I went to the Endodontist about my tooth bothering me, he took x-rays and did some tests. He decided that the tooth has a hairline fracture in it and made an adjustment to it. He said to give it a few days, if it feels better then I'm fine until it bothers me again. If it doesn't feel better then I need a root canal and a crown.
I gave it a couple days and my tooth is 95% better so I guess I'm good, thankfully! I'm not in the mood for a root canal and a crown, though I'm sure I will need one at some point, but not right now and that's what counts.
Thursday, April 23, 2009
Monday, April 20, 2009
Other dental torture!
When I had my last cleaning it was discovered that I had decay in 4 teeth. I had those 4 cavities drilled out and refilled. All is well with 3 of them. However, the last tooth is quite stubborn. I had the bite adjusted and then LF did some other stuff to it for sensitivity in the area where the pain is coming from. She doesn't think it needs a root canal, and from the tests she did on it I don't think it does either. So now I'm off to an Endodontist to get that area looked at. I suppose this all works out ok with the rest of the problems with my teeth, I certainly wouldn't want to put braces on a tooth that was bothering me.
Sorry if this was boring, but thought since things will be kinda dry here with my delays I would throw out some other dental torture stories.
Sorry if this was boring, but thought since things will be kinda dry here with my delays I would throw out some other dental torture stories.
Thursday, April 16, 2009
Universal Health Care is looking good right now
After discussing with Dr. S's office about insurance it was suggested that GHI insurance is what a lot of people come in with as insurance. The other insurance that is an option for me is HIP POS. There is Aetna too, but it would probably be cheaper for me to just pay out of pocket then to switch to them. Before making any decisions about that I decided to call around to my existing doctors to see if they take GHI or HIP. Right about now Universal Health Care looks like a good option! My primary care physician takes HIP and my Gastrointestinal takes HIP. My Neurologist and Dermatologist take GHI. It's like a bad joke! Then I called the office to see which one was going to be better then the other, in terms of difficulties getting approval and paying out - the girl was no help. Nothing like getting support from your doctors office! If everything works out all the surgery done with Dr. S would be done in one year so I would only have to deal with this issue for the year. I could probably just deal with some doctors via the phone, or if I needed to go I could pay out of pocket for the 20% the insurance wouldn't cover.
Monday, April 13, 2009
Begging for money
I currently have health insurance through Blue Cross, but through my union at work I have dental insurance. The dental insurance sucks, like most do, or worse then most do. But it's better then nothing. Unfortunately, it covers orthodontics for children of members, but not for members themselves. Really frustrating since I don't even have kids! On my sisters advice, in January I wrote a letter to my union about my dental issues, basically begging them for money. I put a brief history of my medical/dental issues and told them what I had planned and asked them to consider giving me additional benefits. After a month and a half I got a response from them:
"This is to inform you that your case was brought up to our dental insurance and their consultant and it was advised that you should first see what is covered by your
Medical plan and for you to keep in mind that the we don’t cover implants. Keep us inform on your status."
Well at least they didn't tell me no.
"This is to inform you that your case was brought up to our dental insurance and their consultant and it was advised that you should first see what is covered by your
Medical plan and for you to keep in mind that the we don’t cover implants. Keep us inform on your status."
Well at least they didn't tell me no.
Friday, April 10, 2009
Back to the oral surgeon
I went back to the oral surgeon to discuss how to progress, the plan, and insurance.
First we went over the dental plan. First a surgically assisted palate expander would be placed in my mouth by Dr. F. Then I would go to Dr. S and he would cut into my gums to break some bones in my mouth. I didn't ask too many questions about this since the thought of it grosses me out, this is why they have anesthesia. But this is a necessary step since my bones are fused and wont move the way the palate expander would make them. The recovery time for this is about a week and I will be swollen. Dr. S didn't tell me if I would have any pain, but I read a bit about this on the internet and there isn't any real pain. Then I would have to crank the palate expander twice a day for around 2 weeks - how long will depend on how much Dr. F wants to expand. Once I'm expanded I will have gaps in my teeth, Dr. F told me he would put on some temporary fake teeth so things look good in the meantime.
