Tag Archives: dentist

Teeth cleaning

12 Jun

I just got back from my routine six-month cleaning at the dentist’s office. I only saw a hygienist; the dentist didn’t look at my mouth. To my relief, she didn’t find any cavities. She told me that one of my back teeth has a deep groove in it that will need to be brushed extra carefully, but she emphasized that this was the anatomy of the tooth rather than a cavity.

When my mouth was wired shut, I was unable to brush most surfaces of my teeth, so I find it quite remarkable that I don’t have any cavities. A large part of this, as the hygienist pointed out, is that I’m lucky to have hard enamel. What I don’t owe to luck, I owe to my WaterPik, which proved to be an absolutely indispensable tool for cleaning my teeth and the wires around them.

I also learned that the dentist’s office has already billed my second insurance for the rest of the charges on my account. I should be receiving a bill for whatever they don’t pay in a few weeks. The statement of benefits from the insurance company, however, will probably go to my parents’ address.

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Bills and such

10 Jun

I’ve been out of town for a bit, and I returned home this morning to find some billing-related materials waiting for me.

The only actual bill came from Bay Imaging Consultants Medical Group. as far as I can tell, this has something to do with the x-rays I received in the hospital. This is apparently separate from the radiology item on my statement from the hospital. The bill lists charges for three items: “ORTHOPANTOGRAM”, “SHOULDER COMPLETE”, “FACIAL BONES, COMPL., MINIMUM”. The total charges were $147, but payments from my insurance brought it down to $53.79. The bill doesn’t say, but I’m pretty sure (based on my memory of some paper which I think I have in a big stack somewhere) that those payments come from my UC Berkeley SHIP plan, rather than my parents’ plan (which is supposed to be my primary insurance). I’ll have to give them a call to see if I can get them to bill the other insurer for the remainder.

I also received an explanation of benefits from the university insurance plan for my services from the oral surgeon. The insurance was billed for $3,720, of which $3,200 was for the surgery and $520 was for anesthesia. The insurance company has covered $1,831.82, and they expect me to pay $1,888.18. Of this amount that I’m responsible for, $146.21 is applied to my deductible, $457.95 is my coinsurance responsibility, and $1,284.02 “exceeds the allowed expense and is the member’s responsibility to pay.” For the record, I don’t really understand what all of these words mean, but maybe some day I’ll find out.

I’m hoping that the oral surgeon’s office will bill the remaining balance to my other insurance. I shouldn’t need to remind them about my second insurance, seeing as they called me for information about it while I was still sleeping off the anesthesia from the surgery.

The last related document I received was an explanation of dental benefits from MetLife, which provides my dental benefits for the SHIP plan. This was for the repairs of the chipped teeth. The statement tells me that the fee for my services is ordinarily $372, but the dentist agreed to accept only $286 as part of his participation in Metlife’s Preferred Dentist Program. Metlife reports having paid $208.80, leaving me to pay $77.20. As I understand it, they are applying $25 to my deductible and then paying 80% of what’s left. I’ll have to ask the dentist if they are also billing my parents’ dental insurance. Either that or I will just wait until I have a bill before I do anything.

Tooth repair (again)

27 May

Yesterday was a busy day, so I didn’t get a chance to write about it, but I returned to the dentist’s office to get my broken tooth repaired again. I was afraid that I’d get a lecture about watching what I was eating, but the dentist seemed to think that it was more likely that the break was caused by my teeth grinding against each other. I certainly wasn’t going to object to that hypothesis.

The dentist fixed the tooth again. This time, he didn’t need to numb my mouth because he wasn’t doing very much drilling. The whole procedure took about 20 minutes, and at the end he told me I was “better than ever”. He then had me move my jaw around to see if there was any way in which I could make my lower teeth collide with the newly repaired upper tooth. I managed to find an extremely contrived and awkward position that achieved such a collision, and the dentist shaved the artificial part of the repaired tooth accordingly.

The tooth has held up just fine so far, but I’ve been extremely careful not to use it to bite anything that will provide significant resistance.

New teeth

22 May

I went to my dentist’s office yesterday morning expecting to have my routine six-month cleaning. I had called to schedule an appointment a couple of weeks ago and explained that I needed two appointments: one to have the teeth fixed, and the other to get them cleaned. The receptionist scheduled one appointment, which she told me was for the cleaning. She said that the dentist would look at the chipped teeth and we could decide what to do about them thereafter.

When I went in yesterday, though, the dentist looked at my teeth for less than a minute before he started discussing the repair options for the front teeth. The fastest option was bonding, which he could do on the spot. However, for the tooth that was more seriously broken, this would probably eventually fail. The other option was a crown which would cover the whole tooth, which would also have the advantage of looking more natural. However, he wouldn’t be able to begin work on that while the arch bars were on my teeth.

I elected to get the bonding done, even though I knew it might just be a temporary solution for at least one of the teeth. The dentist numbed my mouth, and over the course of the next half hour had me periodically bite down and open my mouth. He then had me rinse my mouth and look in a mirror. The teeth looked terrible. The seam between the natural tooth and the artificial piece was very visible, and there were also white splotches on the tooth.

The dentist told me that I should avoid using the bonded teeth to bite into harder foods for a while. This, of course, wasn’t a problem because I had been avoiding harder foods altogether. He also told me that the repaired teeth would never be as strong as my natural teeth.

