The Naughty Molar

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The very first filling I ever got in my life fell out the same day I got it. I went back to the dentist and to have it replaced, but the dentist grumbled the whole time saying the molar needed a crown or something and that this new filling wasn’t going to last without it.

That was almost 40 years ago and I’ve never had a single, solitary problem with that tooth.

Every dentist I’ve seen over the last almost 40 years however has wanted to do something with that molar — from reconstruction, to extraction and implants, to root canal, to crowning. I’ve told them all to leave it the hell alone.

Then, a couple of weeks before Christmas, I was eating some nice soft lettuce and I chipped a chunk off the inside of that molar.

“Shit, shit, shit, shit, shit, shit,” I thought. (Actually, I may have said it out loud whilst spitting out bits of tooth).

Off to the dentist I go.

“It needs a crown,” he says.

I bow to the inevitable. We’ve had a astonishingly good run, but obviously something finally needs to be done.

However, since it’s almost Christmas, the lab is closed for 3 weeks, so the crown had to wait until the new year. The dentist puts on a temporary filling thing and the appointment team booked me in for January 12th – this coming Monday.

On Wednesday I finally got the estimate from my insurance company. The crown will cost  $1,180.79, of which the insurance will only pay $546.44 because being an insurance company  they only cover major work at 50% and, for some reason are re-imbursing at 2007 rates while dentists are charging at 2009 rates.

So, for those of you without a calculator handy, that means I would have to pay $634.79. And since it’s the beginning of the year there’ll be a $50 deductible on top of that. And, the insurance company will only pay for a metal crown. 

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So, unless I want to look like one of Karl Stromberg’s henchmen, there’s an extra charge for a porcelain crown.

I get on the phone with the dental office and tell them there is no way I can justify paying that kind of money for one stinkin’ tooth. What are my options? They said they’d have a meeting about it and call me back.

Later that same day, they call back and offer me the following 2 options:

  1. The dentist will build up the tooth with filling material as best he can. The insurance company will cover that at the usual 90%. However, there is no guarantee that this will last. Some people go for several years before the filling cracks or crumbles; some people crack the filling within a few days. They do not recommend this route because it’s just another short-term fix.
  2. The dentist will do a porcelain crown for me; have the insurance company send the $546.44 they’re willing to kick in, directly to the dental office and then I pay the dental office an additional flat fee of $420 to cover the rest of their costs.

The floor is now open for your input, advice and horror stories of crowns vs. make-shift dental solutions. I have until my appointment on Monday afternoon to make my decision. On the one hand, $420 is a lot less than $634.79 and I’ll finally be able to close the book on this tooth. On the other hand it’s still $420 for one tooth. molar3

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41 responses to “The Naughty Molar

  1. When I read (and write) about this kind of things… I always thank for the benefits this company gives me!

    Have a great day XUP…

    By the way… I’d like the 5 questions! Thanks…

  2. Guillermo – Does your insurance cover this stuff 100%? Because the dentist tells me that most, fi not all insurance companies will only cover major work at 50%. Ours covers the regular stuff (cleaning, fillings, x-rays, etc.) at 90%, but not the big stuff.

  3. Go for the crown. I know it’s a lot of stinkin money but $420 is a ton better than a grand and you may eventually have to go that route anyway once the filling cracks.

    I am sporting 2 temp fillings as well. I need 2 crowns along with reconstructive gum work, root canal and filling. Lovely. I’d rather they just pull the damn tooth.

  4. If you go for option 1 and it fails, you’ll be pretty angry that this problem isn’t resolved. Then again, it could end up like that filling you got 40 years ago which has stood the test of time. It’s a gamble. I’d just ‘bite the bullet’ (groan) and go for option 2 – it’s over and done with and you won’t have to worry everytime you eat something crunchy whether or not that temporary solution is going to hold.

  5. I’m in favour of rationalizing through amortization. If you spread out even $1000 over the next 40 years, it’s only $25 per year!