Approximately 4 months later I will be ready for the bone graft. The bone graft would likely be taken from my shin just below the knee. Some fancy synthetic bone growing stuff thing would also be used to help the bone grow in. Dr. S estimated that the recovery time for this would be closer to 2 weeks because of the grafting from the leg, I would probably have a limp for a good week. The palate expander could be taken off at this time since the bone will fill in the gap created. After another 4 months they'll do some x-rays to see how the bone graft set, if it has set then I will be ready to start with the implants.
At this point no one knows how many implants I will need, there are currently 3 teeth that are candidates and the gap would create a spot for my missing lateral incisor, which would be a 4th. My left canine, which is part of the two tooth cap/bridge with the bicuspid, may not (and it sounds like wont) be salvaged because of the lack of bone in the area of the tooth's root. That will be decided at the time of the bone graft. The bicuspid, which is set back in my mouth, is also an unknown. As I recall the tooth was in good condition before it was capped, but may have broken down since then, that tooth is an unknown until the cap is removed. My front tooth is another tooth that may have to be removed. About a year and a half ago I had the tooth capped, ever since then the tooth has been a little loose and it occasionally hurts, particularly if I bite into harder foods. It could be from the tooth having to deal with a cap, or from lack of bone, though Dr. S thinks there is good bone (though not perfect) to hold the tooth. A decision will be made about that tooth prior to the bone graft.
Then we talked about prices and insurance. As I previously stated Dr. S does not take my health insurance and my insurance does not provide out of network coverage. I have 2 options: pay out of pocket or change my insurance. Dr. S said that if I opted to pay out of pocket he would discount me and he would charge $3000, I would also have to pay around $1500 for an anesthesiologist. This would be done in the office, but this would only cover the palate expander. The insurance girl did say that I would still have out of pocket expenses of around $3000 with insurance, that sounded high but she also didn't know what exactly was being planned and what surgeries would be done so I'm not going to get stuck on that amount. But with insurance I wouldn't be paying for the anesthesiologist. I'm sure I'll be in contact with her again.
Changing my insurance is slightly more complicated and will delay things until next year. My insurance change period is in the fall and the change takes effect for January 1. Then they would still have to get approval for surgery which will take another 6-8 weeks. I wouldn't get started with things until late February. If I did wait though I would be able to set up a flex-spending account, where you put pre-tax money into an account to pay for medical expenses and then get reimbursed as you pay out. This could save me a bit of money, especially when looking at $9000 for braces and the out of pocket expenses for the 2 surgeries.
The other issue is that even if I decide to pay for the palate expander I still have to have the bone graft. I'm not independently wealthy, I can't afford another $5000 for that, assuming it would only cost $5000. I suspect it will cost more because it is a more complex procedure. So, I would still need to change my health insurance no matter what.
If I opt to pay out of pocket for the palate expander and change insurance for 2009 to cover the bone graft then I should probably wait until October or November to do the palate expander. That's assuming 4 or 5 months after the palate expander until I could get the bone graft. And I would also need to allow another 2 months to get approval for the bone graft. So paying out of pocket for the palate expander would only save me 3 or 4 months of a delay.
The other factor is that if I pay out of pocket then I would have the palate expander done at the office, if I wait and use health insurance then it would be done in the hospital.
First we went over the dental plan. First a surgically assisted palate expander would be placed in my mouth by Dr. F. Then I would go to Dr. S and he would cut into my gums to break some bones in my mouth. I didn't ask too many questions about this since the thought of it grosses me out, this is why they have anesthesia. But this is a necessary step since my bones are fused and wont move the way the palate expander would make them. The recovery time for this is about a week and I will be swollen. Dr. S didn't tell me if I would have any pain, but I read a bit about this on the internet and there isn't any real pain. Then I would have to crank the palate expander twice a day for around 2 weeks - how long will depend on how much Dr. F wants to expand. Once I'm expanded I will have gaps in my teeth, Dr. F told me he would put on some temporary fake teeth so things look good in the meantime.
