the Price of Special Dental Procedures

I had a cracked molar which could not be saved due to the fact that it was cracked up the middle and the crack extended up under the gum line. My dentist put in a temporary filling until I could get an appointment with the oral surgeon for the extraction. But the tooth cracked even more, resulting in a piece of it flapping around in my mouth, so the dentist had to remove that portion.

I called several oral surgeons who were within a reasonable distance and recommended by my dentist. We live in a rural area, so a reasonable distance for us is about 50-75 miles from home. The oral surgeon that we would have preferred to use could not see me for 2 months, and the others said that the could not fit me in for a month. But after my second visit to the dentist for removal of part of the tooth, I called back one of the oral surgeons, explained the situation, and they were able to give me an appointment for the following week.

Of course I was apprehensive about this procedure, but upon arrival, I was ushered into the examination room. First they took a panoramic X-ray, which they said was normal procedure and they would not charge for it. (I had brought the X-ray taken at my dentist's office, but that was not sufficient for the oral surgeon.)

The oral surgeon looked at the tooth, said it did need to come out and explained that there were several options.

1) It could be removed that very day with a local anesthetic.

2) In addition to local anesthetic, they could administer laughing gas or some other medication to help me relax.

3) It could be done under general anesthesia, but that would mean coming back another day, since the procedure would then have to be done on an empty stomach (due to the use of the general anesthesia).

Cost of the procedure increases also, depending upon the option that you choose.

It was explained to me that under local anesthesia, I would not feel anything except pressure. I would probably hear crunching and other noises, but would not feel pain. If I did, I was to advise them and they would administer more novocaine.

I opted for the local anesthetic and to have the procedure done that day. The nurse then brought in the forms for me to sign, showing that the cost was $325, but that my insurance would cover all but $75 and payment was expected that day. I signed the forms, which also included various consent forms, and then the novocaine was administered as an injection.

While waiting for it to take effect, the nurse stayed with me and chatted. She was a very nice young woman, and it was helpful that she stayed and talked to me, since I was nervous about this procedure.

When I was sufficiently numb, the oral surgeon returned and removed the tooth. I was told to keep my eyes closed in case any debris from the tooth accidentally flew out, and the tooth was out within a few minutes. They were correct--I only felt pressure, no pain. A piece of gauze was inserted into the area where the tooth had been and I was told to bite on it for an hour or so.

I left there with a list of post-operative instructions and a prescription for Tylenol 3 for pain. The bleeding stopped in about an hour and I was able to eat fairly normally that evening, although I stuck to soft foods and avoided chewing on the side of my mouth where the tooth had been extracted.

That night when I rinsed my mouth after brushing my teeth, the water drained out of my nose. I looked around on the Internet and found that this could mean that there was an opening now from my mouth to the sinus and it could possibly become infected. I called the oral surgeon who said he had not seen a hole there after the extraction, but one could have formed. Did I blow my nose? Yes, I had blown my nose, albeit gently. His list of instructions did not caution against nose blowing. He said to refrain from nose blowing or sneezing (how do you do that?!) for several days and he told me to come back on Monday for him to check it out (this was a Friday night).

I returned the following week as he suggested and he did not see a hole. But he said that sometimes they do form and then have to be surgically repaired. Once everything heals, we will see if there is a hole. If there is, I will be able to feel air being sucked between nose and mouth. Meanwhile, he gave me a prescription for an antibiotic to be used as a prophylactic, to ward off any possible infection.

I feel that once I actually got an appointment, the service was excellent. The oral surgeon explained everything and has patiently answered any questions. His nurse was excellent too, as mentioned earlier.

The follow-up visits appear to be at no additional charge. The options for replacement of the tooth are open, and it seems that the oral surgeon does implants and bridges, so once healing is complete (about 4-6 months) we can discuss that. I would have no qualms about returning to him for these items, if I decide to have one of them done.

1) Ask your dentist for oral surgeons that he would recommend.

2) Call each, ask prices (they are usually vague about answering, but can usually at least give you a minimum price), and see how long it takes before you can be seen.

3) If the waiting time seems too long and you do not feel that you can wait, explain the situation. Some may be able to fit you in sooner under certain circumstances, but some may not.

4) If you have dental insurance, during your phone call ask if they accept your insurance. Some that I called did not accept my insurance, so even though they were able to give me an earlier appointment, I did not go to them.

5) You may want to get a second opinion as to whether or not the tooth needs to be removed, before you actually have the procedure done.

6) Remain calm. Having a tooth removed can be upsetting, but it will probably go better than you imagine.