I just don't want to waste too much money. Thank you.
This post was edited by Summer at February 19, 2018 1:11 PM MST
There are a lot of different reasons for crowding and most are genetic. One cause is having teeth that are too large for your jaw. When that's the case, having wisdom teeth or other teeth removed is the first step because it gives the teeth enough space to spread out. That's really really common with people of European heritage because we have super small jaws/ arches. Mine weren't so severe that I needed extra treatment, but my son actually had to wear a palatal expander to spread his jaw apart more and make room for his teeth.
The mechanics of the jaw are insanely complex- how you bite, how force is applied, and how the body responds to that force is something dentists in certain specialties actually undergo extra training to learn about- particularly orthodontists, prosthodontists, and doctors who focus on TMD (jaw dysfunction/ pain). I don't know how to explain this without a model or without drawing something out. lol Bear with me. Your teeth aren't necessarily solid in place. They can drift/ move. You've got ligaments that are like rubber bands holding them where they are. Those ligaments will stretch and firm back up. That's what makes braces work- by stretching those to their max and then giving them a chance to firm back up some when the teeth are in their new location before moving onto the next set of aligners or getting the braces tightened again. That's also why people who have had ortho usually need to wear a retainer, because their teeth will naturally try to go back to where they were. Anyway, you also don't bite straight up and down. Your grind while you eat, so instead of being hit head on, like a hammer to a nail, your teeth have to slide together perfectly in that back and forth motion. Now, let's say that just one tooth pops up a millimeter more than it should or has a high ridge on it. That spot is going to get hit every time you chew. The repetitive banging will eventually result in some kind of problem. For some, it kills the nerve, causes jaw pain, or breaks the tooth. For others, it nudges the tooth out of place. If that tooth is getting pushed, all the others around it are going to get pushed too. It's a slow process. The dentist could theoretically smooth out that ridge so it doesn't get hit anymore, which works if it's just one tooth. If your jaw is aligned the way it should be, issues like that are few and far between, but when the jaws don't match up, aren't shaped well, and so on, lots of your teeth can be like that.
I'm not qualified to diagnose, and no dentist would diagnose online anyway. (So folks reading at home, please see an actual dentist and get information that relates specifically to you. Don't listen to me!) However, I'd venture to guess that you have something else going on that's impacting the alignment and that your crowding will continue to become progressively worse until you treat it- not just through braces, but through fixing the alignment and mechanics of your bite. People tend to think of braces as a cosmetic service, but they're not. Alignment matters a whole lot in your health, comfort, and ability to clean between your teeth to avoid decay.
Because there are so many causes of crowding, I don't know what your cause and recommended treatment will be. If you're trying to keep costs low there, go with traditional metal braces rather than clear aligners like Invisalign, and visit a couple of reputable orthodontists for estimates- just be sure that whoever you see has a good reputation. If you already have a dentist you know and trust, ask him for a few recommendations and meet with them. If you take along your x-rays, there's a good chance you'll be able to get free consultations.
As far as doing the fillings vs ortho first, I'd talk to your primary dentist about that and get his opinion. Usually, stuff like that is done after ortho. However, if any of the amalgams look suspicious (could be leaking, might have decay under), your dentist may want to replace them first.
Also, let the dentists know you're working on tough finances (if you are). Oftentimes, there are multiple treatments that produce similar results, but one might be cheaper... kind of like going with metal braces over something like Invisalign. Both will straighten your teeth. Invisalign has benefits like no wires and aesthetics, but it costs more. If you're cool with putting up with the occasional poke from a wire and the other traditional issues with braces in order to save money, then they're the better choice for you. You obviously shouldn't go into it telling the dentist/ orthodontist that you want cheap dental work, but if you politely explain that you're looking for the most cost-effective way to achieve the results you want, they'll get it and will pitch different solutions to you.
Thank you. I guess I'd better consult a dentist and keep working my as_ off. LoL! Right now my teeth don't bother me at all. No toothaches or pain of any kind. I just think nice teeth look better. Have you ever heard of people coming in with old fillings, getting them removed and then having pain and dental problems?
This post was edited by Summer at February 19, 2018 2:52 PM MST
Benedict Arnold 