Deep Cleaning Charges


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I'm in the process of having a deep cleaning which includes root planing and scaling. I was quoted $440 for the left side and $570 for the right side. I've had the left side done. The procedure was done entirely by the hygienist and took about 45 minutes which is about how long they have taken in the past for a standard teeth cleaning which is $105. Why am I charged slightly more than 4 times what a standard teeth cleaning would be when they call it a deep cleaning? I don't have dental insurance. This seems like what they used to call price gouging. I've been a patient of this dentist for a long time, so I don't feel like I deserve to be taken advantage of.
 
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honestdoc

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Sorry, in the US, scaling and root planing can be difficult to understand and justify. We look at bone loss and probings of 5 mm and greater. At many places, they may scam you for those procedures. If you go in regularly and have healthy gums, and the new dentist/hyg team tells you that you need SRPs, then it may be a scam. If you haven't gone in for years, then it is on you.
 

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My question was aimed at trying to understand why I was being charged so much more for a deep cleaning over a standard cleaning when the deep cleaning took about the same amount of time with the hygienist as did my standard cleanings in the past? Approximately 4 times the cost. Prior to the pandemic I was having my teeth cleaned every 6 to 9 months. The probing of my gum pockets identified several 6 mm on the right side and 4 mm ones on the left, so by your 5 mm gage, the deep cleaning was justified at least on the right side. I don't know why the left side was recommended for deep cleaning also. I'm scheduled to go back for deep cleaning of the right side on Aug. 31 with a charge of $570 for the side. I'll be trying to get some explanation for these charges at that time, but was trying to get some other opinions before this second visit. I'm wondering if this pricing may have more to do with getting what the market and insurance will bear rather than any connection to a reasonable profit margin for the dentist? I'm also wondering how one can go about getting some competitive pricing without having to change dentists if I should be advised to have another deep cleaning in the future?
 

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MattKW

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Unfortunately, if you wanted a 2nd opinion I would suggest seeing a specialist periodontist. But that means more money.
If the dentist you currently see has been keeping records of your probing depths, ask to see these too and have them explain to you why the charges have suddenly lifted.
 

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I'm not looking for other opinions on whether the deep cleaning was appropriate. I'm looking for opinions on whether the charges for the deep cleaning are appropriate. My question more directly might be, does the dentist charge for the services of the hygienist depend on what procedure is being done by the hygienist and not simply for the amount of time spent? As an example, my recent deep cleaning on the left side took approximately 45 minutes and cost $440. A standard cleaning takes about 45 minutes and costs $105 (it may have went up some, post pandemic). Apparently this dentist does, based on my experience, but is that a typical practice. I doubt whether the hygienist is paid 4 times her wage when doing the deep cleaning vs a standard cleaning.

Ron.
 

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honestdoc

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We in the US, bill SRPs in quadrants such as Lower Left (LL), UL, UR, LR. Depending on how severe and the experience level of the hygienist, within the hour, 2 quadrants can be completed, sometimes only one. It is very unusual to suspicious that all 4 quads are finished in the hour. SRPs are very labor & skill intensive which is which is why it is very expensive.
 

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Two quadrants on the left were completed in about 45 minutes. The deepest pockets in these two quadrants were 4 mm. The right two quadrants are scheduled to do next with some 6 mm pockets.
 

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honestdoc

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4 mm pockets should not be coded for SRP. If there are calculus (tartar) build up with pockets less than 5 mm, then there is a code (D4346) for "scaling in the presence of inflammation." If a quadrant has 1 to 3 teeth with 5 mm or deeper pockets, then the code will be SRP 1-3 teeth (D4342). (D4341) is SRP of 4 or more teeth per quadrant. With 5 mm pockets, there will be some bone recession on the x-ray.

3rd party dental insurance requires SRPs to have 5 mm or deeper pockets. Hyg and dentists may "deepen" the probings to 5 or deeper to get that code. I see too many scams. Also it seems suspicious when they charge you over $400 when the work seem quick and easy.
 

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