Approximately 4 months later I will be ready for the bone graft. The bone graft would likely be taken from my shin just below the knee. Some fancy synthetic bone growing stuff thing would also be used to help the bone grow in. Dr. S estimated that the recovery time for this would be closer to 2 weeks because of the grafting from the leg, I would probably have a limp for a good week. The palate expander could be taken off at this time since the bone will fill in the gap created. After another 4 months they'll do some x-rays to see how the bone graft set, if it has set then I will be ready to start with the implants.
At this point no one knows how many implants I will need, there are currently 3 teeth that are candidates and the gap would create a spot for my missing lateral incisor, which would be a 4th. My left canine, which is part of the two tooth cap/bridge with the bicuspid, may not (and it sounds like wont) be salvaged because of the lack of bone in the area of the tooth's root. That will be decided at the time of the bone graft. The bicuspid, which is set back in my mouth, is also an unknown. As I recall the tooth was in good condition before it was capped, but may have broken down since then, that tooth is an unknown until the cap is removed. My front tooth is another tooth that may have to be removed. About a year and a half ago I had the tooth capped, ever since then the tooth has been a little loose and it occasionally hurts, particularly if I bite into harder foods. It could be from the tooth having to deal with a cap, or from lack of bone, though Dr. S thinks there is good bone (though not perfect) to hold the tooth. A decision will be made about that tooth prior to the bone graft.
Then we talked about prices and insurance. As I previously stated Dr. S does not take my health insurance and my insurance does not provide out of network coverage. I have 2 options: pay out of pocket or change my insurance. Dr. S said that if I opted to pay out of pocket he would discount me and he would charge $3000, I would also have to pay around $1500 for an anesthesiologist. This would be done in the office, but this would only cover the palate expander. The insurance girl did say that I would still have out of pocket expenses of around $3000 with insurance, that sounded high but she also didn't know what exactly was being planned and what surgeries would be done so I'm not going to get stuck on that amount. But with insurance I wouldn't be paying for the anesthesiologist. I'm sure I'll be in contact with her again.
Changing my insurance is slightly more complicated and will delay things until next year. My insurance change period is in the fall and the change takes effect for January 1. Then they would still have to get approval for surgery which will take another 6-8 weeks. I wouldn't get started with things until late February. If I did wait though I would be able to set up a flex-spending account, where you put pre-tax money into an account to pay for medical expenses and then get reimbursed as you pay out. This could save me a bit of money, especially when looking at $9000 for braces and the out of pocket expenses for the 2 surgeries.
The other issue is that even if I decide to pay for the palate expander I still have to have the bone graft. I'm not independently wealthy, I can't afford another $5000 for that, assuming it would only cost $5000. I suspect it will cost more because it is a more complex procedure. So, I would still need to change my health insurance no matter what.
If I opt to pay out of pocket for the palate expander and change insurance for 2009 to cover the bone graft then I should probably wait until October or November to do the palate expander. That's assuming 4 or 5 months after the palate expander until I could get the bone graft. And I would also need to allow another 2 months to get approval for the bone graft. So paying out of pocket for the palate expander would only save me 3 or 4 months of a delay.
The other factor is that if I pay out of pocket then I would have the palate expander done at the office, if I wait and use health insurance then it would be done in the hospital.
Wednesday, April 8, 2009
Roadblock
A few days after meeting with Dr. F I made an appointment with Dr. S to get things moving. The following day I got a call from one of the girls from Dr. S's office, apparently Dr. S does not take my health insurance and my health insurance company does not pay out of network benefits. I wasn't happy, actually I was pretty upset. I was going to either have to pay out of pocket or have to change my insurance. And why didn't anyone tell me this when I first met with Dr. S???? I didn't even feel like going to Dr. S again to even discuss my options, what was I going to learn? That I was going to be broker then I thought or I was going to be or change insurance and wait almost a year to get started. Ugh!
