Tag Archives: teeth

The Dentist

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Long time readers of my blog may remember my tooth problems of the past. (You can read about my tooth problems here: http://www.rubbertrampartist.com/2015/02/12/my-teeth/, here: http://www.rubbertrampartist.com/2015/03/04/princess-tooth-revisited/, here: http://www.rubbertrampartist.com/2015/03/06/another-day-in-the-saga-of-my-mouth/, here: http://www.rubbertrampartist.com/2015/03/25/murphys-law-of-the-mouth/, and here: http://www.rubbertrampartist.com/2015/03/31/good-bye-my-sweet-princess-tooth/.) In summary, in the last five years, I’ve had two lower molars extracted, and I’d prefer not to lose any more teeth.

View of ClinicIn my home state, I go to a free dental clinic where students training to be dental hygienists practice on patients. The students are only weeks away from graduation and closely supervised at all times.

However, I haven’t found a similar clinic near where I work in California. Last year, I went to a dental care chain and had a terrible experience. Then I found a dentist I really liked.

The new patient fee at the new dentist’s office was only $59 for an exam, x-rays, and a cleaning. The dentist was a woman, as were all the workers in the office. Everyone was super nice. Between the x-rays and the cleaning, the dentist consulted with me in a little office  The dentist found a cavity and was able to fill it that day, which saved me the time and expense of driving down the mountain again. I also paid to join the discount program of the network this dental office belongs to. I was pleased with the entire experience.

(Well, ok, I wasn’t pleased with having a cavity or getting it filled. But the office was super fancy, and I was able to watch Pawn Stars while the professionals were working in my mouth.)

From the time I arrived in California this May, making a dental appointment was in the back of my mind. In August, I finally called and found out I was covered by the discount plan until early September. So I made an appointment. The woman who made the appointment for me was at a call center and didn’t know how much the visit would cost, so I called my dentist’s office later that day and spoke with the office manager. Since neither woman told me anything different, I expected I’d see the dentist I met last year.

I arrived at the office at the appointed time on the appointed day. No one was at the desk to greet me. I checked in with a computer. Then I sat down to wait. At some point the nice office manager returned to the desk and called me up to check in with her. I sat down to wait again. I waited for twenty minutes past the time of my appointment. No one apologized. No one offered any explanations.

Finally, a young woman brought me to a room and took x-rays. The process took about ten minutes. Then she brought me to an exam room at the end of a long hallway. The other exam rooms along the corridor were empty. The woman gave me the TV’s remote control, but the satellite signal wasn’t working properly. I’d get 40 seconds of Chopped Junior and two minutes of nothing. I sat alone in that room for another twenty minutes until a young man in blue scrubs walked in.

Oh good! I exclaimed. You haven’t forgotten about me!

I know I was being a sarcastic asshole, but I felt like a sarcastic asshole by that point. I was hungry. I’d been waiting for forty minutes without apology or explanation. And the one thing that may have distracted me was experiencing technical difficulties.

The young man in blue scrubs tried to turn my frustration into a big joke. His joking did not make me feel better.

Then the young man in the blue scrubs said, Hello! I’m Dr. Whoever. And you are?

Wait!! What?! This was the dentist? What had happened to the young woman dentist with the cute bow in her hair whom I’d seen last year? (I have a slow brain, or I would have asked the young man in the blue scrubs that very question.) Also, it was obvious to me that this guy didn’t even know my name when he walked through the door. Really? Shouldn’t a medical professional look at the patient’s chart and know her name before he walks through the door?

It became obvious he hadn’t looked at my chart either. Images of my mouth popped up on the screen where I’d earlier been trying to watch Chopped Junior, and he dentist started talking to me about my teeth.

The first thing he told me was that I had an “infection” on one of my wisdom teeth that’s still below the gum.

I said, I was told it was a cyst.

Probably ten years ago, the dentist at the poor people’s clinic I was visiting for checkups and cleanings every six months noticed what this dentist was referring to. The dentist at the clinic specifically referred to what she saw as a “cyst.” She sent my x-rays to a consulting oral surgeon who said it was no big deal, unless it started giving me trouble.

So the dentist in the blue scrubs said “infection,” I countered with “cyst,” and he said, Same thing.

Ummmm, no they’re not the same thing.

A cyst is a sac of tissue that has either fluid or soft material inside it.

Cysts can form in a wide range of tissues including in the face and mouth (including the jaws). Some can form next to or around teeth, which are called dental cysts…

They can be sterile or become infected…

Abscesses are localised acute infections, which require immediate attention from your dentist. It is rare not to know you have an abscess – they are usually associated with acute pain (they hurt a lot!), swelling (eg of your gum or even face and cheek) and sometimes an unpleasant smell or taste in the mouth. Abscesses can form inside or near dental cysts, which is where the confusion can occur.

