Yearly X rays at the dental office
- Thread starter whizbyu
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I think I get them once a year…. My office uses a fancy panoramic scanner that I barely fit into and was clearly designed for people absolutely no taller than ~5’10”. My cost is $0.
That said, I have never had a cavity or anything else done to my teeth other than braces (got those off a month before turning 19) and sealants when I was like… 12.
That said, I have never had a cavity or anything else done to my teeth other than braces (got those off a month before turning 19) and sealants when I was like… 12.
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There are times I wonder myself how difficult it might be to "profit" or earn a living as a dentist. For the last 25 years we have always gone to a sole practioner, all Ivy Leaguers (dunno if coincidence or what), and really have seen overall services decline where it's become a lot of perceived nickel and diming (like an email we concourage you to pay cash otherwise we'll charge 4% for CC, more upsell, etc.). First and foremost these are hard working individuals and highly educated. So it just seems that for all these new upsells etc., just imho it's hard to make ends meet (when I say that I mean to make the business thrive and then for the owner to have their compensation, they likely put it into the business). the flip side is overhearing everyone's problems and why the can't pay today, or last time, or last year. Just tough--the business owner is not at all insulated from the patient's personal, often financial, issues. i.e. free services are obtained.
For us we have a $50 deductible I don't really care it's ok. Then everything above is 100% covered. For what is covered that is. I found out a mouthguard is not, whereas my last insurance with 70% coverage, it was.
When I was being xrày trained they told us that dental X-rays were not recommended for children under the age of 12. Especially girls as test had shown it increased the incidence of leukemia in children
That's what we were taught. I worked xray for 42 years and I now have a lazy thyroid.
That's what we were taught. I worked xray for 42 years and I now have a lazy thyroid.
I am knowledgeable of a lot of what is going on in patient's lives.
As far as making a living, the biggest issue is insurance reimbursement not keeping up with inflation and I'm not saying if inflation has been 20% in the past 10 years they've come up a little short and increased fees 18% - some dental insurance companies have not increased their fees in 10 years. Some have but maybe 5-10% over that time. So a lot of dentists are leaving insurance or limiting it severely because there comes a point where the fee doesn't even cover the procedure. So your only really choice to make up the deficit is to take a pay cut (and no one likes taking pay cut) or do more dentistry, either by doing legitimate work faster and more efficiently, or if you're not on the up and up, finding more things to do.
Doing more dentistry and packing every moment of your day is exhausting and takes its toll. Dentisty is a PITA dealing with people's anxiety and mental issues and that takes its toll. Being a business owner is a PITA dealing with staff's mental issues and that takes it toll. Now, I'm certainly not looking for sympathy, I still make a great living, but I do hustle for my swag and end most day absolutely exhausted with little left in the tank.
Well I'll mention how I deal with dentists.
Retired, Medicare Advantage, conscious of my health and what people want to stick, probe and inject into me! I basically walk in and say I have a pain in this tooth and have them focus on that.
Yes of course I have had a full set of dental X-rays.
Retired, Medicare Advantage, conscious of my health and what people want to stick, probe and inject into me! I basically walk in and say I have a pain in this tooth and have them focus on that.
Yes of course I have had a full set of dental X-rays.
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I do have the utmost respect for people like yourself who are professionals and hard working. Again, I saw it with my current dentist. In conversation she was upset about a $9x UPS package not getting delivered and lost--just like anybody would. My employer would not worry about things like that, they are getting people in to the golf club and worried about the jet's billable hours.
But I feel I read the writing on the wall when she's asking me if I'm interested in braces. At my age? I had them as a teen. And the last dentist had a super sweet 22 yo. hygienist that I would loan DVDs to, and get it back 6 mos later! They were a Ukranian shop so at the time I loaned her the Red Army movie. Of course she left to get married etc. and in her place was a not so nice older person maybe my own age, always upselling. One time all these x-rays were NOT covered (more than 4) and I had to pay for all of them so that was the last straw. Too bad. This is a dentist who called us to congratulate us on the birth of our son. And she was the one I always could overhear how empathetic she was when someone could not pay....
Sometimes, I feel we need to all be more personable and not so whatever we are today, distant and impersonal if that's the word(s). When I was born, yes, there was electricity already, and, I heard the OBGYN doctor was on call and would meet the mom at the hospital. When my son was born, it was the doctor on-call in a rotation, could be someone the mom has never ever met at all, that's what I'm driving at...
I'm a pediatric dentist and so I talk a lot about orthodontics. I also employ an orthodontist and so when I refer a kid to my orthodontist, I absolutely benefit from the referral, but that is secondary to doing the right thing. Parents will often ask me, "Does Billy NEED braces?" I will answer with something like, "People NEED liver transplants and nobody NEEDS braces" followed by one of the following statements:
1. There are no major problems with Billy's bite and if you're happy, they're happy, then I'm happy. If you tell me you want them to have textbook perfect teeth, then sure, go see the orthodontist, but it just cosmetic.
or
2. There are some pretty major issues with Billy's bite and these issues could cause bigger issue later in life and so I do recommend seeing the orthodontist for a consult.
You're probably thinking cool...what's my point?
99 out of 100 people accept statement #1 and thank me for my honesty but every now and then, someone gets mad that I made statement #1 above because why won't I just tell them if their kid does or doesn't need braces - they seem angry that I've tried to empowered them and that they in fact need to make a decision for their child. It's their $6500, not mine, and yes THEY need to make a decision.
