Wednesday, July 15, 2009

Dental Adventures, or how a little grey spot cost $20k

This has nothing to do with video games or the tech industry , but rather falls under the category of stuff I had trouble learning about and maybe my post can help someone else.


I'm about 95% of the way through a crazy bunch of dental work that started about three and a half years ago, have a little time on my hands, and figured I'd post about it. Those with a weak stomach for stories of dentistry or financial pain may not want to read on.

Five years ago or so, I noticed a small discoloration on my front tooth. Like a slight grey color beneath the surface, in one corner near the gum. It'd been there a while I'd asked dentists about it, but they'd always kind of said "hmm... not a cavity. Not sure. Just leave it."

Early in 2006 I got fed up and decided I wanted it taken care of and went to see a high end dentist (Spektor dental in Bellevue, WA, who are awesome). Dr Spektor consulted with her husband, who's a high end specialist, and they decided it was most likely root resorption. The wikipedia entry spells it out in detail, but the short version is that it's a condition where something (small defect or trauma to the tooth or such) causes your system to attack the tooth, killing it from the inside out. Unlike decay, it takes a long time to do its thing, but eventually the tooth has to come out.

So the doctor tells me that (a) it's not only in the one tooth I've noticed, but in a neighboring one as well, (b) the solution is to pull them out and put in implants, and (c) that because one of the teeth is out of line from the others, they want to put braces on me for a couple years first.

"Let me get this straight", says I, "you want to put braces on my teeth for two years, then yank them out? I'm getting a second opionion!" Turns out she was right.

To make matters worse, they break the news to me that I have a bunch of other work that needs doing (20 year old amalgum fillings that are starting to go, a crown that needs doing, a crown that needs replacing, etc), and that it'd be a good idea to do it all before I get the braces.

OK, off we go.
  • March 06 through Aug 06 - Two crowns, various consults with specialists, numerous fillings replaced. Total out of pocket spend about $2500.
  • August 06 - Braces on. After insurace this cost about $2500 out of pocket
Now it was a matter of waiting for the braces to do their thing, going in once in a while to get the wires replaced, etc. A major pain in the butt to floss (Waterpik's electric flosser is awesome btw), but not that bad. On the plus side, getting braces made me lose 10 pounds.

In early 08 I relocated to Oregon, so I had to find new dentist (Kaiser - meh), new orthodontist (Kaiser - Dr Ratliff - very good, but Kaiser is *ok*), new prosthedontist (Dr Halmos - awesome), new dental surgeon (Dr Henshaw - also awesome).
  • Second half 08 I go see all the new guys and get various Xrays, consults, etc. Total spend about $500
With teeth almost straight, we start to coordinate all my stuff. Dental surgeon worries that my frenulum (little piece of skin attaching top lip to gum at center) is going to tug at the gum after the implant surgery, potentially pulling the gum up assymetrically. Solution: Snip it!
  • March 09 - frenectomy, a 'minor surgery' that is fast, but smarts like hell for days afterward. Total out of pocket, $500 (IIRC)
Next up is the big surgery, the extractions! I was NOT looking forward to this. Again, further complications, it turns out that I have thin gums, so he's going to do a skin graft as part of it.
  • March 09 - surgical stint made by prosthedontist to guide the surgeon, and temp teeth to cover implants while they heal (I forget the cost of this. $500?)
The day of the surgery was not fun. Go to prosthedontist, get stint and fake teeth. Go to Ortho, 30 min appointment to get wires removed. Go to dental surgeon, >4hrs in the chair getting skin graft from roof of mouth to gums, two teeth pulled, two 12mm titanium posts implanted in my skull, etc Maybe 25 injections in all. I lost count.

After that, mouth all bloody and numb, back to ortho for another 2 hrs, where he gave me more novocain and vasoconstrictor and then put braces back on, with fake teeth covering gaps attached to the wires.
  • April 09 - Surgery, gum tissue grafts, etc. Total out of pocket, about $8700.
Now it was a matter of that healing up and the bone growing in around the implants until they were solit enough to load.
  • June 09 - bottom braces off (no cost)
  • July 09 - top braces off, temporary crowns on implants ($800)
I'm more or less done now. It's a matter at this point of making sure the gums settle at the right height, and then getting the permanent, porcelain crowns put on (sometime in august or september), which will cost another $3000

So, in the end it's going to cost me a total of about $19k to have my little gray spot fixed. It needed to be done though, as it would have turned into far more. I'd never heard of root resorption but have since run into a number of friends that have had it and have had more or less the same process to go through. Maybe this post will help someone else running into the same thing.

2 comments:

Shri said...

wow, your account is like an idiots guide to dentistry and its branches. BTW, after reading your post the term 'dentist' sounds very generic now. :)

Dwayne Robinson does not believe... said...

Your grey spot sounds a lot like what I have. My dentist and endontist just called it deep tooth decay and gave it a root canal. Mine was less expensive, but at least your dentist diagnosed it correctly.