Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 7/11/2008

Question
QUESTION: I am a 35 year old who recently had restorative gum treatment to resolve an infection at a about $4,000. I work at A retail store with low wages. The gums are now acting well and I have one loose tooth in the lower rear. I have been informed that I need to spend an additional $8,745 as follows Osseous Surgery $1500, Remove erupted ( tooth is loose but nothing else)$295, Ridge Aug/sinus lift (why sinus lift?) $4,000,Implant/specialist $2,500 (??), prefab implant abut $450. Total $8745. Insurance pays about half leaving me with a bill that will bankrupt me or leave years of payments. I live in Upland, Ca. Is this reasonable and customary. I am considering Mexico as an option. Private due to cost discussion.

ANSWER: Zeus - The fees in this day and age are definitely high, but the fees, other than the sinus lift surgery and the removal of the loose tooth seem okay.  I don't know the type of doctor doing the work on you, but for some reason it sounds like a periodontist.  If that is the type of doctor doing the surgery, you are making a mistake.  Get back to me, tell me the type of dentist doing the surgery and I might be able to assist you in choosing the correct type of doctor to help and for a more reasonable rate.

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QUESTION: it is a periodontist that recommended all those procedures, he wants to remove the tooth  lower left back molar, put bone in the hole, as its a 10 mm socket the rest on that side are 4-7 mm according to him, I'm not sure about what he is saying ,as the hygienist in the same office I've been seeing told me they were all  4 ,5,6 mm she is the one who recommended i see the periodontist   he also wants to put bone on the rest of the lower left side of my mouth,  and put an implant to replace the lost molar ,that final cost was to just fix the lower left side of my mouth  as that is the worst problem area ,

ANSWER: Zeus -  You are in a very common situation when periodontists try to embellish situations.  I am not saying that you may not have bone loss that might need some treatment to correct it, but it sounds like the periodontist you saw is taking the "bull by the horn" and really doing a little beyond what most likely is necessary.

Upland, I believe, is not too far from LA.  My suggestion is for you to get examined by a doctor who works at a dental school in LA.  Not a dental student, but get a second opinion from the doctor who teaches periodontics at the school (USC or UCLA).  I know this sounds like a lot of work for you, but it might be the best solution.  Not only can they advise you there, they should also be able to help you at a reduced rate.  You could probably be treated by one of the postgraduate doctors there at a significantly reduced rate for any treatment that is needed.

I know this may sound like a little work for you, but I think it will be much less expensive and probably better.




---------- FOLLOW-UP ----------

QUESTION:  the same office has been calling me and reviewing my case ,what do you think would most important to address  the lower left molar or the upper left back 2 teeth?  i have the office im seeing charging me 279 to remove the lower left molar it not savable cleaning out the socket and doing a ridge augmentation for 500,  829 my cost to fix just the lower back left
is that reasonable?  if the tooth is not savable should i put that money on the upper left back teeth which i could still save ?   i am going to get a second opinion thank you again for your advice im going to try the ucla is there a number for that office? is that in the phone book?  

Answer
Zeus - I have to be honest with you.  I really should not truly advise you what is right or wrong without and exam or xrays of the region.  That is why I suggested seeing another facility.

At UCLA, call (310) 825-0834 and ask to be examined by Dr. Freymiller, Dr. Shetty or Dr. Felsenfeld.  I wish you well and hope the doctors there can properly advise you.