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overcharged???deep clean coupled with irrigation (chlorhexidine gluconate)
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| sanshi 2005-02-12, 1:32 pm |
| Thanks for taking a look at my message and replying with your comments.
I was told by my dentist that I need a deep cleaning of my teeth. Later
I found out that it was a periodontal scaling and root planning (my DMO
insurance covers) coupled with "medical irrigation using chlorhexidine
gluconate". The irrigation treatment does NOT have ADA procedure code
and my insurance will NOT cover it. It costs $336 total. The treatment
will be done in two seperated times ($168 each time). It will come out
from my own pocket. I really want to get a second opinion about the
price. It is the normal price for irrigation treatment? It is essential
for this treatment?
Thanks for all your inputs!!! I appreciate it very much!!!
a guy from San Diego
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| JWN DDS 2005-02-12, 1:32 pm |
| We do chlorhexidine irrigation at my office. There is a code for it. As
for cost it would depend how many units were necessary.
jwn dds
"sanshi" <sanshisd@yahoo.com> wrote in message
news:1108100798.693788.218300@f14g2000cwb.googlegroups.com...
> Thanks for taking a look at my message and replying with your comments.
>
> I was told by my dentist that I need a deep cleaning of my teeth. Later
> I found out that it was a periodontal scaling and root planning (my DMO
> insurance covers) coupled with "medical irrigation using chlorhexidine
> gluconate". The irrigation treatment does NOT have ADA procedure code
> and my insurance will NOT cover it. It costs $336 total. The treatment
> will be done in two seperated times ($168 each time). It will come out
> from my own pocket. I really want to get a second opinion about the
> price. It is the normal price for irrigation treatment? It is essential
> for this treatment?
>
> Thanks for all your inputs!!! I appreciate it very much!!!
>
> a guy from San Diego
>
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On 10 Feb 2005 21:46:38 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Thanks for taking a look at my message and replying with your comments.
>
>I was told by my dentist that I need a deep cleaning of my teeth. Later
>I found out that it was a periodontal scaling and root planning (my DMO
>insurance covers) coupled with "medical irrigation using chlorhexidine
>gluconate". The irrigation treatment does NOT have ADA procedure code
>and my insurance will NOT cover it. It costs $336 total. The treatment
>will be done in two seperated times ($168 each time). It will come out
>from my own pocket. I really want to get a second opinion about the
>price. It is the normal price for irrigation treatment? It is essential
>for this treatment?
>
>Thanks for all your inputs!!! I appreciate it very much!!!
>
>a guy from San Diego
MORE INFORMATION IS NEEDED
Specifics:
Scaling and root planing (4 quadrants. per quadrant) ........
INSURANCE PAYS _ _ _ _ _ (per quadrant)
plus YOU PAY _ _ _ _ (per quadrant)
IRRIGATION _ _ _ _ _ per quadrant.
Joel
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While irrigation with Chlorhexadine sounds like a good idea, charging
a hefty fee may be a little suspect. Some research suggests that
the Chlorhexadine is no more beneficial than water when scaling and
root planing. It is not effective in the presence of blood (which is
usually
all over the place if you really needed scaling and root planing in the
first place) hence it's use for this purpose is dubious.
Chlorhexadine is helpful as a daily rinse after scaling and root
planing.
Fawks
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| Dr. Steve 2005-02-12, 1:32 pm |
| On 11 Feb 2005 06:20:46 -0800, "Fawks" <tuthjockey@earthlink.net>
wrote:
>
>While irrigation with Chlorhexadine sounds like a good idea, charging
>a hefty fee may be a little suspect. Some research suggests that
>the Chlorhexadine is no more beneficial than water when scaling and
>root planing. It is not effective in the presence of blood (which is
>usually
>all over the place if you really needed scaling and root planing in the
>first place) hence it's use for this purpose is dubious.
>
>Chlorhexadine is helpful as a daily rinse after scaling and root
>planing.
>
>Fawks
It might be a DMO thing too. (wink)
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
| |
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| On Fri, 11 Feb 2005 16:25:40 GMT, Dr. Steve <drsteve@no-spam.com> wrote:
> It is not effective in the presence of blood (which is
>
>It might be a DMO thing too. (wink)
>..
>Stephen Mancuso, D.D.S.
Ya think ? ;*)
--
W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
| |
| sanshi 2005-02-12, 1:32 pm |
| Scaling and root planning, 100% covered by my DMO insurance.
