Up-charge for crown ?? Does this sound right ?

[SonicExplorer]

Hi,

First timer with a pending crown. Dealing with a dentist who's office is operating a bit shady. Paid for a 3rd party dental discount plan and when I get to the dentist the office manager targeted a crown code that wasn't on the plan. But I was ready and did my own shuffle by informing them I preferred a gold crown instead of the Zirconia they were pushing. Metal crowns ARE listed on the plan at a 50% discount, which the dentist wasn't pleased about. Then he grumbles..."well, we are going to have to upcharge you for Gold, probably $100 to $200, depending on what the lab charges us."

The code is a 2790 which is a "High Noble Metal Crown". This is by definition of the ADA already a crown of at least 40% gold. So what is this dentist trying to pull? Even if we moved up to a 70% gold content, it wouldn't likely run more than another $50 or so based on a variety of research I've done online. (but correct me if I'm wrong)

Any thoughts or recommendations on this situation? How might I go about making sure I'm getting quoted appropriately and verify what exactly they are putting in my mouth, etc. Without rocking the boat more than necessary. Do I request the name of the lab, do I let them know in advance I expect to receive lab paperwork indicating the cost and content of my crown?

Thanks,

Sonic

 

[honestdoc]

See another dentist. That clinic is ripping you off. You can consider "Noble metal crown" (lower gold content) instead. Labs charge differently based on zip code. If your zip code is in a less expensive housing area, you are in luck.

 

[SonicExplorer]

As far as I am aware, if a person decides to go with gold, especially for rear chewing molars, it is best to target a content of at least 60% gold, preferably in the 70% range. I believe it has to do with durability and hardness compatibility with opposing teeth so neither incur excess wear during chewing (or grinding) as can happen with other materials. Again, keep in mind I'm a newbie on this crown stuff, but that's my understanding anyway.

Yeah, I could try another dentist but they ALL seem to be scammy in my area. And none will give much in the way of discounts even for cash customers. Worse yet, this particular dentist used some kind of high-tech Xrays that rendered on a computer - NOT conventional bite-wings and panoramas with film. So I suspect I'd have start all over and pay again for another Xray series and exam with another dentist. So I'd need to factor all that in as well.

The dentist walks in the room, consults with the hygienist for 10 seconds, looks in my mouth for literally no more than 10 seconds, says I need 4 crowns and walks out. No exaggeration, this is exactly what happened.

Sonic

 

[honestdoc]

You don't need higher gold content for durability. More gold will soften the alloy. A lot of my patients cannot afford high noble and I would use noble (semiprecious metals). Dental x-rays are all digital now. Nationwide, the dental supply companies stopped providing conventional x-rays supplies, equipment, and support. Where are you located? What are your priorities such as cost, location, scheduling, cosmetics?

 

[SonicExplorer]

I'm still learning, but seems a Type III gold crown is most ideal for rear chewing molars. That typically has about 65%-70% gold if I recall. Seems high noble also tends to have less of the types of alloys that may lead to health issues or adverse reactions in some patients over the long haul. Again, I'm just learning, doing a lot of reading, so if any of that is wrong please share your insight.

My priorities are to invest wisely to get the best balance of cost & durability over the long haul, without jeopardizing my health. I don't care about cosmetics since all the crowns would be on rear molars. One other note: I tend to grind my teeth at night apparently. While I may get a guard, I'd like to make the best decision on crowns with that also in mind - so if a Gold Type III crown is not a wise choice the please let me know.

BTW, I'm Central Florida.

Thanks,

Sonic

 

[SonicExplorer]

Well, I found a much better dentist but am still encountering some questionable pricing from the office mgr. Mainly the lab fee aspect again. Some offices are doing "upcharges" for certain metal types while others are trying to pass on the metal charge plus lab mfr costs in one lump. How do I find out what a total reasonable lab fee (material and labor) is for metal crowns?? $175 for a simple base metal crown seems steep and $375 for a 64% gold noble metal crown sounds really steep. I suspect these fees are being inflated when instead they are supposed to be passed on directly to the customer (per my current plan). I currently see no way for a patient to really know what the true lab costs are, and if a dentist is padding lab fees they certainly aren't going to show an invoice.

Any suggestions on how to handle this situation? Most every dentist office (and I've talked to dozens) clearly seem to be skirting the discount plan fee schedules on high price procedures by either targeting procedure codes not on the schedule or padding lab fees.

Sonic