Welcome to European Tribune. It's gone a bit quiet around here these days, but it's still going.

Tales of American Dentistry

by Izzy Mon Feb 11th, 2008 at 04:50:47 PM EST

So my friend is telling me about his last visit to the dentist. He's got pretty nice teeth, but needs a few things done, which the dentist is telling him about.  And so he asks "well, how much will that cost?"  and the dentist says -- with a straight face -- "only twelve thousand dollars."

Only.

I'd like to tell you that this is a freak occurrence.  That perhaps there's some hidden, overwhelming catastrophe in my friend's mouth or that the dentist is a rip-off artist, but no.  

Welcome to The American Way where we routinely pay thousands just to make our teeth stop aching.  In fact, I wouldn't be surprised if this wasn't a hidden factor in the mortgage meltdown, with people refinancing just to get this or that fucking tooth fixed so they could think straight for a minute.  

I know I've had toothaches I'd trade my first born to fix, although so far it hasn't come to that...

Promoted by Migeru


In my circle of friends and acquaintances, almost no one has dental insurance.  So it was no surprise when I took a trip back to my hometown of Los Angeles and was catching up friends, that I was regularly regaled by dental horror stories.

There's my friend who lives with her husband and two children in one of the richest suburbs in the US.  They own a popular store and live comfortably.  They can't afford either dental insurance or dentists.  This isn't a huge problem for them since they can afford to take short trips down to Tijuana, where they pay $35 each for cleanings and stay in a nice hotel for a couple of days for less than it would cost to get their teeth cleaned here.  Apparently this is a thriving business and Tijuauna is now full of state-of-the-art dental clinics catering to Americans.

There's my other friend, also not poor.  In fact, he's a highly-paid skilled craftsman.  But he has no dental either.  Just had some fairly major work done by students at the nearby dental school and considers it a complete bargain that he only paid $3,500.

I have another friend, a schoolteacher.  Having what's basically a government job, she's a bit less well-paid than the others, but has better benefits, including dental.  She's married with two kids.  The kids get their cleanings.  The adults don't.  They can't afford the co-pays and deductibles.

And, of course, I related back how my family can't afford the dentist either and that finally my then husband and I had our teeth cleaned and a few small cavities filled.  I hadn't been in 10 years, so I also had a back tooth pulled that I'd broken a few years ago -- in fact, the weekend before my wedding, which should have been a clue.  

In any case, I just lived with the jagged edges and it only took a few months before I could drink liquids of extreme temperature again.  Long story short, my bankruptcy now includes over $6,000 in dental fees.

People who have good teeth and access to dental care don't realize what a huge problem this is.  Your teeth can affect your health, even kill you.  And having your teeth look bad is a huge impediment to not only your social life and well-being, but to your ability to be gainfully employed.  

Who wants to hire someone with rotten or missing teeth?  You can't put that shit out there in front of the public!  And what choices do the people have?  Do you reveal your teeth or go around never smiling and giving the impression you're antisocial?

The American Academy of Cosmetic Dentistry has a foundation that runs the Give Back a Smile program.  This program matches up volunteer dentists with battered women.  It's really a great program.  All they do is repair these women's teeth, but it restores their dignity and gives them the ability to get jobs, meet people, rebuild their lives where it may not have been possible before.  

It gives these women a chance after someone has hit them so hard their teeth get knocked out.  It's too bad they don't give the same chance to everybody when life does the same thing.

Display:
Ok, this feels a bit off-topic in all the excitement of today's Blair-frenzy, but I promised that damned Jerome I'd post something...

Maybe we can eventually make language a complete impediment to understanding. -Hobbes
by Izzy (izzy at eurotrib dot com) on Tue Feb 5th, 2008 at 04:30:04 AM EST
Que coño.. viva tijuana!!!

It's so.... that it is better to make a joke.

