bigstockphoto/BIGSTOCKPHOTO - This model show the teeth have been capped and the stainless pin in the gums.
Talk about sticker shock.
I’d just learned what it was going to cost to finish the work on a dental implant I had begun six months earlier, in May 2010. Back then, my periodontist had surgically placed a screwlike titanium post within the bone socket below my missing tooth. I had paid $1,750 out of pocket to have the device implanted, since my insurance wouldn’t cover it. I’d assumed that this was going to be the most expensive part of the procedure.
I still needed a supportive abutment and the tooth-shaped crown, which would fit on top of the implant in the space where the natural tooth used to be.
My regular dentist said she could do it. Great, I thought. Then she quoted a fee.
It was a staggering $3,000, meaning my total cost would be almost $5,000 to replace a single tooth. I was nearly speechless.
To be sure, living in Bethesda can be expensive. So I called a dentist I knew in Cumberland, Md., Her price was $2,000 — a third less, but still too high for my budget.
My Bethesda dentist was sympathetic but said she couldn’t negotiate. The crown is custom-made by a lab, and it isn’t cheap.
Here’s what’s involved: After the implant bonds to the jawbone, which takes about six months, the dentist attaches it to the abutment, a small connector post designed to support the crown. The dentist takes impressions of the teeth, creates a model of the bite, and bases the crown on this model. The lab makes the crown, and the dentist attaches it to the abutment. The end result looks just like a real tooth.
I hadn’t gone this far to stop in the middle. But how to pay for it? My dentist had an idea: “Why not have it done at a dental college? Dental students learn by practicing on patients, and it’s all supervised by professionals. And the school will charge you a lot less.’’
It was a great piece of advice.
Shortly thereafter, I became a patient in the prosthodontic clinic at the University of Maryland School of Dentistry in Baltimore.
It took a considerable amount of time, but it was worth it. I received excellent care, and a beautiful new tooth.
I also saved a bundle of money.
A genetic legacy
People lose teeth for many reasons, including disease and injury. My genetic legacy was the gum disease and bone loss that had afflicted my mother. She lived to 100 but died toothless. One of my enduring childhood memories is the vision of her dentures soaking in a glass beside her bed.
To be sure, many advances available today didn’t exist when she was growing up. Moreover, her generation knew little of home care beyond brushing. (Flossing still was in the future even when I was a child.) Her teeth were pretty much gone by middle age.
Hoping to avoid her fate, I took scrupulous care of my teeth and have managed to hold on to most of them. Nevertheless, I began to lose bone. With no supportive bone, teeth begin to loosen, infections develop and extractions inevitably follow. I had several surgical bone grafts, with mixed success. I lost five teeth, but because they were located at the back of my mouth, they could not be seen and caused me almost no trouble.
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