Question I have a front fixed bridge that needs replacing. The fixed bridge contains 6 teeth, 2 crowns connected to my eye teeth and the other 4 missing teeth all connected. The eye teeth had root canal done many years ago and the bridge held up well. My dental plan wants to pay for an alternative plan, replace the 2 eye teeth with crowns and the remaining 4 missing teeth put on a removal denture with wire clasp that will connect to my eye teeth, the eye teeth will have crowns and they had root canal treatment. My dentist and myself agree that this is the wrong way to proceed. Are we correct in this?
Answer Dear Anthony,
Sadly, there is no "correct" here. You know what you've had that has worked so well for many years. The insurance company knows that it will pay less for 2 crowns and a removable partial than it will for a 6 tooth cemented bridge. The insurance company does not care what is right and what is wrong for you. It just cares about what will cost it less. And in most dental policies, there is a lowest-cost-alternative clause which states to the effect that, if there is more than one alternative that will accomplish the same task, they will pay for the lowest cost choice.
Example: We can fill teeth with silver or white fillings, or baked ceramic inlays. Since the silver is the lowest cost alternative, most insurances will pay only for the silver filling. No matter that this still contains mercury, a known human toxin. You then pay the added cost if you want the non-toxic alternative. The same applies here. The cemented bridge feels, looks and works better than a removable partial. Doesn't matter to insurance. They can pay for the lower cost alternative, and leave you pay the difference.
You can contact your dental plan and work them over. You can contact the owner of the plan, usually your employer, and let them know about this, and ask them to contact your dental plan in your behalf. You can ask your dentist to speak to the plan's dental consultant. The strategy would be that a removable partial is not the equivalent alternative to a cemented bridge in terms of appearance, function or durability. But if your dental plan contract has this lower cost clause, there's usually not much anyone can do.
[It took me almost a half hour to answer your question. How much time are you, your employer or your dentist willing to give to your cause? Remember, we're all busy people for whom time is short. And usually time waiting on hold is long]
In the end, you should get the bridge and pay the difference. Generally, insurances are not on the side of consumer, but rather on the side of their own pocketbook. But this is a subject for another conversation. Watch last Sunday's 60 Minutes segment about life insurance companies. It will open your eyes and make you gag.
Knowledgeability = 10
Clarity of Response = 10
Politeness = 10
This is one of the best answers I ever received from an AllExperts contributor. Thank you
I am a Family, Implant and Cosmetic dentist. I will answer questions on any aspect of dentistry and matters relating to the smile, gums, jaws and lower face. Member American Dental Association, Florida Dental Association, Broward County Dental Association, and Atlantic Coast District Dental Association. I have served as District Council Member of Alpha Omega, as well as serving for one term as its President. I am also a member of The Vedder Honors Society, Broward Dental Research Clinic, and Mount Sinai Hospital Guild. I have served as a Volunteer for Project Dental Health and The Tri-County Dental Health Council.
Having attained over 30 years of clinical experience in private practice in Michigan, in 2001 I was re-certified by taking and passing the Florida State Dental Board Examination. After moving to Florida, I spent nearly 10 years re-honing my skills while working as an Associate Dentist for several large dental groups. In September, 2004, I was appointed Adjunct Clinical Professor at Nova University's College of Dental Medicine. I am certified in placement of Mini Dental Implants, and I am Director of The Florida Implant Center (floridaimplantcenter.com). On March 1, 2010, at the age of 62, I began all over again by buying a dental practice near my home in the Fort Lauderdale area. As sole owner and Chief Dental Officer of the new Nob Hill Dental Center (nobhilldentalcenter.com), I can now carefully provide dental care to patients who care, all within a caring, joyful environment. Over my career lifetime, I have provided thousands of diagnoses, fillings, crowns, bridges, root canals, periodontal treatments, TMJ therapies, partials, dentures and extractions, and dozens of implants for my patients. The only aspect of dentistry with which I have very little experience is orthodontics.
Organizations American Dental Association, Florida Dental Association, Broward County Dental Association, Atlantic Coast District Dental Society, Vedder Honors Society, Broward Dental Research Clinic, Alpha Omega Alumni Association, and American Association of Dental Implantologists. Formerly, American Academy of General Dentistry, Michigan Dental Association, Macomb Dental Society, Detroit District Dental Society, Tri-County Dental Health Council (a charitable dental care organization)
Publications "How To Save Money At The Dentist" Going to press soon.
Education/Credentials Bachelor of Arts and Sciences in Psychology from Wayne State University
Doctor of Dental Surgery from University of Detroit College of Dentistry
Adjunct Clinical Professor, Special Needs Department, Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Florida
Awards and Honors Membership in The Vedder Honors Society
Past/Present Clients HIPAA rules do not allow me to post this information.