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Dental, dental, dental

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Little dental update:  I ended up paying an extra $30 for a special fluoride treatment the dentist recommended, so my total was $69 (for regular cleaning, x-ray, exam, and extra fluoride treatment). I paid using my debit card and plan to transfer money from my Capital One 360 checking, where I’ve been saving for dental/vision. It knocks the account balance down to $50, but I won’t be needing this money again until August (for my vision appt.), so there should be enough to build back up and be able to pay for new glasses/contacts if my prescription changes (Remember, my insurance covers the exam – minus copay – but I owe out-of-pocket for glasses/contacts).

Since I just went to the dentist this morning it seems a fitting time to have this conversation….

We do not have dental insurance.

I am fortunate in that my teeth have always been pretty good. I’ve never needed braces, only had a couple cavities ever (and they were YEARS ago), and generally have pretty good oral hygeine.

My husband……not as lucky.

For him the problem extends decades back. His family never paid for dental insurance while he was growing up, so seeing the dentist – at all – was a rarity (in contrast, I was on my parent’s plan until I was 18 and have continued pretty regular care since then by using Groupons to have cleanings done). So, even when we met, his teeth were not in the greatest shape. Add to that the fact that he smoked for over a decade (he quit cold turkey the day our babies were born….a total shock to me!), which certainly compounded the problem. And he hates the dentist and still refuses to make regular appointments.

Okay.

So all that back history being stated, let me tell you a little story:

On Thanksgiving of 2011, after Thanksgiving festivities, we decided we wanted to try to hit up the Black Friday sales at midnight. We were stuffed from eating and decided to take an evening nap before shopping. We set our alarms for 11 pm.

Our alarms went off as planned but our plans were quickly derailed. Chris’ face was swollen so large it looked like he’d been in a fight (I looked for a photo I know I had taken, but can’t find anywhere! Argh! It looked terrible).

Turns out, we spent our day-after-Thanksgiving driving to Mexico.

We live in Tucson, about an hour north of the border. The largest industry in Nogales, Mexcio is dentistry (seconded by pharmacy). Many of the dentists were even trained in the States but ended up practicing in Mexcio. There are obvious “cons” of traveling to Mexico for dental care (particularly with all the problems with drug wars), but because its such a huge industry, its easy to find safe, clean, and reputable places. I would NOT just walk in somewhere off the street (some are super-sketch!), but if you do your research you can find a good place. Anyway, Chris had a horrible infection that required antibiotics and a root canal. This took 3 separate trips because the infection was so bad (1st trip = get antibiotics, let infection and swelling subside, 2nd trip = do the root canal and add a temporary crown, 3rd trip = place the permanent crown). This was pre-baby days so it was no biggie and we would just go together for an afternoon trip. The whole thing ended up costing $800. It’s still a sizable chunk of change, but its not terrible. My Mom has dental insurance and still has to pay $1000 out of pocket for a root canal and crown, so our (uninsured) price was even cheaper than that of others’ who have insurance.

Everything has been great since he got his crown and he hasn’t had any problems.

However…..he needs a lot more dental work. A lot. We had an exam when he was at the dentist and everything is just a mess, so we’re trying to decide what to do. Some of the work isn’t as immediate, but some of it is more pressing (and involves more expensive procedures – more root canals and crowns, as well as several cavity fillings, wisdom teeth extraction, and more). At this point, his initial appointment was  two and a half years ago so I’m sure things have only gotten worse and it feels like a ticking time bomb until his face explodes with infection again!

So at some point before our debt-payoff journey is complete we’ll be forced to cash-flow some expensive procedures. I’m hoping we can hold out on this until 2015 so we can make some serious progress this year, but there’s no telling if or when a tooth (already in need of root canal) will become infected and require immediate attention.

So the question…..

What would you do? Just hold out and wait as long as possible? Try to get some work scheduled? Would you go to Mexcio or buy dental insurance? Like I mentioned, Mexico prices seem to be even cheaper than  insurance prices (not to mention the insurance premiums), but it requires a full afternoon trip + mileage etc. Also, we would have to make sure he isn’t given any drugs that make him unable to drive because ain’t no way I’m taking the babies to Mexcio (the 2011 dental work was pre-baby days), so he’ll be solo.


19 Comments

  • Reply Kerry |

    http://smilepaul2011.blogspot.com/

    THis is a great blog from a guy who had really jacked up teeth due to poverty, bad habits, depression, not taking care of himself. He got his work done over the course of a year+ at A.T. Still up in Mesa. It’s a great story. He was also dentist phobic and credits his relationship with that student dentist and the whole experience as life-changing.