A pleasure

I therefore claim to show, not how men think in myths, but how myths operate in men's minds without their being aware of the fact. Levi-Strauss, Claude

by kcurie on Tue Feb 5th, 2008 at 07:09:08 AM EST
[ Parent ]
It's a drag when you are too darn far from Tijuana and don't have the cash to get your work done overseas. My daughter was recently in the UK for a visit. She had just recently borrowed $3000 from my mother for scaling (multiple visits) and repair of bad past dental work. She has 2 missing teeth with a poorly fitted and obvious bridge--and she is  a hairdresser, an occupation where you are supposed to look good and where you work close to people.
It's all because when she was younger, we either had no dental coverage and no money, or the coverage was terrible. There was only 1 year when we had full coverage, we tried to get lots done but there wasn't time to fix everything. For 3 years we had MediCal, which is California's state insurance plan for poor people (we were on welfare so no extra cash at all after rent and very basic food). She needed a root canal but only ONE dental surgeon in the whole county would accept MediCal. His rule was that if you wanted treatment and you were on MediCal, you weren't allowed to make an appointment like "real" patients, but you could come and wait at his office for days on end until someone didn't show up. The he was horribly abusive to us. To make matters worse, his work was awful--one of the 2 teeth she is missing now is the one he "fixed," the other is the one right next to it and was lost due to his poor work as well.
She wants to get tooth implants but they are $6000 each at minimum. As a single mom, even with a reasonable job that is not going to happen.
BTW, since moving to the UK I have had really good dental care. And no problem finding an NHS dentist. I think maybe that is mostly a London/SE issue? I have needed to register with a new practice 3 times in 7 years and always found someone close to home, and right away, with no problem or waiting. So far the work has also been good, although I do think they are still too quick to extract rather than save teeth. Mine have the same history as my daughter's though, so probably were beyond saving...
by expatyank on Thu Feb 7th, 2008 at 05:48:36 AM EST
[ Parent ]
Welcome to ET and to Europe, expatyank!

Our knowledge has surpassed our wisdom. -Charu Saxena.
by metavision on Thu Feb 7th, 2008 at 03:46:51 PM EST
[ Parent ]
People who have good teeth and access to dental care don't realize what a huge problem this is.  Your teeth can affect your health, even kill you.  And having your teeth look bad is a huge impediment to not only your social life and well-being, but to your ability to be gainfully employed.  

Who wants to hire someone with rotten or missing teeth?  You can't put that shit out there in front of the public!  And what choices do the people have?

I must be unemployable then! by far the majority of my teeth are plastic.

Any idiot can face a crisis - it's day to day living that wears you out.

by ceebs (ceebs (at) eurotrib (dot) com) on Tue Feb 5th, 2008 at 04:41:29 AM EST
Plastic is ok -- as long as they're something whitish and there's no gaps.  

Maybe we can eventually make language a complete impediment to understanding. -Hobbes
by Izzy (izzy at eurotrib dot com) on Tue Feb 5th, 2008 at 04:46:19 AM EST
[ Parent ]
Well the colour does seem to match. Thanks to the Influx of Polish dentists we had a year ago.

Any idiot can face a crisis - it's day to day living that wears you out.
by ceebs (ceebs (at) eurotrib (dot) com) on Tue Feb 5th, 2008 at 04:50:27 AM EST
[ Parent ]
See?  There you go -- they don't have to be nice, just look nice.  That's what the Give Back a Smile thing does mostly - fake teeth.  I wouldn't mind some plastic ones about now...

Maybe we can eventually make language a complete impediment to understanding. -Hobbes
by Izzy (izzy at eurotrib dot com) on Tue Feb 5th, 2008 at 04:52:59 AM EST
[ Parent ]
I almost feel guilty, seeing as with the aid of the national health, I've had about 20 teeth removed, and upper and lower false teeth, and it's cost me around £200 for the replacements.

Any idiot can face a crisis - it's day to day living that wears you out.
by ceebs (ceebs (at) eurotrib (dot) com) on Tue Feb 5th, 2008 at 05:02:06 AM EST
[ Parent ]
to be honest.

