Greetings,
I am at the end point of the surgical placement of two implants. Naturally,
insurance did not cover the cost. An abutment tooth under a 20+ year old
bridge had developed decay below the gum line. The periodontist stated that
by the time they cut off the old bridge, performed crown lengthening on the
decayed abutment tooth, restored the decayed tooth & then replaced the
3 -unit bridge, it would be more cost-effective to spend a little more money
& place implants to replace the extracted abutment tooth & the original
missing tooth that the bridge corrected. Naturally he advised that it did
not include the new crowns on the implants. Without considering the cost of
the crowns, I figured it was about $1000 more to get the two implants than
repair the decay & replace the bridge but it made sense to me because I did
not know the condition of both abutment teeth after all those years &
thought that after all that work, a new bridge may not be supportable or
have a very much shorter lifespan & I would be back in a few years for
implants anyway (I am 55 years old).
Crowns cost me ~$500 with insurance, so even after factoring in another
$1000 I agreed. I was never informed nor did I have any reason to know two
key facts. First, that my insurance covers crowns only over natural teeth. I
just assumed a crown over a prosthetic root would be even simpler & a crown
would be covered. Nowhere in my payment schedule is there an asterisk
stating that crowns are not covered when placed on top of an implant.
Second, that an implant crown without an abutment, is more expensive than a
normal crown.
Imagine my surprise when the dentist office called me before my crown
appointment to give me a price of $1400 per tooth for abutment & crown,
effective tripling the final additional cost that I was figuring. The lady
at dentist office even stated a different payment code for this type of
crown. She also stated that it was more invasive than a regular crown. I
must be really naive because I envisioned the dentist unscrewing the healing
cap, screwing in the appropriate size abutments, taking an impression, etc.,
etc. like a normal crown. Is that incorrect? If it is correct, would not
grinding down a diseased old tooth for 30 minutes considered more invasive
than selecting & screwing in an abutment?
My MAIN question is: what is it about an implant crown that makes it more
expensive than a normal crown over natural tooth? The breakdown was
something like $350 for the abutment & $1050 for the crown.
Also, I live in Phoenix. Is this price in line or am I subsidizing the
discount that I & others with dental insurance receive? I
Thanks for reading this long post.

Rich

> My MAIN question is: what is it about an implant crown that makes it
> more expensive than a normal crown over natural tooth? The breakdown was
> something like $350 for the abutment & $1050 for the crown.
> Also, I live in Phoenix. Is this price in line or am I subsidizing the
> discount that I & others with dental insurance receive? I
> Thanks for reading this long post.
>
> Rich

Implant 'parts' are quite expensive, more training and experience is
needed, and there is a higher incidence of not getting a perfect fit
on the first try, leading to more lab fees.

If the dentist is standing behind his work, then there is also the
assumed cost of any failure to deal with down the road. They aren't
that common, but can be time consuming and expensive for the dentist.

The cost doesn't sound out of line for a big city.

As far as 'invasive', you are quite correct. I usually do not have to
use anesthetic for any of the procedures. It is also proper for the
patient to understand the total cost of the entire treatment before
signing on.

Big reason I don't do a whole bunch of implants out here is 'wally world'.

JMO,
Steve Fawks

Steven Fawks wrote:

>

>
> Implant 'parts' are quite expensive, more training and experience is
> needed, and there is a higher incidence of not getting a perfect fit
> on the first try, leading to more lab fees.
>
> If the dentist is standing behind his work, then there is also the
> assumed cost of any failure to deal with down the road. They aren't
> that common, but can be time consuming and expensive for the dentist.
>
> The cost doesn't sound out of line for a big city.
>
> As far as 'invasive', you are quite correct. I usually do not have to
> use anesthetic for any of the procedures. It is also proper for the
> patient to understand the total cost of the entire treatment before
> signing on.
>
> Big reason I don't do a whole bunch of implants out here is 'wally world'.
>
> JMO,
> Steve Fawks

I would add that if this is a PPO dentist who is contractually
obligated to offer crowns at the PPO fee for COVERED SERVICES, the
dentist may feel justified in billing his private fee for the
implant-supported crowns, since they are not a covered service.
I personally don't do this, but sometimes the lab will charge me more,
and I do pass through the extra lab fee if there is any related to the
crown.
FWIW, my lab probably charges close to $350 for a STOCK abutment, and
the lab fee for custom abutments generally average in the $400-600
range. So the fee for the abutment is very reasonable--cheap even.
Neither is the crown fee out of line.
Communication beforehand can help eliminate these understandings. And
lastly (I know you'd agree with me here, Steve)--if you have a good
dentist it's a bargain. If you don't, it's not a bargain regardless of
the fee.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

On Feb 14, 2:24*am, "Rich" <rg...@cox.net> wrote:

