Harveyspecter

As per the title. I had my first dentist visit this morning. Naively I thought I'd be in and out in 30 mins but that wasn't the case! I know it was my first time so there are forms to fill in and initial checks to be made, but it all seemed a hell of a lot more in depth than I have been used to in the UK.

I got a checkup the day before I emigrated just over a year ago and now I finally have a job I get myself a checkup etc. Well as I say it all seemed a lot more comprehensive than in the UK and they did all manner of checks and tests that I don't recall ever having had in the UK. So they are doing their thing and I hear a lot of 'problems' being talked about. A few minor cavities and then there was one filling that apparently needs re-doing. Then they were talking about pulling my remaining wisdom teeth out.

They were very nice, but having never visited a dentist in the US before and based on my UK experience, it just seemed like they were quite pushy in terms of wanting me to get treatments and telling me I needed a lot of work. Nothing huge, just cleanings and one minor filling (The US seem very keen on teeth cleaning?) that all comes to tens of dollars under my insurance, but then there is one filling that is $300 so given my recent stupid thumb injury I'll need to build up my HSA a bit again first. My wisdom teeth have long been monitored in the UK and I had one out about 3yrs ago because it was giving me discomfort. One other might be an issue because it's hard to clean but the other 2 which have never been a problem and my UK dentist said were fine to leave in, they are now saying I should take them out.

I unfortunately am not a very trusting person by nature, so I'm always very cautious when it comes to things like this, especially given in the US it costs significantly more and I especially don't want my teeth hacked about with just to make a dentist more money. I was especially uncomfortable at the fact they seemed very pushy for me to set appointments right there and then and I had to get quite stern with the consultant and say I wanted to review my work schedule before setting an appointment. So what are other expats experiences of dentists here? Is that just the way it is here or am I right to feel cautious?

Many thanks.

WEBlue

Yes, caution is a NUST with some American dentists.... Especially the ones who see you've come from 'outside' the US dental system & want to "fix" things that they would have tweaked (for big bucks) for their regular American customers years ago.


I actually love the deep cleanings you get here--I feel they're worth the money. And I do also love the proactive approach--I like being warned of possible problems down the road with my teeth. But .... some dentists here are just out to make work/money and need to be resisted. Maybe you've got one, maybe not. But I would (speaking for myself) look for another, less pushy dentist, if I were in your shoes.


I quit my first dentist. She pointed out some potential problems--I said we'll wait till they become 'real' problems--then she got more & more insistent until she was almost haranguing me. So I switched to a more laid-back dentist who listens to me.

Pulaski

Sounds about normal-ish, mine isn't too pushy, but I think I got lucky. The dental practice I visit changed hands twice in two years, so there wasn't much continuity, but my wisdom teeth were a topic of interest for the second (interim) dentist, who seemed keen to discuss removing them - all are impacted and completely concealed, and have caused me no issues.

I did some on-line reading and the advice is fairly consistent across many sites - removing them seems to be preferred, but only if you are in your 20's. Once you reach your 30's removing them gets more difficult and the risk of complications (a broken jaw) increases, BUT wisdom teeth rarely cause issues if they haven't caused you an issue by the time you reach your 30's. .... So, depending on your age, and whether your wisdom teeth are causing issues, I would push back on having them removed.

So, back to my personal experience, when my dentist's practice changed hands a second time, the new owner/dentist was more aligned with most of what I read on-line - that he would monitor them with periodic X-rays, but unless they start to give me problems, he will leave them alone.

Harveyspecter

Thanks Pulaski, I'm 35 on Monday (Happy Birthday to me!) so that's good to hear. The one I had out gave me problems which gradually got more painful and common until I decided to have it out 3yrs ago. The other one they talked about could be causing issues with cleaning and hence bacteria build up and decay so I can see why they want that out at some point. But in the dentist himself' defence, he did say it;s best to monitor it for a while and if it isn't staying clean then to take it out.

chawkins99

I was at the dentist on Monday due to toothache. They said it was 'gum recession' exposing the nerve and to use a Sensodyne or equivalent toothpaste.
They then proceeded to list all the other work I need including 3 fillings and 2 crowns but first they need to do a 'deep clean' as that hasn't been done in over a year. I now have 2 x 2-hour appointments for the cleaning
Then they will move on to the fillings and crowns.
Even with insurance, I'm looking at close to $1,000 this year.