My dentist charges $80 for cleaning.  Had a tooth filled today.  $110 if I went amalgam or $180 if I wanted epoxy.  I'd have paid your bills to avoid having to sit in that chair, but that's another story.

Took him roughly an hour with an assistant there the whole time.  Wild ass guess that materials were $30-50 including the novocaine(sp?).  Say $25-30 for the assistant for an hour with benefits (health care mandatory for full timers in HI) so he might have made $100-120/hr gross to cover rent/office staff insurance etc.  Doesn't seem too outrageous to me.  

 We've no dental cover but the programs we've had in the past from recent employers would have only paid about half.  We live in one of the most expensive places in the US for most things so this isn't Tijuana pricing.  The days of Big Business paying 80%+ are long past for us.

Hard to see how you got to $6000 for one extraction and "a few" cavities.  Might want to shop around for a new dentist.

Agree that health care in the US is a disaster for the lower middle class on down.  We need a single payer system.

by HiD on Tue Feb 5th, 2008 at 06:04:24 AM EST
Yeah, my costs are about the same as yours. I was surprised by this diary as well. I have had dental insurance at all my post college jobs (common in the semiconductor industry). The most expensive work I've had done was getting my severely impacted wisdom teeth taken out (at 28 years of age) by an oral surgeon. That set me back $1000 with (thankfully) insurance covering the other $3000.

you are the media you consume.

by MillMan (millguy at gmail) on Tue Feb 5th, 2008 at 12:56:35 PM EST
[ Parent ]
Hard to see how you got to $6000 for one extraction and "a few" cavities.  Might want to shop around for a new dentist.

My dentist charges $80 for cleaning.  Had a tooth filled today.  $110 if I went amalgam or $180 if I wanted epoxy

Uh, I think you and Millman are making my point.  My dentist (or former dentist probably) is completely inline with the others.  Don't forget that I said this was for two people.  

I needed 4 fillings plus the extraction.  Only one filling was a deep one, but two were small ones on teeth that show, requiring the more expensive type of material so it' would look normal.  My then husband also had 4 or 5 fillings.

And you seem to be forgetting that if you've missed regular cleanings, you require x-rays and then what they call a "deep cleaning" where it takes 4 visits and they do it in quadrants.  Plus, I confess they had to give me the gas for the extraction...

Anyway, at almost 150 - 200 bucks a filling, plus the office visits, etc., it adds up.

It seems to me you're being somewhat cavalier about spending a minimum of $200 for a cleaning and one filling -- that's more than a lot of people can afford.  That's also regular maintenance prices when you go every 3 - 6 months.  Think how much that costs a year for people with kids, assuming absolutely nothing goes wrong with the kids' teeth.  

When your budget is tight, you might be tempted to skip a visit or two.  Then god help you when you're suddenly diagnosed with subprime teeth...

Maybe we can eventually make language a complete impediment to understanding. -Hobbes

by Izzy (izzy at eurotrib dot com) on Tue Feb 5th, 2008 at 04:03:42 PM EST
[ Parent ]
The prices aren't obscene, they are what I expect from professionally trained doctors. Lack of universal coverage is the issue.

you are the media you consume.

by MillMan (millguy at gmail) on Tue Feb 5th, 2008 at 06:41:41 PM EST
[ Parent ]
Oh, my apologies -- I didn't realize we were discussing pointless distinctions.

Maybe we can eventually make language a complete impediment to understanding. -Hobbes
by Izzy (izzy at eurotrib dot com) on Tue Feb 5th, 2008 at 09:52:47 PM EST
[ Parent ]
We're in the wrong career, Izzy.

(Glad to see a diary from you though.)

by In Wales (inwales aaat eurotrib.com) on Wed Feb 6th, 2008 at 08:56:43 AM EST
[ Parent ]
It's not pointless - you mentioned cheaper dental care in Mexico that is pretty much as good. There is a reason that it's more expensive here that goes beyond extortion.

you are the media you consume.

by MillMan (millguy at gmail) on Wed Feb 6th, 2008 at 12:55:37 PM EST
[ Parent ]
Perhaps the prices are what you would expect but the point surely is that most people can't afford it?  I still don't see how it can be justified to charge so much.