99 out of 100 people accept statement #2 and thank me for my honesty but every now and then, someone gets mad when I say statement #2 above because they think I'm trying to sell them on braces because their kid's teeth don't look that bad to the parents. Here's the catch - if I don't tell them their could be issues and I don't make the referral, and then there are issues and I have not documented we had that conversation and I made the referral, then they could come back in the future and say they never knew there'd be a problem.
So these are situations where I really can't win and I lose if I do and I lose if I don't. But it's a CYA world we live in and I'm going to have that conversation and document it every time because it's the right thing to do. I don't pressure anyone to anything, even in the second case above where there will likely be issues later. My other saying with patients is, "It's my job is to tell you what I see, tell you what I think needs to happen to fix it, and it's your job is to decide if and how you want proceed."
I can relate similar scenarios for just about any thing in dentistry - ex. need for fillings, need for crowns, need for root canals.
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Modern digital radiographs expose patients to way less radiation than back when film was used. I guess I would rather my dentist have as much information as possible to help prevent small issues from becoming expensive restorations. My practitioner has a membership plan thing where the subscription fee covers all preventative care, and any dental work is discounted. Dental insurance is a scam anyways, so this is a better option for me.
JHZR2
Staff member
I went to a new dentist this year. They gave me x-rays, I figured why not. They also scanned my teeth, which took a while. On the way out they gave me a $4k plan for invisible teeth straighteners. I have straight teeth and have never had a cavity….
I suspect the scanners are given for free by the Invisalign-type vendor as a perk for selling the product as a profit center.
I suspect the scanners are given for free by the Invisalign-type vendor as a perk for selling the product as a profit center.
The last generation of scanner we use was $55K and no they aren't free. As of next year, the last generation will no longer be supported because of the Windows version it runs. The new scanner is $65K, it does the same thing, and our old scanner is only 4 years old. We will keep using the older scanner until it actually needs some kind of support and then buy the new one.
Medical insurance is primarily there so if you have a catastrophic disease/injury you're shielded from a bill that can be ten or hundreds of thousands of dollars.
Dental insurance isn't insurance - it's a prepayment and discount plan. Your yearly benefits are roughly whatever your premiums are for the year and whatever isn't covered by insurance gets discounted to the insurance fee schedule which for us would be a 30% discount from what we charge.
This discount is what makes the margins more difficult every year. A practice with an overhead of 55% of their full fees is doing really well and this does not include owner salaries. An average practice is around 65% overhead of their full fees. If you're in network with an insurance giving a 30% discount with 65% overhead, that leaves 5% of total fees for the owner. If someone produced $1M, they would make $50k.
How could anyone make a living this way? Well, not all our patients get the 30% discount because we limit insurance participation so only about 30% of our patients get the 30% discount. In the decades of the past, you could easily participate with more insurance programs and make a good living - these days, not so much.
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JHZR2
Staff member
Thanks for that clarification on the provision of the hw.
I mean, sorry that tech is poorly forward compatible with OSes. I have run extremely high dollar analytical instruments in the past, and software forward and backwards compatability was a big consideration in selection of vendor and devices that are many times more expensive.
Point really was - I didn’t need a tooth scan, didn’t really want one (didn’t care that I got it either, as it’s mapping, not X-rays)…. But I was taken aback by the fact that it was immediately used to try to upsell me $4000 worth of stuff, on teeth that have been straight and fine for as long as I’ve had them - 30ish years now on my adult teeth?!?
The upsell because of the obnoxious cost of equipment and poor sw practices isn’t a good justification.
I'm in no way justifying the upsell. Scanning everyone is obnoxious, unnecessary and to be honest a waste of time. We only scan people who approach us, get a consult, and sign a contract because THEY want ortho from us.
As for the OS issue - that's dentistry and it's not like there are a ton of manufactures who make these.
I also wasn't making the point that the scanner is all that expensive but it's certainly not free. Roughly 12 Invisalign cases covers the cost of the scanner and in the past 4 years of owning it, we've easily done +400 Invisalign cases.
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All x-rays cause tumors. Do not get any x-rays that aren't absolutely necessary.
How do you explain the billions of humans who have been exposed to X-rays and never developed a tumor?
Edit - not going down this rabbit hole this morning - I don't really care what your rationale is here.
Your immune system has t-cells that kill cancer tumors. Tumors are always spontaneously occurring due to many many factors, x-rays being only one. Your immune system is in a constant battle with them and kills them off. They don't always win though as evidenced by the skyrocketing cancer rates in the US.
I have a really strong background in immunology and specifically in CD4+ T-cells and whether or not something induces an immune response or tolerance. One of those papers used prostate cancer as the model, I've been published twice in leading journals (20 years ago) on these topics, and all I can say is you have presented a gross oversimplification here.
JHZR2
Staff member
I’d argue it’s not dentistry, it’s poor obsolescence management for the HW vs SW.
If you break even so fast on cost of a $55k machine, and there’s so much money in it, the manufacturer has no incentive to provide lifecycle management and support. That’s not dentistry, that’s the manufacturer contributing to the excessive cost of care.
People are paying and there’s no reason to drive cost down. Maybe the Chinese will start selling kits that under cut the price by 90%, lol.