Rete

I'm not a dental hygienist but I can tell you that teeth cleaning on an annual basis is important to help you control tartar and to help keep your gums healthy. I don't have dental insurance any longer and my last cleaning was over $300 and after having dental insurance for a lifetime, my jaw dropped at the bill. $300 for a filing sounds about right. Now to ask you what type of filing was he telling you he would do?

As for your HSA, if you don't have it available there is nothing stopping you from waiting until you have saved more and then ask to be reimbursed for the amount of your dental visit.

Actually sounds like your dentist was quite conservative and not at all pushy. As for his staff, the dentist recommended treatment and they assume, correctly or not, that you would be returning to have the work done.

What people need to understand is that as the patient, you are the one holding all the cards. The doctor or dentist is employed by you. A firm "no" and "I'll call when I am ready to set up an appointment" is all that you to say or do.

Harveyspecter

Thanks Rete, The dentist himself was pretty good, and I wouldn't say they were overly pushy, but more pushy than I am used to as I said in my original post. I tend to ask on here as people know what expats are 'used' to, which is something not even my wife can relate to.

Thanks for the advice.

mrken30

I had my last 2 wisdom teeth out around age 40 with no issues. Was a 10 minute procedure including anesthetic and very little pain. Mine were impacted with just part showing above the gum. The first 2 came out in my twenties and took best part of an hour and hurt like a MF.

Unless it's urgent, it may be worth trying a different dentist on your next check up or just go and get another opinion now.

jjmb

Pity, PF is away, she could tell you exactly why teeth/gum cleaning is so important. As a first visit, it doesn't seem so bad. As to the wisdom teeth, they do seem quite obsessed by them over here. I did ask once, as I have all 5 of mine (yes, I have one extra apparently) and its because if they haven't erupted, they can can cause problems with the roots of your back teeth as they have tendency to shift. However, the dentist assured me that as I had got to 40 (at the time) without any problems, she couldn't see any issues with just leaving them there but would keep an eye out for any movement in them.

Pulaski

Not sure about that, I think we should be relieved that she is away.
That seems to be the most common advice - if they're going to cause trouble it will usually be before you get to 40.

tom169

I currently have a wisdom tooth coming through, but luckily no pain right now. I'm expecting the dentist to want it out next check up.

I also had a long initial checkup. The main difference I found was the bulk of work done by the hygienist. In England it was the actual dentist that did the cleaning etc.

Pulaski

Yeah, I think my dentist has three rooms, each with a hygienist, that he flits back and forth between, though given how long he spends with me as a fraction of the total time I spend there, he could probably run four or five rooms in parallel.

Rete

In terms of what? Service? Price? Procedure? Treatment? Expectations?

I thought some input from someone who is familiar with the dental charges and procedures in the country you are living in would help you to understand what is considered the norm in the US dental field.

I suppose over the last 20 yrs on BE I have grow accustomed, right or wrong, of many stating how expats do not take care of their teeth in the same way as is done in the US.

Sorry for interfering and I shall go back to the US corner where involvement has been regulated to visa questions only. Toodle!

scrubbedexpat091

Go to a dentist without insurance and it can be amazing how much less work they recommend.

SanDiegogirl

I believe this has to do with how dentists are rewarded (paid) in the UK and US.

By the time we left the UK in 2000 we had moved to a totally private dentist as, based on the treatment we received from an NHS dentist (who was also part of a dental insurance scheme), we concluded that as the NHS dentists are paid an amount per patient by the NHS (regardless of what treatment they actually provided) it was, perhaps understandable, that the less the dentist treated you, the more money he pocketed.

In the US, dentists all have private practices - they only earn money when they provide treatment. Hence they are somewhat more pushy than British dentists - however, I also think they provide superior dentistry.

I had loads of dental work when I first arrived - I was on employers insurance (not a lot, but it paid for around 25% of any work).

Now I've got good teeth, but am on Medicare. I refuse to have 6 monthly X rays, and I'm only checked out by the dentist once a year. I do have 4 monthly cleaning.

I think a lot of British people have awful teeth - but, maybe, the US goes a bit overboard on the "great white smile"; one has to strike a good balance between what is necessary for good teeth and "cosmetic extras"