    Your first step in the U.S. or Mexico is to see at least 2 dentists and have them do an exam and come up with a list of procedures to do, and in which order. And you should treat this like a serious medical problem–bad oral hygiene and an unhealthy mouth have been linked to heart disease, he could have oral or head and neck cancer and not know it–all sorts of health problems start int he mouth.

    • Reply Ashley |

      Oh god – thanks for the scare factor! (j/k!) Really though, thanks for this resource – I’ll have to check out the blog!

    • Reply Jocelyn |

      What an interesting blog. I just skimmed through the whole thing. I wish he had more recent updates!

  • Reply Theresa |

    Is there still a chance that you could pick up a full time university position for this Fall? (2014) If so and if dental is generally included in those employment packages I would wait. If a Fall position with dental is not likely I would start setting up treatment. His mouth is just getting worse. The cavities of 2 years ago are probably more expensive crowns (?) now. And as a self employed person if he is out of work for a week- esp. now during his busy season your family income suffers.

    As far as Mexico or no Mexico that is your call. I wouldn’t be comfortable but that is me. And it seems inconvenient with the girls and no local family. Some of the work he may have to be put under and I don’t know how that would work. A benefit of going local is that you could get one dentist to put together an entire treatment plan and s/he could maybe be more efficient in implementing the plan rather then doing it piecemeal as an emergency arises.

    There are whole body health consequences of bad oral care I wouldn’t let the time bomb keep ticking.

    • Reply Ashley |

      Nah, Fall 2014 is out (the hiring tends to be in fall/spring so it’s already complete at this point). Still a chance for fall 2015 *fingers crossed*

  • Reply Klm |

    I would look at the local schools of dentistry as well. Find out how long their waits are though–you may not be able to delay it all.

  • Reply Georgie |

    I’ve never had great teeth and when I got the job I had now, which has awesome dental, it took 5 years to get my mouth back to where it should be. My dental allowance is $2k per year and I maxed it out the first 5 years. Easily $10K worth of stuff! Even if you can’t afford the major stuff for him right away you should get him cleanings.

    • Reply Ashley |

      Ouch! That’s quite the investment! I’m worries we will be looking at a similar overall cost for my husband’s teeth!

  • Reply Angie |

    I would not delay. I agree with Kerry and triage which procedures need to be done first. Does he brush after meals and floss as well? (Not judging personal habits or anything here, but just want to make sure it doesn’t get worse.) Some of it is just genetics – I make sure my kids do everything they’re supposed to do and my son’s teeth ALWAYS have cavities while my daughter’s never does.

  • Reply Hannah |

    I urge you to act immediately. I am sorry to hear that your husband has put off seeing a dentisty in his adult years, and even more sad to hear that his parents neglected his health so badly.
    Still, he is old enough to have taken responsibility years ago, and needs to act immediately.
    Do you realize that your mouth health is directed related to the rest of your health? Bacteria issues, i.e. gingivitis ( which I am sure he has) has been directly linked to serious health issues, and will lead to periodontal disease which he could already have also.
    This will lead to loose gums and teeth falling out.
    Whatever action you choose, realize that your husband’s health is one of the most important things you can invest in. Even though dentistry is staggering cost, the cost of neglecting it is even more so, as you have learned by his parent’s neglect.
    I second the idea to have two separate dentist opinions. Look up gingivitis and impress on your husband the seriousness of delay.

  • Reply Mary |

    Have your husband use a Groupon to get his teeth cleaned, xrays, etc. While he is there, you can find out what exactly needs to be done and what is urgent. I might even get a second opinion at another dentist to compare what is needed and to compare costs. Be sure to get cost estimates on both. I’d skip the whole Mexico deal for the reasons listed above.

    If he has something that’s urgent, get started on that. You don’t want it to turn into an infection or something where he can’t work. Plus, you don’t want him to be in pain either while he’s the breadwinner for your family.

    Don’t get too concerned if there is a lot of dental work or how expensive it all can be. Take it one step at a time. Get the urgent stuff done now and then if you get a full time job with dental, you can tackle the more expensive items at that time. In the meantime, you could compare dental plans once you know how much work needs to be done.

    Even if you had all of the money right now, you wouldn’t get everything done at once. It would take months or years to get everything done so don’t panic because you don’t need all of that money right this second. Instead, do whatever is urgent and then get a little bit done every month. He’ll feel better and you’ll feel better.