  6. I have a crown, and I had to pay about the same as what they’re telling you to pay – root canal included. And you know what? As much as I hate having a crown and having had to pay out of pocket so much, I prefer it over what I had before. OH THE PAIN! THE PAIN! Go for it.

  7. Sky girl – I know. I know. Last time a dentist suggested some big, insane procedure I said I thought I’d rather just get them all yanked out and forget all this crap forever. He was horrified and said there was some direct link between missing teeth and heart disease. That seems odd. But this teeth stuff is such a pain. There’s always something new and fun they think up.

    Violetsky – Ouch. How do you rationalize that much money for one tooth? I had trouble seeing my way to even forking over half that. But ya, I’m going to be doing a lot of bullet biting in the near future so I’d better have good teeth.

    Quack – Ya, I figure I’ve done pretty well out of that 40-year-old filling and it WOULD be in the back of my mind forever if the filling was going to crack or not – in fact that tooth has been on my mind for 40 years, wondering how much longer it was going to hold out. So this could be a huge weight off my mind that I’ve been carrying for decades. Think of it!

    Julia – Ah – ah. Good thought. And I don’t even have to pay $1000 – only $420, so that’s only $10.50 per year. Hmmm – that still seem like a lot. What if I spread it over 12 months? 86 cents per month. That doesn’t sound so bad.

    Uncouthheathen – I don’t even have pain. The tooth is fine. I don’t need root canal thank goodness. I hear, actually that they’re not doing that so much anymore. It’s kind of gone our of style. But I think all of you are right and I just need to go get it done and over with.

  8. Canada does not cover dental care??

    I didn’t know that.

    I say go for the crown, invest in the future of your tooth.

    FYI- the insurance plan I have with my huge public university covers 80% of a crown, but I pay $1 more per month than I have to for that benefit.

    I am so grateful for that benefit because my husband was with health insurance for years and we are paying for it now, but paying a lot less thanks to that extra $1 per month. Insurance is so fucked up.

  9. without health/dental insurance, I always have so many typos when I comment on your blog. I just get so nervous around your genius and wise fan base!

  10. I figure I’d already invested over 40 years in the tooth and with a crown I could get, well, not quite 40 more, but otherwise it’d be yanked, then I’d have a gaping hole in my mouth and probably need a bridge so the neighbour teeth didn’t fall over.

  11. I think you should have been crowned many years ago. I’ll leave the particular title up to you as you deserve any you can think of. Long live the Queen.

  12. I’ve got a couple grand in my mouth right now because when I was a cavity-prone kid, my dentist loved his silver fillings. They lasted about 20 years longer than they should have, but the result was that I needed a few crowns. My insurance covered some of it, but I paid half too. It sucked, but it’s a hell of a lot better than the root canal I had to have on the one I didn’t get fixed.

  13. Missy – My genius fan base scares me a lot, too. Don’t worry about typos – we’ll figure it out. And no, sadly we don’t have universal dental care. Some provinces have free dental for kids up to a certain age, but the rest of us have to pay through the nose — and that hurts when your mouth is frozen

    Violetsky – Ya, yanking means an implant or bridge or partial, which all would add up to probably as much or more than the crown.

    Bandobras — Dude! Where’ve you been? And thanks, I think.

    Mo – Point taken. Thank you. The idea of root canal is unpleasant.

    Meanie – Yes! I’m looking forward to your Dad’s advice. I remember you and Jobthingy, I think, both had dental connections somewhere and I was hoping you’d have some input.

    Raino – They won’t even entertain that idea. The tooth, such as it is, is fine — no root canal needed. I’m kind of fond of Naughty Molar — like the child everyone else is always telling you is bad and troublesome, but turns out the one you love best while all the good children get cursory attention and otherwise ignored.

  14. i say go big or go home. get the crown now cause really it will have to be done eventually and at least they are spotting you a deal. it seems like alot not but dentist rates will only go up.