From the dentist’s office, I took a bus to campus, where my first stop was a bathroom to see if my teeth had somehow changed in the last twenty minutes. Somehow, they had. I didn’t even recognize my teeth when I looked in the mirror. At first glance, they looked natural to me, but upon closer examination I could see that they weren’t. I could see that the bonded piece was a slightly different color and a little bit shorter than the other one. Still, they looked much better than they had in the dentist’s chair. My guess is that when I looked in the dentist’s chair, there was some substance from the procedure on the surface of the tooth, but this had rinsed off since then. The idea of having swallowed this substance is not a particularly pleasant one, but I seem to still be alive.

Finally, a photo:Repaired teeth

The picture isn’t great, but for comparison, here are the chipped teeth.

Monday doctor visits

6 Apr

I called the oral surgeon’s office as soon as they opened at 8AM. They were able to make an 11AM appointment for me, but they told me that  I should get a referral from University Health Services (UHS) so that my student health insurance plan would cover treatment. I called UHS, and they told me that I should come to urgent care to get my authorization.

I very much resented being required to get this authorization. It seemed ridiculous that they couldn’t just trust the emergency room doctor’s word that I needed to see an oral surgeon. I spent the better part of an hour waiting at UHS before seeing a nurse and then a doctor. The nurse took my temperature and my blood pressure (both were normal) and asked me a few questions about my accident and the injuries. She showed me a piece of paper with faces showing various levels of discomfort and had me rate my pain according to the numbers labeling the faces. However, there were two sets of labels, one from 1-10, and one from 0-5. I didn’t ask which one she wanted me to use, but I said my pain was about a 2. For the most part, my injuries have been a bit uncomfortable, but not particularly painful.  The doctor looked at my various injuries and had another nurse bandage my scrapes. This actually made me rather glad to have come in because I had so many scrapes and not enough energy to bandage all of them. The nurse also gave me material for dressing my wounds for the next five days before I go back to get my stitches removed. I left with a bill of $15.60 not covered by insurance. Most of that was for the bandages the nurse had given me, which were $55 before insurance  (and $11 after).

About an hour after getting out of UHS, I had my appointment with the oral surgeon. He seemed nice and friendly without being intrusive (and, as a somewhat shy individual, I’ve found a lot of medical professionals to be intrusive). He showed me my x-rays, and explained my fracture, a condyle mandibular fracture. I was mildly disgusted when he told me that the model skull on which he was pointing out the condyle, a thin part of the mandible near the joint, was a real human skull, and I became altogether horrified when he removed the jaw from the skull and asked me to hold it.  He told me that the condyle fracture was a common type of fracture, which usually was treated without open surgery. The usual treatment was to anesthetize the patient, prod the bone back into place, and wire the jaw shut for a few weeks. In a small proportion of cases, however, this doesn’t work, so an open surgery is necessary. He added that there was a small number of cases in which it isn’t necessary to wire the jaw shut; sometimes the bone will stay in place well enough that  it is sufficient to keep the patient on a liquid diet. He didn’t specify any time frame for the liquid diet, so I asked if this liquid diet would be for the rest of the patient’s life. “No, just a few weeks.” he answered, laughing.

In my case, the surgeon said, it will be necessary to wait a few days until my face is less swollen to do anything. He wasn’t sure whether it will be necessary to wire my jaw, and he won’t know until he has me asleep in the office. He told me he would have his receptionist call me in the afternoon to set up an appointment.

The oral surgeon also expressed concern about my two chipped front teeth. I told him that I was planning on having them fixed, but I thought that the broken jaw was a more pressing concern. He agreed, but said that I should have a dentist put a temporary seal on it. He said that since I had only  lived in the area for seven months, he couldn’t imagine that I would have had any reason to find a dentist by now. I was more than a little bit amused by this, having long been told that I should have a dentist clean my teeth every six months. I said, that I had, in fact, found a dentist, and I told him who it was. The oral surgeon told me that my dentist was a great dentist, and then made an appointment with the dentist for me that afternoon.

I also asked the oral surgeon if he had any suggestions for keeping my mouth clean if my mouth were wired shut. He suggested getting a children’s toothbrush and Sensodyne toothpaste. I wasn’t crazy about the Sensodyne suggestion, but I decided to get a children’s toothbrush to use with my usual Tom’s of Maine toothpaste.

I had plenty of time to get to the dentist’s office, but somehow I still ended up running to catch the bus to get there. This certainly wasn’t a good thing for me to be doing with broken jaw, but I didn’t fall, and I did catch the bus. When I got to the dentist’s office, he put a seal on one of the teeth, which he said almost had a nerve exposed. He said that both of the teeth were only chipped in the outermost layers, and he expects that they will be fixable. However, we’ll have to watch them carefully, and they may end up needing root canal work.

I repeated the question about keeping my teeth clean to the dentist, and he suggested a Water Pik, so I added that to my shopping list, too.

About twenty minutes after I got out of the dentist’s office, I got a call from the receptionist at the oral surgeon’s office. She told me that the next two appointments available were Wednesday of this week and Tuesday of next week. She added that she’d have to check with the surgeon to see if Wednesday would be too soon and call me back later. She also told me I’d need a friend to drive me home from the procedure, so I headed into the office to find somebody who could do that for me.

I was relieved to learn when the receptionist called me back a couple of hours later that the surgeon will be able to do the procedure on Wednesday. Although I’m not in pain most of the time, there are enough positions that are quite painful, that I’d really like to get it done as soon as possible. After scheduling the appointment, the surgeon transferred me to another member of the office staff, who told me that their office didn’t contract with either of my health insurers, and she told me the cost of the service, which was just under $3700. I knew that my insurance would cover some of the costs, even if it was out of network, but I wondered why I was referred to an out-of-network doctor in the first place. I know I’ll be able to afford whatever it costs, but of course I’d rather pay for as little as possible.

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