Dental cysts aren’t necessarily infected and can grow slowly for many months or even years without any or many symptoms.

Also, it occurred to me later, if I had an infection, why hadn’t the dentist given me a prescription for antibiotics?

So the dentist said he wanted me to speak to the surgeon about having the tooth extracted. I told him I’d speak to a surgeon in my home state about whether or not the tooth needs to be extracted. He looked at me blankly, and I had to explain yet again that I’m only in California five months of the year for work.

The dentist worked across the screen to the other side of my mouth and pointed out a tooth around which I have some bone loss.

What happened here? he asked. There’s bone loss.

My jaw was fractured, I told him.

What happened? Did you get in a fight? he asked as if my fractured jaw and bone loss were some big joke.

Yeah. You could say that, I answered flatly.

Well what happened? he demanded. Tell me the story.

I don’t want to talk about it, I told him.

Perhaps it’s the man’s professional responsibility to check on the welfare of people who show up in his office with bone loss due to jaw fracture. But I didn’t feel as if he were concerned about my welfare. I felt like he just wanted me to air my dirty laundry.

If the dentist were concerned about my welfare, these are some things he could have said to assess the amount of danger I was in or to offer assistance:

Are you still seeing the person who did this to you?

Here’s the number to the local/national/regional domestic violence hotline. (If anyone reading this needs it, the number to the National Domestic Violence Hotline is 1−800−799−7233.)

Would you like me to refer you to a counselor/social worker/therapist?

But no, he offered me no help or support.

When he realized I wasn’t going to tell [him] the story, he moved on to listing the special treatment he wanted me to have. He wanted the hygienist to do a special deep cleaning around the tooth, then shoot a laser around kill bacteria.

He didn’t explain things very well, but I think the bone loss has caused a pocket to form between the tooth and gum. I think it’s difficult to clean out the pocket, so bacteria grows there. Somehow a regular cleaning isn’t enough.

Before the hygienist  came into the exam room, the office manager showed up to have me sign off on the price of the procedures. The x-rays, exam, and cleaning were supposed to cost $80, and I planned to spend an extra $25 on a fluoride treatment. With the deep cleaning and the laser treatment, the bill shot up to $300. I didn’t really know what to do.

You can pay half today and half next month, the office manager offered me, but the issue wasn’t that I didn’t have the money in my bank account. The issue was that I didn’t know if I actually needed the procedures the dentist was recommending.

I approved the deep cleaning and the laser treatment, but decided to skip the fluoride.

The hygienist was the same women who’d cleaned my teeth last year. I asked her if the condition of the tooth with the surrounding bone loss was worse than it had been the year before. She said she didn’t know. She said in order to know, she’s have to pull up my x-rays from last year and compare. I realized no one–not the dentist, not the hygienist–had even compared this year’s x-rays to last year’s x-rays. I wish I’d asked the dentist if the condition of the tooth had gotten worse in order to see how he justified the special, more expensive treatment.

By that time I was discouraged and just wanted to be done and get out, so I didn’t insist the hygienist pull out the old x-rays and compare.

I’d already decided I’d never go back to that office, but as I wrote about what happened there, I realized the dentist never actually looked into my mouth. He looked at images of my teeth, but never looked at my actual teeth. This is the first time in my whole life where “going to the dentist” did not involve a dentist physically examining my mouth.

Images courtesy of https://www.pexels.com/photo/view-of-clinic-305568/ and https://www.pexels.com/photo/blur-bristle-brush-clean-298611/.

Scam Artist: Western Dental

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Folks who’ve been reading my blog know that I had a lot of problems with my teeth this past spring, culminating in having a molar extracted. It’s been six months since my last cleaning, so I called to make an appointment at the local Western Dental office. I figured the dental chain would probably have lower prices than a dentist in a private practice. When I spoke to the woman on the phone (who was not in the same town where the dental clinic I’d be visiting was, but at some corporate office), I told her I needed to have my teeth cleaned. She told me there was a special running, and I could get the cleaning for $39.99 with free x-rays and exam.

On the day of my 10:30 appointment, I arrived early, at 10am. I tried to confirm with the receptionist that the cleaning would cost $39.99. I told her that was the price I was quoted when I made my appointment. She told me the exam and x-rays would be free, but she couldn’t quote me a price until after the dentist examined me and recommended treatment. She said if I needed an extraction or a root canal, it would cost more than $39.99. I told her I understood that, but I wanted to confirm the cost of the cleaning. I told her I didn’t want to spend any time there unless I was going to get a $39.99 cleaning. She said they would get to my cleaning that day, and that the $39.99 special was still in effect.