I am incredibly lucky that I have never even needed a filling in my whole life. I had teeth pulled as a child due to an overcrowded mouth, and a brace - all free on the NHS. I pay £22 or thereabouts to get my teeth cleaned and checked at my NHS dentist (which when I was a student I couldn't afford and so didn't have my teeth checked for about 6 years.)

It's appalling that the system in America expects people to pay out so much to secure their health, either through direct costs accrued or through insurance.  When people can't afford it, health deteriorates - it costs the country more due to that in the long run.

by In Wales (inwales aaat eurotrib.com) on Wed Feb 6th, 2008 at 08:55:22 AM EST
[ Parent ]
Pre 1940 in the UK knock on effects of Dental problems were the biggest killer of UK adults apart from Heart problems.

Any idiot can face a crisis - it's day to day living that wears you out.
by ceebs (ceebs (at) eurotrib (dot) com) on Wed Feb 6th, 2008 at 10:08:47 AM EST
[ Parent ]
Not insignificant.
by In Wales (inwales aaat eurotrib.com) on Wed Feb 6th, 2008 at 10:15:23 AM EST
[ Parent ]
not trying to be cavalier.  but your 2nd description of your services --8 cleanings + 10ish fillings + 1 extraction + extras-- has a different look to it than your first description.  But it still looks OP by half unless that gas is brutally expensive.

$160/year for dental health checkups ($14.50/month) is hard to sell as a budget buster except for those deep in poverty already. Not middle class people in "nice suburbs".  That's about 2 trips to Starbucks.  Or dropping soccer fees.  Or half a cell phone.

Like any maintenance, if you let things go, the catch up is brutal.  I support single payer, but it's not like people with jobs won't be paying extra taxes to cover the cost.  It's still probably economic though.

by HiD on Wed Feb 6th, 2008 at 04:01:41 AM EST
[ Parent ]
I've got a solution to the US / Iran problem.

My Iranian colleague was quoted privately £6,000 ($12,000, near enough) in London (where it is literally impossible to get on an NHS list these days) for some crowns etc.

On a visit to Teheran, he had the work done by a top flight dentist (and Iranian doctors and dentists are pretty good, although there is a shortage of top class kit).

$250

Maybe Ahmadinejad could start the "Give the US a smile" campaign". It would certainly appeal to his perverse sense of humour.


"The future is already here -- it's just not very evenly distributed" William Gibson

by ChrisCook (cojockathotmaildotcom) on Tue Feb 5th, 2008 at 06:09:02 AM EST
we're already draining the Philippines of trained nurses.

I thought my dentists in London were just fine though and don't recall the price being too nuts even if the company was paying.  But I never had any real work done.  Just cleaning and a couple of tiny filling replacements.

How's your IOB?  The paranoid are back blaming its imminent startup for internet cables being cut.

by HiD on Tue Feb 5th, 2008 at 06:14:52 AM EST
[ Parent ]
I know, I get emails from the paranoid all the time.

The IOB will happen over the dead bodies of the Iranian elite. The last thing they want is more transparency in the oil market.

Ahmadinejad actually does want it, and he has his own people as Oil Minister and Central Bank governor, but they have no chance against the entrenched interests of those with snouts in the trough.

The reality is totally divorced from the rhetoric, and the Ministers who make these announcements over there just believe the crap they are told by their minions.

It may be that a few of the domestic petrochemical transactions shortly (around the 19th - maybe) start to take place in a room they will call the "Exchange", and will then be recorded in a vapourware spreadsheet they blagged from somewhere and is currently used in just that way by that household name: the "Teheran Metal Exchange".

ie they'll list existing petrochem physical contracts on that piece of crap and call the result an Exchange.

