Chomping your favorite grub. Flashing your killer smile during a Zoom get-together. Opening plastic packaging that defies fingers. There are myriad ways we use our teeth, and just as many reasons to keep them feeling and looking good, including boosting overall physical and mental health. If you don’t have a go-to dentist, finding one should be at the top of your health-care agenda.
If you need a good dentist in the D.C. area, Washington Consumers’ Checkbook, an independent nonprofit, surveyed more than 45,000 local consumers about their experiences with dental practices they used. Checkbook is offering free access to its ratings of area dentists, including the results of our undercover price shopping, to Washington Post readers at Checkbook.org/WashingtonPost/Dentists until April 10.
Checkbook reported results for practices that received at least 10 ratings in our surveys. Many dentists were rated “superior” (as opposed to “inferior” or “adequate”) for “overall care and service quality” by more than 95 percent of their surveyed patients. In contrast, some dentists received such favorable ratings from 65 percent or fewer of surveyed patients.
If you don’t carry dental insurance, check prices for treatment. Checkbook’s undercover shoppers contacted each of the dental practices in our study and asked for prices for several common procedures. They found enormous practice-to-practice fee differences. For example, for a routine examination and cleaning for an established adult patient, prices among surveyed dentists ranged from $52 to $467; for a one-surface composite filling on an adult molar, prices ranged from $80 to $485; and for a new porcelain crown for an adult molar, including post and core, fused to high-noble metal, prices ranged from $892 to $3,854.
You don’t have to forsake quality to see a dentist who charges low fees. Checkbook found many dentists who receive high ratings for patient care and also charge below-average fees.
Ask about specials and discounts. Some practices will offer specials on certain procedures. Others advertise low-priced packages for new patients. Some will offer discounts to special groups, such as senior citizens, students, fire or police professionals, and more.
Good preventive care is by far the best way to save money. More important than anything the dentist can do for your mouth is what you can do for yourself. Regular brushing, flossing and professional cleanings will help you avoid future expenses for treatments and restorations. Your dentist or hygienist should thoroughly explain proper brushing and flossing techniques, and they can offer tips on selecting a toothbrush, floss, toothpaste and other supplies. The dentist also should periodically have you demonstrate your brushing and flossing techniques so they can suggest improvements.
Unfortunately, overtreatment is a problem at many area practices. Be suspicious if a new dentist recommends far more treatment than your previous one did — for instance, if they tell you many silver fillings need to be replaced or several teeth need to be crowned. This is an area where Checkbook receives frequent complaints.
Evaluate whether recommended services make sense. To help you decide, your dentist should supply a written treatment plan that includes a description of the condition of your mouth and the corrections needed.
If the proposed treatment is extensive and/or expensive, get a second opinion from a specialist. General dentists often refer patients to specialists for root canals (endodontist), gum surgery (periodontist), moving multiple teeth (orthodontist) or removing impacted teeth (oral surgeon), but as some dentists become increasingly hungry for business, they are trying to tackle these tasks on their own. Not all are qualified to do so.
Because various treatments require more or less of a dentist’s time — and therefore higher or lower charges — the advice may be colored by self-interest.
Ask about all of your options. There is often more than one treatment for the same condition. The dentist should be willing to describe the pros and cons of all of them, so you can make your decision based on cost, discomfort and inconvenience. You’d expect a roofing contractor to explain the pros and cons of repairing vs. replacing your roof; you should demand the same from a dentist — and get it in terms you can understand.
Check your health plan for dental benefits, especially for dependents younger than 19; the Affordable Care Act mandates pediatric dental coverage on individual and small-group medical plans. Some Medicare Advantage plans include dental coverage, and many “consumer-driven” and “high-deductible” health plans let you set aside funds for dental work.
If you don’t have dental coverage but know you’ll soon need costly dental work, consider joining a dental discount plan; Checkbook found that these often yield significant savings. But be aware that many top-quality dentists — including many rated highest by Checkbook — don’t participate in these programs.
Regardless of whether you have dental insurance, estimate your out-of-pocket medical and dental costs, and stash that money in a flexible spending account. By funding an FSA with pretax earnings, you effectively get a 20 to 40 percent discount on out-of-pocket medical costs.
Before choosing a dentist, ask whether they offer warranties for several common restorations, but don’t expect to get concrete guarantees. Some dentists guarantee work for only an approximate time, and almost no dentists put the guarantees in writing. Among dentists who do offer guarantees, about half offer a five-year guarantee for crowns and about two years or less for fillings.
If you find a dentist who will provide a warranty on their work, get it in writing — including a description of the current problem, proposed treatment, expected costs, expected results and a specified period during which the dentist will redo (at no cost to you) work that proves to be defective. Remember that any warranty is subject to reasonable wear and tear, and that a crown might not be covered, for example, if you do something ill-advised, such as use your teeth to open a beer bottle.
Kevin Brasler is executive editor of Washington Consumers’ Checkbook magazine and Checkbook.org, a nonprofit organization with a mission to help consumers get the best service and lowest prices. It is supported by consumers and takes no money from the service providers it evaluates. You can access Checkbook’s ratings of Washington area dentists free until April 10 at Checkbook.org/WashingtonPost/Dentists.