> Greetings,
> I am at the end point of the surgical placement of two implants. Naturally,
> insurance did not cover the cost. An abutment tooth under a 20+ year old
> bridge had developed decay below the gum line. The periodontist stated that
> by the time they cut off the old bridge, performed crown lengthening on the
> decayed abutment tooth, restored the decayed tooth & then replaced the
> 3 -unit bridge, it would be more cost-effective to spend a little more money
> & place implants to replace the extracted abutment tooth & the original
> missing tooth that the bridge corrected. Naturally he advised that it did
> not include the new crowns on the implants. Without considering the cost of
> the crowns, I figured it was about $1000 more to get the two implants than
> repair the decay & replace the bridge but it made sense to me because I did
> not know the condition of both abutment teeth after all those years &
> thought that after all that work, a new bridge may not be supportable or
> have a very much shorter lifespan & I would be back in a few years for
> implants anyway (I am 55 years old).
> Crowns cost me ~$500 with insurance, so even after factoring in another
> $1000 I agreed. I was never informed nor did I have any reason to know two
> key facts. First, that my insurance covers crowns only over natural teeth.. I
> just assumed a crown over a prosthetic root would be even simpler & a crown
> would be covered. Nowhere in my payment schedule is there an asterisk
> stating that crowns are not covered when placed on top of an implant.
> Second, that an implant crown without an abutment, is more expensive thana
> normal crown.
> Imagine my surprise when the dentist office called me before my crown
> appointment to give me a price of $1400 per tooth for abutment & crown,
> effective tripling the final additional cost that I was figuring. The lady
> at dentist office even stated a different payment code for this type of
> crown. She also stated that it was more invasive than a regular crown. I
> must be really naive because I envisioned the dentist unscrewing the healing
> cap, screwing in the appropriate size abutments, taking an impression, etc.,
> etc. like a normal crown. Is that incorrect? If it is correct, would not
> grinding down a diseased old tooth for 30 minutes considered more invasive
> than selecting & screwing in an abutment?
> My MAIN question is: what is it about an implant crown that makes it more
> expensive than a normal crown over natural tooth? The breakdown was
> something like $350 for the abutment & $1050 for the crown.
> Also, I live in Phoenix. Is this price in line or am I subsidizing the
> discount that I & others with dental insurance receive? I
> Thanks for reading this long post.
>
> Rich

The labs charge MORE and the tiny parts are wicked expensive. You
should have been informed about the whole ball of wax - start to
finish. And you can NEVER, EVER be sure what the sleaze-bag insurance
company will cover until the work is actually completed. Actually
$1400 is quite reasonable for both crown AND abutment. Yes, it IS much
simpler than a REGULAR crown for the dentists, however the
manufacturer's parts and the lab fees negate any time/labor savings
for the dentist.

Just a factor of higher laboratory fees, and the cost of the abutment which
is placed between the crown and the implant.

AC


"Rich" <> wrote in message
news:3lull.652$...

> Greetings,
> I am at the end point of the surgical placement of two implants.
> Naturally, insurance did not cover the cost. An abutment tooth under a 20+
> year old bridge had developed decay below the gum line. The periodontist
> stated that by the time they cut off the old bridge, performed crown
> lengthening on the decayed abutment tooth, restored the decayed tooth &
> then replaced the 3 -unit bridge, it would be more cost-effective to spend
> a little more money & place implants to replace the extracted abutment
> tooth & the original missing tooth that the bridge corrected. Naturally he
> advised that it did not include the new crowns on the implants. Without
> considering the cost of the crowns, I figured it was about $1000 more to
> get the two implants than repair the decay & replace the bridge but it
> made sense to me because I did not know the condition of both abutment
> teeth after all those years & thought that after all that work, a new
> bridge may not be supportable or have a very much shorter lifespan & I
> would be back in a few years for implants anyway (I am 55 years old).
> Crowns cost me ~$500 with insurance, so even after factoring in another
> $1000 I agreed. I was never informed nor did I have any reason to know two
> key facts. First, that my insurance covers crowns only over natural teeth.
> I just assumed a crown over a prosthetic root would be even simpler & a
> crown would be covered. Nowhere in my payment schedule is there an
> asterisk stating that crowns are not covered when placed on top of an
> implant. Second, that an implant crown without an abutment, is more
> expensive than a normal crown.
> Imagine my surprise when the dentist office called me before my crown
> appointment to give me a price of $1400 per tooth for abutment & crown,
> effective tripling the final additional cost that I was figuring. The lady
> at dentist office even stated a different payment code for this type of
> crown. She also stated that it was more invasive than a regular crown. I
> must be really naive because I envisioned the dentist unscrewing the
> healing cap, screwing in the appropriate size abutments, taking an
> impression, etc., etc. like a normal crown. Is that incorrect? If it is
> correct, would not grinding down a diseased old tooth for 30 minutes
> considered more invasive than selecting & screwing in an abutment?
> My MAIN question is: what is it about an implant crown that makes it more
> expensive than a normal crown over natural tooth? The breakdown was
> something like $350 for the abutment & $1050 for the crown.
> Also, I live in Phoenix. Is this price in line or am I subsidizing the
> discount that I & others with dental insurance receive? I
> Thanks for reading this long post.
>
> Rich
>

> My MAIN question is: what is it about an implant crown that makes it more
> expensive than a normal crown over natural tooth? The breakdown was
> something like $350 for the abutment & $1050 for the crown.
> Also, I live in Phoenix. Is this price in line or am I subsidizing the
> discount that I & others with dental insurance receive? I
> Thanks for reading this long post.
>
> Rich

Thank you to all of you for your concise professional responses. I
understand now. I'll just need to do one crown now & one after 6-1-09 when
my flexible spending account starts over as I had not budgeted it for that
high an amount. Actually, on my 2nd call back to the office, I informed them
of their private dental plan that I had purchased from their organization
(South West Dental) to discount the implants. Naturally, abutments & implant
crowns were not listed on their fee schedule but I was informed that with
their private plan, the cost was discounted 20% to about $1150 per
crown/abutment. Thanks to your informed information about material &
regional costs, I feel much better (relatively) now.
I feel a little bad because I was so frustrated on the phone with the
office. Just the day before I went through an horrifically unprofessional
incident with my daughter's dentist. I may provide the details of that in a
separate thread just for general interest.
Anyway, thanks again, Doctors. Your pro bono advice was helpful &
appreciated.

Regards,

Rich

Sometimes you get what you pay for, and sometimes you get *less*.

;-)
Steve

> And lastly (I know you'd agree with me here, Steve)--if you have a good
> dentist it's a bargain. If you don't, it's not a bargain regardless of
> the fee.
>
> Steve
>