  15. Oh, I pity you, XUP! Dental costs are anything but affordable. I’ll tell you the entire story over coffee one day (do you like how I assume we’re going to have coffee some day? I’m a bold Maven!) but the long and short of it is that I went from having two crowns my the top center teeth to shelling out 40% of $6,000 to get a purdy mouth. Thanks to running out of options I ended up with a six tooth bridge that spans the top pearly whites. The good news? It’s permanent and my teeth are straighter than they could ever be naturally – kind of like getting veneers. The bad news? It took about a year to pay that sucker off.

    Porcelain crowns aren’t all that bad. Just take really good care of it and it should last you a long time. I’ve had more dental surgery than I can shake a stick at (although quite honestly I have no idea why I would want to shake a stick at it…) and crowns are a fairly safe bet. Well worth the money, too. Just make sure the work is guaranteed for a while!

  16. Jobthingy – Ya, you’re totally right… and it is a deal, right? Who knew you could whine to your dentist and get a deal? I just thought they’d come up with something else to do that didn’t cost so much.

    CP – A tiara – ha ha. And speaking of tiaras, I’m really hurt that no one has mentioned the fabulous illustration job I did with Naughty Molar before and after her tiara. Really hurt. It took a long time and no one even noticed. Waaaahhhh.

    The Maven – Wow. 6 Gs for 6 teeth. I’m dying to hear the story of where all those teeth went. There’s nothing I like better with my coffee than dental surgery stories; preferably after I’m through with my dental adventures… so anytime after Monday. And I would totally love to have coffee with you. Let me know when you can get sprung from Casa del Maven for a few hours and we’ll hook up.

  17. I have a similar molar issue. Twice in the last 9 years a specialist has insisted I needed a root canal and a crown. Both times I went for a second opinion. Both times my dentist filled it. The first time it lasted 9 years. This second time, well, we’ll see… it’s only been 3 months… my advise… get a second opinion. I have a dentist who still takes new patients… let me know if you are interested…

  18. I have four crowns and don’t remember them being so expensive. Maybe I had better insurance. But if you need a crown, you need a crown, so get it.

  19. Woodsy – I don’t have much doubt that it needs a crown. No one has said anything about root canal, though. I hope they’re not saving that for a surprise. Thanks for the offer.

    Geewits – Our insurance sucks and also dentistry has boomed lately cost-wise, so it could be a little of both. And you’re right. I should just get it.

    Cedar – A lifetime? Is that a personal guarantee? Because if this crown comes with a promise of no more dental issues then the money is well worth it.

  20. jeesh. isn’t it your choice though? not that i am comparing you to a cat or anything but i used to have a cat that was 17 and sickly, something or another wrong with his kidneys, would have had to be hooked up to a machine at a cost of 1500 which at the time was 1499 more than i had. anyhow, i asked how much to get him put down. the vet was horrified. i went to another vet, who did agree to do it for 50. anyhow, i just think it should be your choice. they are your teeth. even if you get it pulled now and then when you are rich you get a false tooth put in…whatever. i don’t like to generalize but sometimes dentists, mechanics don’t like to do things the cheap way cause frankly they don’t make much. that’s just my opinion.

  21. I got a discount from my dentist years ago when he was putting in two crowns. He was a tad shocked; but I pointed out he was doing them at the same time and it just made sense to give me a discount.

    Anyway, get the crown and give up biting bullets.

  22. I have no sage advice to give, I just wanted to chip in (somewhat forlornly) that I wish I was on the right side of the Atlantic so I could come for coffee too!

  23. That sucks XUP… M has a similar ongoing tooth saga that he’s currently in the “ignoring” phase of, and I have a dentist appointment in 2 weeks that I’m not feeling very good about (I fear the discovery of cavities..)
    My thoughts: just get the porcelain crown and let the saga be over…

  24. The Boy had to have a non-malignant tumour removed from the roof of his mouth. (No clue why this is not covered by OHIP.) Cost $355. My refund $170. Me — very not happy.

    The Man had an issue with a tooth. He wanted them to extract it. They refused. So we scrimped and save and sucked it up and paid the (insert expletive) load of money they asked for the crown and all that jazz. (Covered at the same level you are.)

    It lasted about a year.

    Then the crown cracked.