A total joke, and for public consumption in Iran only.

As for the cable cutting, my take is that it's just more pressure being applied , this time by the spooks. I think the Syrian bombing was 50% about that too, although apparently Sy Hersh has a piece coming out about that next week.

 

"The future is already here -- it's just not very evenly distributed" William Gibson

by ChrisCook (cojockathotmaildotcom) on Tue Feb 5th, 2008 at 07:40:50 AM EST
[ Parent ]
not shocking

I'm not rooting against you, but I  never thought this thing had a chance.  

by HiD on Tue Feb 5th, 2008 at 03:52:19 PM EST
[ Parent ]
Well, we never recommended an IOB in the first place....

The proposal always was for a Middle East Exchange led by the producers, instead of by the middlemen.

What is your take on the various current Gulf initiatives btw: ICEFutures, Dubai Mercantile Exchange and Qatar's IMEX?

"The future is already here -- it's just not very evenly distributed" William Gibson

by ChrisCook (cojockathotmaildotcom) on Tue Feb 5th, 2008 at 06:43:37 PM EST
[ Parent ]
I'm long gone from the industry and hardly follow it beyond skimming the usual press + the weekly DOE info.

I only miss it on payday!

by HiD on Wed Feb 6th, 2008 at 04:03:49 AM EST
[ Parent ]
America's health care plan: Don't Get Sick.
by asdf on Tue Feb 5th, 2008 at 08:13:00 AM EST
Canada's plan: You can get sick but don't have dental problems - unless they have to hospitalize you.

Major problem with Canada's medical system is the lack of Dental care.

aspiring to genteel poverty

by edwin (eeeeeeee222222rrrrreeeeeaaaaadddddd@@@@yyyyaaaaaaa) on Tue Feb 5th, 2008 at 09:57:42 AM EST
[ Parent ]
A similar issue in the UK surpisingly. The govt has messed the dentist's contracts about for at least a decade and they are voting with thier feet into private medicine.

In many parts of Britian it is almost impossible to find a dentist who will provide NHS dental care (nb which is not free). So most people have insurance. Fortunately it is pretty affordable, mine is about £30 a month. Alright that's a lot for people on low wages, but it means that those of us who can don't clog up the queue for those that can't.

Course that doesn't mean I don't want a proper nhs funded dental service. I'm far too familiar with the stories such as yours, Izzy, to feel complacent about where we are going. The NHS is being accounted to death, one cheapskate slice at a time.

keep to the Fen Causeway

by Helen (lareinagal at yahoo dot co dot uk) on Tue Feb 5th, 2008 at 11:36:02 AM EST
There are dentists in England?

I learn something every day...

The Hun is always either at your throat or at your feet. Winston Churchill

by r------ on Tue Feb 5th, 2008 at 11:51:14 AM EST
[ Parent ]
I'm taking our child to the dentist on Friday. His name appears to be Slovak.

We have met the enemy, and he is us — Pogo
by Migeru (migeru at eurotrib dot com) on Tue Feb 5th, 2008 at 11:53:01 AM EST
[ Parent ]
You're likely safe, then.

The Hun is always either at your throat or at your feet. Winston Churchill
by r------ on Tue Feb 5th, 2008 at 11:53:38 AM EST
[ Parent ]
I thought his name was Johnny

keep to the Fen Causeway
by Helen (lareinagal at yahoo dot co dot uk) on Tue Feb 5th, 2008 at 11:57:14 AM EST
[ Parent ]
I mean the dentist's.

We have met the enemy, and he is us — Pogo
by Migeru (migeru at eurotrib dot com) on Tue Feb 5th, 2008 at 12:51:02 PM EST
[ Parent ]
my first one was Aussie and the 2nd Dutch.  Both chosen because of distance to the offic (none).  I began to wonder if there were English Dentists.
by HiD on Tue Feb 5th, 2008 at 03:54:20 PM EST
[ Parent ]
Not long since I worked at an NHS trust which was expanding its community dental service. I think the near term plan was to widen the catchment to take in those who  no longer had access to the general dental service. I wasn't in the department, so I can't be sure, but I know the level of investment far outweighed any normal or natural increase in service users.

