Looking for any kind of dental treatment is a negative in many ways. It's painful, it's uncomfortable, it's time out of your day, and often your mouth is left uncomfortably numb for a long time.

The worse thing about dentistry is also the cost, which always seems to be higher and less justified with each visit. That root canal which you had quoted over the phone and cost $1,500 likely meant more cost in terms of time away from work, being grumpy with your kids, or in not being able to enjoy last nights dinner as much. Worse still, your dentist has told you you need a crown as well for another $1,500! Ridiculous!

No wonder most people, when they climb into a dentist chair say "I hate dentists".

It is almost a revenge tactic to try to barter the dentist down in tems of their costs. They already seem overly expensive, and it appears their treatments either don't work very well, or for very long, and leave you with the inevitability of even more dental treatment, and more exotic treatment costs down the line.

Why not delay the inevitable, and when worse comes to worse, shop around and try to get the cheapest quote possible? After all, you know what you have to have... Your dentist already told you last year... A $1,500 crown.

Bartering is something we all do... We shop for televisions, and we shop for cars, and usually we decide on the best model, and then try to get the cheapest price for it. We open the Yellow pages, ring through Bing Lee, Harvey Norman, and maybe The Good Guys, and eventually we find a salesperson who is a dollar less than the last phone call... Sold!

Does this same model of shopping work in dentistry?

The short answer is... And I think you already know the answer... No.

You may be surprised, but your general dentist doesn't usually look at a tooth by itself. If they are worth their salt, they usually look at all your teeth, and then single out broader problems, breaking them down into individual units of treatment packets. The aim is to go through a sequence of treatment steps, each of which has a unit cost, and then once all is finalised, you have a perfect smile, dentition or bite. And treatment which lasts.

Dentistry is an overall thing, and nothing occurs without an overall examination, individual itemisations of your dental problems, and treatment planning towards a final overall end-goal. That process usually is actually quite cheap, and provided you have regular check ups, and return to your dentist at key times, then your dental costs are minimal.

The other extreme is the patient who only seeks care when they have a problem. He (or she) usually call, get the cheapest possible price for a very direct treatment outcome (like a root canal or a crown), and ignore all other problems, because they see an evil professional consipracy in potentially being over-serviced.

If you ring for a quote, and are looking for the cheapest possible treatment, you will get the cheapest possible treatment. But what is cheap treatment anyway?

When you look at costs, there are broadly three types, and you should consider each of them every time you look at any proposal for dental treatment.

The first is biological cost. What will happen if you don't get this treated, or what will happen if you get this treated an expensive way over a cheap way? Usually the more expensive financial option, is the cheapest biologically... but this is not always the case (read through this web site to find out why).

The next cost is time. Temporal cost is the amount of time you dedicate to a treatment. Some treatments like implants take a lot of time to heal (or osseointegrate), but usually such treatments last forever. A bridge may take only a few days or weeks to create, but it may cause the abutment teeth to fail in only a few years (or even months), leading you back to having an implant, with abutment teeth that also need to be replaced with implants. In comparison then, the orginal plan for an implant was both temporally and biologically cheap.

The final cost is financial.

Consider the root canal treatment of an abscessed tooth (scenario 1) vs removal of the tooth and a direct implant replacement (scenario 2).

The first scenario is root filling a dead tooth, then crowning it. A process that can take a few weeks to months, is financially expensive (about $3,000), and has taken a lot of time away from family and work. Three years later the crown fractures, and the tooth is removed with a bridge placed after preparing the teeth either side of the gap. The total cost of this was $5,000, and still a lot of time away from family and work. Four years later the teeth under the bridge abscess, and the bridge is removed, as well as the abutment teeth, and now the gap is so long you ahve to start wearing a denture. The new denture costs $2,000, as well as the cost of bridge and tooth removal (another $500).

Overall, with scenario 1, the cost to the patient has been $10,500 (a large financial cost), he has lost 3 teeth and now wears a denture (a large biological cost), and he has spent approximately 10 years in dental treatment!

The second scenario was to primarily remove the dead tooth and replace it with an implant. The implant takes about 3 months to integrate, and another month is made with specialist crown manufacture. The teeth either side of the "gap" remain untouched, and in fact protected by the implant tooth, and the final result is permanent. The costs here were ~$6,500 for the implant, about 4 months of treatment, and the loss of only one tooth.

But when the patient first rang for a quote over the phone, which treatment do you think he decided upon?

Ocean Surgical does not recommend doctor shopping for obtaining treatment quotes of specified treatments. We do however recommend that you seek the very best style of care (or in car or TV terms, the best model), and then seek the person who has the best equipment, best staff, and best training to provide it.

The costs usually are then very cheap.