Monday, April 6, 2009
Orthodontist #3
In the middle of March I met with Dr. F. He's a bit older then the others, and knew my old orthodontist and plastic surgeon. This felt good. He started with a very basic history and I liked his style. Then he hit me with the $650 consultation fee. I figured I wasn't really in a position to walk out and I liked him so far so I went with it and had the whole history done. Besides the $650 would go towards my total price from my braces - I was trying to think positive because I knew the braces were going to be expensive. During the history he seemed to do things a little differently and in a good way. I left poorer, but felt like I might have met, the one...
Three weeks later Mom and I met with Dr. F. He presented 3 options. I'll go in reverse order... Don't do anything except have LF make a better crown for the two teeth and go on with life and be done. He didn't say it, but I will, it wouldn't last forever. Option 2 had me using braces to round out my mouth and make other adjustments. Get a bone graft to secure the teeth in that area and call it a day. This was pretty much I was expected and was similar to what Dr. G had suggested. But plan 1 was still to come. This plan would start with a palate expander, braces, then bone graft. What this would do is open up my smile more, widen the base of my nostrils and allow for a more extensive bone graft. All of this would allow the opportunity for me to also have surgery to further repair my cleft lip and the partially collapsed nostril. The price tag was just about $9000. for the braces. Dr. F explained that the palate expander and bone graft would be processed through health insurance which would probably have some sort of co-payment/deductible issues. He also explained that NY State has a law that requires health insurance plans to pay for an implant for a congenitally missing too, which I have, or rather don't have.
I walked out feeling more then a little overwhelmed. I didn't walk in thinking that I needed perfect teeth, nor did I ever consider having my nose and my lip re-repaired. But the ability to do so, if I chose to, made me lean toward the most extensive plan. Mom seemed to agree too, though she never said so. I did a little research on this infamous palate expander and found this account of the experience, and it really didn't seem that bad.
Three weeks later Mom and I met with Dr. F. He presented 3 options. I'll go in reverse order... Don't do anything except have LF make a better crown for the two teeth and go on with life and be done. He didn't say it, but I will, it wouldn't last forever. Option 2 had me using braces to round out my mouth and make other adjustments. Get a bone graft to secure the teeth in that area and call it a day. This was pretty much I was expected and was similar to what Dr. G had suggested. But plan 1 was still to come. This plan would start with a palate expander, braces, then bone graft. What this would do is open up my smile more, widen the base of my nostrils and allow for a more extensive bone graft. All of this would allow the opportunity for me to also have surgery to further repair my cleft lip and the partially collapsed nostril. The price tag was just about $9000. for the braces. Dr. F explained that the palate expander and bone graft would be processed through health insurance which would probably have some sort of co-payment/deductible issues. He also explained that NY State has a law that requires health insurance plans to pay for an implant for a congenitally missing too, which I have, or rather don't have.
I walked out feeling more then a little overwhelmed. I didn't walk in thinking that I needed perfect teeth, nor did I ever consider having my nose and my lip re-repaired. But the ability to do so, if I chose to, made me lean toward the most extensive plan. Mom seemed to agree too, though she never said so. I did a little research on this infamous palate expander and found this account of the experience, and it really didn't seem that bad.
Thursday, April 2, 2009
Orthodontist #2
At the end of January I met with Dr. K, Orthodontist #2. He immediately seemed very nice, caring and interested in my case. I got the appointment really fast with Dr K the downside was that he hadn't spoken to LF or Dr. S so I had to explain all the different issues, probably not the most effective way to do this. I liked him and his office manager seemed well versed in getting insurance companies to pay for things. Additionally, he was only charging $5000 for the braces. I must admit that I was weary that the price was so low compared to Dr. G, but his office seemed a little more modest so I hoped it just had to do with lower overhead
A few days later I got a call from LF, she had spoken to Dr. S and they decided that Dr. K wasn't up to doing the job. She found another Orthodontist for me to go to, Dr. F. I started to wonder if this was every going to happen.
A few days later I got a call from LF, she had spoken to Dr. S and they decided that Dr. K wasn't up to doing the job. She found another Orthodontist for me to go to, Dr. F. I started to wonder if this was every going to happen.
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