Perhaps the family NHS dentist is doomed? All that will be left in the future is private and hospital dentistry.

Just to note, I remember about seven or eight years ago paying about £14.50 for an extraction, which is a good price. Nothing hi-tech though, just me, the dentist, and a pair of pliers. Oh, and thankfully some novocaine.

Member of the Anti-Fabulousness League since 1987.

by Ephemera on Mon Feb 11th, 2008 at 07:37:39 PM EST
[ Parent ]
heh, i remember being told back in '69, growing up in england, that the NHS recommended people to get all their teeth taken out and substituted with dentures, easier maintenance...

my childhood dentist was a harley street alky playboy with way more charm than skill, with the cuttingly (sorry!) accurate name of Kenneth Little.

i didn't get the joke till about 20 years later, when my teeth were in sad shape, and i became practised at sublimating dental pain.

we drank rainwater in hawaii, which is about as low in minerals as distilled water, and all the pineapples, tangerines etc were taking their toll, too.

i found calcium supplements to be useful, i must have tried at least 20 types, ranging from oyster shell powder (hard on the kidneys) to my final choice, chelated calcium-magnesium made from yeast.

i used to eat them like candy.

then i read about mercury poisoning, amalgam and the long history of controversy about it.

i started looking for dentists who were aware of this, and was laughed out of many an office.

eventually finding one, he measured the mercury in my urine and i slowly started having the amalgam fillings replaced with ceramic.

there was an immediate improvement, and over the next 5 years, i had them all replaced. since then, 13 years with almost no problems, i am so grateful. many people have had all sorts of ailments cured by removing the amalgam, from heart disease to cancer.

the water in italy is very good, and calcium supplementation is no longer necessary. completely allergic to sugar for years, now i can handle it, in moderate amounts, though i eat as little as possible.

i have a hunch stem cell tech is going to enable us to grow new teeth, even late in life. i read of teeth bud transplants working, ($30,000 a pop!) way back in the 80's, but they would be rejected by the new host-mouth after 20 years. not ideal, but better than some solutions.

the combination of low sunlight and a high sugar diet have made english teeth notorious worldwide for their crumbliness.

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty

by melo (melometa4(at)gmail.com) on Tue Feb 5th, 2008 at 05:02:00 PM EST
interesting.  Ours is well water and while not super hard it has plenty of minerals.

Which island?

by HiD on Wed Feb 6th, 2008 at 04:06:15 AM EST
[ Parent ]
the big island, puna side.

plenty rain, almost all rural houses had roof-fed water tanks, and back in the mid seventies, bottled water was still quite unusual, just perrier and evian, iirc.

you're on kauai, right?

your island has the deepest soil, being the oldest in the chain, b.i. is mostly lava, and riddled with tubes, except for hamakua, ahualoa, waimea area.

kona side is so dry, they mostly have county water, i wonder if it comes from wells.

people said water in other places picked up mineral content on its journey from the mountains to the sea.

maybe nomad can offer some insight?

there was a gasoline leak there once around keeau, and apparently it travelled underground at an astonishing speed, as far as hilo in 15 minutes.

the soft water makes your hair real fluffy and feels good on the skin, tho' drinking it i found curiously unsatisfying, compared to what comes out of the ground here in italy.

could be the euro-genes, i guess!

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty

by melo (melometa4(at)gmail.com) on Wed Feb 6th, 2008 at 04:39:18 AM EST
[ Parent ]
we have a private system.  I have to treat for bacteria but otherwise it's good.  

As for Italy,  i suspect what makes the water taste good is the fermented grape juice in it.