Although I arrived at 10am for the 10:30 appointment, I  was not called to the back until 11:15. At 11am I asked the receptionist how much longer I would have to wait. She confirmed my name and then left the front desk to ask someone when I would be seen. When she came back, she told me I would be next. I sat there another 15 minutes before the x-ray technician called me to the back.

When the x-ray tech asked me how I was doing, I told her I had not expected to sit in the waiting room for 45 minutes.  She apologized and said they were down one x-ray tech,but  she didn’t know why. She also acted like I was an idiot to have made an appointment on a Monday, which she said is pediatric dental clinic day. I didn’t know that because when I called to make the appointment, I talked to someone at the corporate office. In any case, I am not a pediatric patient, so I don’t know why the pediatric clinic determined when I was seen.

In addition to every messed up thing that happened in the office, I am also concerned about the x-ray tech flipping a switch in the hallway, then sticking her hands in my mouth. How often is that switch cleaned throughout the day? Also, although the computer keyboard was covered with plastic, she touched it after having her hands in my mouth. How often is that plastic changed? Is it changed after each patient? I shudder to think she’d had her hands in someone else’s mouth, then on the keyboard, then in my mouth, then on the keyboard. Gross!
 
After the x-rays were taken, the tech tried to get me into a cubical where I would be examined by the dentist, but none were available, so she sent me back to the waiting room. I sat there over 30 minutes. When I asked when I would be seen, a different receptionist tried to tell me the wait was so long because I was a new patient. The x-rays are computerized. They didn’t have to be developed. I don’t know what was taking so long.  I think I was repeatedly forgotten.
 
In any case, five minutes later, I was called to the back and put in a chair. The dentist was soon there to examine my mouth. I told him I was there for a cleaning, told him I had a regular dentist in another state, but needed a cleaning now while I am in the area working. He looked in my mouth for less than a minute, but managed to ask me a question I had just answered, showing me that he was not paying attention to what I was saying. (I had just told him I was working in the area. The next question out of his mouth was, “So you’re here for a visit?) He told me he had to write up his observations, then one of the “ladies” would be along to do my cleaning.
 
Ten minutes later a woman came over. I asked her if she were going to do my cleaning. She laughed and said, “We’ll get to that.” She was there to explain the cost of my treatment options. 
 
She immediately started talking about dental implants, even though I had given no indication I had any interest in dental implants. (If I wanted dental implants, I would have that work done by my regular dentist.) She was kind enough to tell me which of my teeth had been extracted. I laughed at her and told her I knew which of my teeth were missing. She tried to explain the payment plan for the implants I didn’t want and hadn’t asked about, but I told her I had no interest in implants, that I just wanted a cleaning.
 
Then she told me I need a filling to the tune of $303! That seems exceptionally expensive to me. I told her I was not prepared to have a tooth filled, that right now I just wanted to have my teeth cleaned. (At this point, I was beginning to feel like a broken record.)
 

She told me the cleaning would cost $197! WHAT? I had been quoted $39.99 for the cleaning.  I think this was the old bait and switch. You know what that is, right? That’s when a business quotes a low price to a potential customer, only to require a higher price when the customer is actually in the store.

The woman claimed to know nothing about the $39.99 special I was quoted over the phone. Strange, the first receptionist I talked to didn’t tell me there was no such the special, she said that special was still in effect, but the second woman told me the first woman must have been “confused.” I think they tried to trick me into paying more than they quoted me, thinking after they wasted so much of my time, I would just go along with whatever they said I needed to do. I got out of the chair and didn’t let them do any work on me. When the woman asked me if I wanted to take the paperwork explaining the cost of the procedures, I told her no, because I am never coming  back here.

When I walked out of the office, I was so angry! I called the Lady of the House to let her know what had happened, and I started crying while thinking about all the poor people this corporation is taking advantage of. The company gets poor people in there with the promise of free x-rays and payment plans, then jacks up the prices after keeping people there for hours and wearing them down. Luckily I escaped.

I have an appointment for a dental cleaning with a dentist in a nearby town scheduled for September 14. The price is $59.99 for x-rays, exam, and a basic cleaning. When I talked to the  office manager, she told me the dentist might recommend a deep cleaning, depending on the condition of my mouth, and said a deep cleaning costs more. But, she added, it would be up to me to decide if I wanted a basic cleaning or a deep cleaning.

Imagine that. I get to decide what’s best for me.