    They wanted us to do it all over again — but this time through a specialist. Who said he could maybe “save the tooth.” The Man ended up getting it extracted.

    My advice — if it’s nowhere you can see it get it yanked.

  25. Dental insurance is a RACKET! It’s like they KNOW you have to have your teeth in working order, so they gouge you. But I still say cough up a little more now…so you don’t cough up now and more later and maybe more later after that. But for that kinda money they better offer you some complimentary wine or something first. Maybe a massage?

    Sorry I’m late to the party! Did you think I died? I. Suck.

  26. Eek! Sorry to hear about your tooth!

    I had a crown put on after a root canal last year. Did my insurance cover the root canal? Oh yes! Totally. Did they then say “Oh – we don’t cover crowns, sorry about that” when I tried to get the crown (that the root canal required) put on my tooth. Shifty.

    My advice? Totally take the deal your dentist offered. Keep in mind – you *will* have to replace a crown eventually, though. They are not forever-investments (which for what they cost, they should be!).

    For the record, my (porcelain) crown was $950.

  27. Robin – Ya, I know nothing lasts forever. I did pretty well on that filling that they told me needed to be replaced in a couple of years. Ten years isn’t bad.

    Raino – Well, I don’t like to have teeth yanked out. It causes a lot of other issues with teeth shifting to fill in the space – which is why they want to put a false one in right away. If there was actually something wrong with the tooth aside from the chip, I’d seriously consider extraction, but it’s still functional. I’m totally with you on the 17-year-old cat, though. There comes a time when it’s just nuts to keep an animal lingering and suffering.

    Nancy – Hi Nancy! Do you have a link to your blog? I’d like to visit people who comment here. And, yes – it never hurts to ask for a discount I guess. I never knew I could do that with a dentist, but I also knew I wasn’t going to pay almost 700 bucks for a tooth, so there you go.

    Loth – “chip in” – good one! (Get it…chipped tooth… crown…ha ha). I wish you could come for coffee, too. Next time you’re in the country you’ll have to make a side-trip to Ottawa.

    Noha – That’s my thinking too. Unfortunately the teeth saga never seems to be over. Just when you think you’ve got everything tickity-boo, you crack your tooth and end up needing a crown. Fingers crossed, though, eh?

    Nat – You and Raino are all for the yanking. Did the Man get an implant or something to fill in the space? Are they not worried about all his other teeth shifting? They get you coming and going, they really do. And I’ve heard so many stories in the last few days about crowns cracking or falling out, I’m going to demand some sort of long-term warranty, so they’ll fix it for free if something like that happens.

    Mama Zen – Insurance is in business to make money not to help anyone. They can’t make money if they pay for stuff willy-nilly.

    Lesley – See above. All insurance is a racket. A big money-making business like every other big money making business. And yes, I did think you’d died and I was super-pissed that I wasn’t invited to the funeral.

    Robyn – Nothing is forever. I’ve been around long enough to know that. That $1180 covered the crown and lab fees and something called “resorative services”. The crown itself is only $632.08. I could buy a real crown of gold bejeweled with precious gems for that, couldn’t I? Thanks for the comment Robyn.

  28. an acquaintance of mine migrated to Québec and then had a similar tooth problem. Turns out it was cheaper for her to book a trip back to Mexico to have the dental work done, rather than pay for a canadian dentist. As a bonus you could take a few days off!

  29. Roadmaster – I’m saving Mexico for when I need organ transplants and cosmetic surgery. Either Mexico or one of those slavic countries that do cheap surgery.

  30. we have to pay our dentist up front for everything and then the insurance company reimburses us. i don’t like that too much but it is nice to get a check in the mail.

    i’d go for the repair for $420, there are many layers to improving our physical health that come with benefits.

    it’s cool that your dental office had a meeting about you 🙂

  31. DP – They’re a very hip, multi-faceted dental office. You can read all about them in the post I did when I first went there. I linked to it in the middle of the post above where it says “dental office” in green. And I went yesterday and had the prep work done for the crown. 2 hours! It was not in the least bit fun. Now I have a temporary crown until next Friday when I get the real one.