Off to work on my backyard pizza oven (Italian inspired).

by HiD on Thu Feb 7th, 2008 at 07:43:14 PM EST
[ Parent ]
oh, that's great, a pizza oven!

i got a new woodstove a couple of months ago that has a cooking oven in it, and i use it almost every day, saving me so much gas.

baking was what used most gas, so now i just use the gas stove for a few things, stir-fry etc, and the woodstove for everything else.

roast potatoes in the woodstove come out really good, as well as pizza and breads.

beans come out extra creamy in a ceramic crockpot too.

did you get plans to build the oven, off the internet maybe?

i'd love to see pix. will the stones be kauai red?

i remember special kauai salt, orangey-pink, and tasty.

man i miss bodysurfing...ride some for me!

'The history of public debt is full of irony. It rarely follows our ideas of order and justice.' Thomas Piketty

by melo (melometa4(at)gmail.com) on Fri Feb 8th, 2008 at 03:25:51 AM EST
[ Parent ]
plans are free and open source.  I noticed another infrequent ET poster (DMUN) participates in the same pizza oven forum.  He went wild and made a geodesic dome.  Amazing work.  Lots of tips and info in the forum if you have any interest.  The prefab units are all imported from Italy.  

Here's the link.

http://www.fornobravo.com/pompeii_oven/pompeii_oven.html

It's not all that hard to make your own.  Just cost me a fortune to ship in the bricks/chimney parts/insulation. Not the sort of stuff you find on Kauai. The cost would have been 25% on the mainland (maybe less).  And you have to be willing to get dirty and dusty.

You use firebrick rather than rock so no Kauai stone involved.  And most of the hard rock here is blue.  The swiss cheezy volcanic rock (brown or red) would probably fracture from the temp swings.  I've got enough stuff that is Kauai red anyway if you can remember what that dirt is like!

I doubt we use it more that once/week or so.  Just too much time and energy to get the thing hot (1.5 hrs of serious fire to make pizza).  But looking forward to the parties.  A homesick Italian friend is having a great time helping me play with it.  Great pizza (IMHO).
I suppose we could cook for the week from one firing, but just organizing the dough for 15 pizzas + meat and veg and a few loaves of bread is enough work for me so far.  I've got a lot to learn.

by HiD on Fri Feb 8th, 2008 at 03:54:55 AM EST
[ Parent ]
I could write all night about our problems with American health care, but what's the use. I can suggest alternatives which if combined with a nice vacation could also result in much lower costs and probably better results than you get in the US and many other places.

A few years ago we visited Turkey on business.  In Istanbul two of our travel mates began to experience a lot of pain with their teeth.  Both had recently had root canals in the US and these were the very teeth that were in pain.  The American consulate recommended an American trained, English speaking Turkish dentist.  Both visited the same dentist and each were told that their previous procedures had only been partially completed, some nerve remained, thus the pain.  A root canal is supposed to destroy the nerve so there should have been no pain for either person.  They had each paid dearly for the complete procedure, but apparently it was botched.  Long story short, both received excellent care in Istanbul (root canals completed).  They both had crowns made in Ankara when we continued our journey. One person told me he had never been in a dentist office in the US that was as clean and well-equipped as the office in Ankara.  Costs were less than half those paid in the US and they probably paid a premium compared to typical Turkish costs for similar work.  The other person told me he was considering having his whole mouth done there.  We agreed that Turkey is a nice holiday and when combined with dental work, the holiday could be considered free due to the low cost of dental care.

I have personally had dental care in Mexico, Switzerland, and Estonia. Each experience was generally good and at much less cost than for similar care in the US.  In fact, one broken tooth had been repaired five times in the US over a couple of years before a Swiss dentist repaired it in 1990.  It hasn't needed repair again since that date.  To be fair, I have had decent care in the US.  Our current dentist does not recommend extravagant work, but costs are still high.  It's easy to see how $6,000 could accumulate.  One root canal and crown can easily cost $1,600 - $2,000, and extractions are ridiculously expensive.  An extraction used to be the least costly thing one could do.  Now, it requires a specialist. Our dentist doesn't even do them.