    I needed a lot of dental work done some 15 years ago. I had an infection similar to your husband’s and I wasn’t working at the time. I let the problem go until my dental insurance kicked in and by that time, I had the infection. I got it taken care of and then had all of my silver fillings replaced. it took around 2 years of going to the dentist however once everything was done, I haven’t had any issues since. It’s the best thing I ever did.

    • Reply Ashley |

      Thanks for sharing your story! It’s scary how poor dental hygiene can “build up” and literally take YEARS to rectify (to be fair….the problems were caused from a lifetime of poor maintenance). At any rate, I think your suggestion is a good one. Of course, urging the husband to go to the dentist and ACTUALLY getting him to go are two separate things (anyone else have a partner/spouse who HATES dentists/doctors??? A total pain!) Any suggestions on that component of the problem?? Lol

  • Reply Mark |

    I would get a bid for all work and a prioritization schedule in the US and Mexico. Take the Mexican bid to your dentist in the USA and say “match this!” I suspect she/he would take the job for the price you are willing to pay. I hate to say it, but I suspect many dentists will charge what they can get away with, but when faced with the big old goose egg when you say you are willing to go to Mexico, they will take the smaller paycheck and do the work! The dentist should also see the benefit of working “with” you on this, since you have multiple children and yourself as potential business in the future, as well as future losses when his other customers find out they have price options. In the end, this dentist should be told to just give you the best possible price up front, so you don’t have to drive to Mexico to set his price for him!!

    • Reply Ashley |

      That is really genius! I never even thought to try to “haggle” with the dentist! But I’m sure you are correct – if they need/want the business bad enough they should surely bend on their prices. And the dentist I just went to is super close to our house and has a pediatric dentist on staff, too, so you are correct about being able to potentially getting our whole family as clients (particularly if they work with us on prices). I love this option – thanks for suggesting!

    • Reply Jeni |

      That’s a good idea! I have plenty of friends that use Mexican doctors for things and I also have plenty of Canadian friends that come to the US for things. If you like the dentist in Mexico, stick with them.

  • Reply DC - Kate |

    Talk to an insurance broker about getting dental insurance now. Like others have said, your mouth is a gateway for much more serious health problems. Additionally, as you found out, you can’t always predict when there will be a dental emergency. This is one area I will never, ever skimp on. As a side note, the quality of your teeth is one of the ways people judge socioeconomic status. It may seem trite, but if he works with clients, this kind of stuff does matter in how they perceive him.

    • Reply Ashley |

      I’ve thought about maybe just biting the bullet and buying dental insurance. This will surely happen at some point (particularly now that we have children), but I’m currently trying to avoid taking on additional monthly bills. Plus, when I’d last looked into it (admittedly several years ago), I was shocked by the long “wait times.” You can’t buy insurance today and schedule a root canal in 2 weeks….you have to have the insurance X period of time before they’ll cover a cavity filling, another longer X period of time before they’ll cover a tooth extraction, another longer X period of time before they’ll cover a root canal, etc. I remember thinking that by the time we’d paid the monthly premiums for “X” period of time we might as well have just paid for the services outright. Obviously I need to re-look into this since I no longer remember the wait periods.

  • Reply christy |

    Much like your husband, my parents never took me to the dentist when I was a kid. As an adult, I had some major dental problems. Some of my problems were congenital (I was missing all of my premolars – I still had baby teeth at nearly 30 years old!), and some were just just from bad oral hygiene habits (I swear I never flossed for the first 30 years of my life). It is a vicious cycle, because when your teeth embarrass you, you avoid the dentist. But avoiding the dentist only makes it worse. Your husband has my sympathy.

    What finally motivated me was going home to visit my mom. She had all of her teeth pulled out when she was in her 40’s and now she has dentures, which she complains about endlessly. Suddenly it occurred to me that I was headed down the same path. So, I made an appointment with the dentist.

    I ended up needing a root canal, braces, and 5 dental implants. It took about 4 years to get everything finished (I was in braces for 2 years). And my dental insurance didn’t cover dental implants (which cost about $3,000 per tooth) or the braces. Plus my insurance has a $1,000 maximum per year, which honestly isn’t much money when you have lots of issues. Honestly, the dental insurance was useless. I spent close to $20,000 on my mouth, but I am so happy with the results. I felt guilty at first, because I felt like I was taking much needed money away from my family, but in the end, it was totally worth it. I actually got most of the work done while we were paying off all of our credit card debt. It motivated me even more to save money and be frugal. Maybe it’ll have the same effect on your husband?

So, what do you think ?