I can swear there ain't no heaven but I pray there ain't no hell. _ Blood Sweat & Tears

by Gringo (stargazing camel at aoldotcom) on Tue Feb 5th, 2008 at 09:59:50 PM EST
A friend of mine recommends Bulgaria too (I've never felt the need). Prices about 1/10 of the UK.

Flight prices are about £70/100 euros/$150 from London single.

So for a $6000 procedure, make it a holiday. Fly to europe (really cheap, I culd go to LA for £300/$600 ret), cheap to BG. You'd probably save money.

keep to the Fen Causeway

by Helen (lareinagal at yahoo dot co dot uk) on Thu Feb 7th, 2008 at 10:01:09 AM EST
[ Parent ]
Is Wal-Mart a hope?

Five or six years ago, I was visiting my mother who was, at that time, living in one of the poorer regions in the piney backwoods of Florida... [During] the course of the visit, I noticed that my mother's old TV seemed about to expire, so I decided to buy her a new one. The only place such a purchase could be made, however, was at a Wal-Mart store some 15 miles from where she lived.

The young woman who waited on me wore the ubiquitous red smock worn by Wal-Mart "associates" from coast to coast. She was probably 24 or 25, but she looked at least two decades older, her years already marked by the hardscrabble existence she'd known. Her teeth were bad, her complexion sallow. She was overweight as a result of a bad and unhealthy diet, and her speech was marred by the kind of bad grammar that attaches itself to poor people everywhere.

But, as they say in the south, she was sweet as pie, and as helpful as she could be without knowing much about the products she was selling.

I bought a TV and I gave it to Mom just before flying home to California, 3,000 miles from that Florida Wal-Mart, where there are identical Wal-Mart stores sprinkled hither and yon, places where women like the one who sold me Mom's TV grind out a living at dead end jobs that ensure they will never be able to get their teeth fixed because those jobs don't offer much in the way of hope or health care.

by das monde on Wed Feb 6th, 2008 at 03:20:00 AM EST
France has a universally admired health insurance system,  and it does cover dental care fairly well. But caps, bridges, dentures, forget it. Even with top-up insurance (with, in general, mutual insurance companies), the patient still has a lot to pay out of pocket.

There are procedures (like the deep cleaning you mention, Izzy, which I think is called root planing) that are useful to have done at least once in midlife, that are not covered here. A number of other useful surgical procedures are not covered either. In the false teeth department, implants are not covered.

The national insurance system keeps the standard dental care rates low, with the result that dentists count on false teeth to make money. Prices are high compared to a lot of people's income, and most of the cost has to come out of pocket. The result is that people put things off till later, then find they're of course in a worse state and the costs will be even higher. And certainly, I see plenty of people past 40-50 whose teeth need attention or whose false teeth look really bad. This is, I think, one of the major failings of national health insurance in France. And (since it's not a recent problem, it goes way back) the social results can be seen.

by afew (afew(a in a circle)eurotrib_dot_com) on Wed Feb 6th, 2008 at 03:40:52 PM EST
This past autumn I went to the dentist in Spain. Cleaning: €40; fillings: €60 each. This is for a private dentist, he used to be in the public system and with a number of insurers but decided to go freelance at some point and we just stuck with him because he was excellent.

However, my father has had several large jobs done over the years (crowns, bridges, etc) and I remember one time (and it was years ago) he must have paid maybe €2,500 for the whole thing.

When I was in the US as a graduate student our mandatory health insurance plan included dental coverage, and I don't remember simple jobs like cleaning or fillings being all that expensive. But once I heard of a bigger job (from someone who wasn't a student, but who had insurance) and it was close to $1,000 for fixing a broken tooth or something like that. This is all from 2000-4 so it may be quite dated.

But $12,000? That seems rather excessive.

We have met the enemy, and he is us — Pogo

by Migeru (migeru at eurotrib dot com) on Thu Feb 14th, 2008 at 04:47:20 PM EST


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