Irrigation, no cover at all because there is no code for it (according
to the dental office).
$84 per quadrant.
| |
| sanshi 2005-02-12, 1:32 pm |
| Thanks a lot for all your replys.
Could anyone here recommend a dentist for me? I am new to San Diego and
have DMO insurance.
I do not want to "TRY" every dentist to find out a good one. Very
frustrated....
Thanks in advance!
| |
| Dr. Steve 2005-02-12, 1:32 pm |
| On 11 Feb 2005 10:15:07 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Scaling and root planning, 100% covered by my DMO insurance.
>Irrigation, no cover at all because there is no code for it (according
>to the dental office).
>$84 per quadrant.
How do you spell Bait and switch?
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
| |
| Dr. Steve 2005-02-12, 1:32 pm |
| On 11 Feb 2005 10:19:16 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Thanks a lot for all your replys.
>Could anyone here recommend a dentist for me? I am new to San Diego and
>have DMO insurance.
>I do not want to "TRY" every dentist to find out a good one. Very
>frustrated....
>
>Thanks in advance!
Step one, get rid of the DMO
...
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
| |
|
| sanshi wrote:
> Scaling and root planning, 100% covered by my DMO insurance.
> Irrigation, no cover at all because there is no code for it
(according
> to the dental office).
> $84 per quadrant.
and later:
> Thanks a lot for all your replys.
> Could anyone here recommend a dentist for me? I am new to San Diego
and
> have DMO insurance.
> I do not want to "TRY" every dentist to find out a good one. Very
> frustrated....
>
> Thanks in advance!
Dear Sanshi:
You wrote that scaling and root planing was "100% covered" by your DMO
insurance. However, this is not entirely accurate in the usual meaning
of the word "covered."
What the DMO means is that YOU don't pay any extra for the treatment.
In that sense, you consider it "covered." But instead of "covering" it,
by which most people mean the DMO will actually PAY for it, the DMO may
pay little or nothing to the dentist.
Since the dentist obviously can't pay the rent if he's paid little or
nothing for your treatment, it becomes a financial necessity for the
dentist to do one of the following:
1. Keep your treatment very short so you don't use much of his valuable
time. How long could he stay in business working almost for free? How
could you, or anyone, make a living working for free?
2. Or, the dentist could give you the full time you need, but find a
way to charge you extra for the procedure. That will make up for the
lack of payment from the DMO, so the dentist can now afford to treat
you.
With regard to a DMO, every dentist I know recommends REAL dental
insurance instead. I've been in San Diego for thirty years, but I have
never yet seen a DMO worth joining. Your DMO will restrict you to
choosing a dentist from a limited list of dentists who were willing to
work under the conditions imposed by the DMO structure. It would be
very difficult to recommend a dentist to you because all the better
dentists I know refuse to have anything to do with the DMO schemes, for
the reasons outlined above.
Good luck. You should consider dumping the DMO and give yourself free
choice of dentists instead. Have you thought about getting an
independent second opinion to determine if any other dentists consider
the proposed treatment to be necessary or advisable?
Best regards,
dentaldoc
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On 11 Feb 2005 10:15:07 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Scaling and root planning, 100% covered by my DMO insurance.
>Irrigation, no cover at all because there is no code for it (according
>to the dental office).
>$84 per quadrant.
Get the SRP and skip the squirting thing.
You can do that yourself later.
Joel
| |
| sanshi 2005-02-12, 1:32 pm |
| Thanks! The funny thing is that the dentist (at least the front desk
person from that dental office) said that they do NOT do SRP/irrigation
seperately. They told me that it is NOT grocery store that you can
choose product!
I think I'd better switch to OTHER insurance plan :-)
Sanshi
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On 11 Feb 2005 14:41:30 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Thanks! The funny thing is that the dentist (at least the front desk
>person from that dental office) said that they do NOT do SRP/irrigation
>seperately. They told me that it is NOT grocery store that you can
>choose product!
Oh you woulda known it!
Too funny!
>
>I think I'd better switch to OTHER insurance plan :-)
>
>Sanshi
| |
|
| On 11 Feb 2005 13:19:47 -0800, "Bill" <dentaldoc@hotmail.com> wrote:
>all the better
>dentists I know refuse to have anything to do with the DMO schemes, for
>the reasons outlined above.
>
>Good luck. You should consider dumping the DMO and give yourself free
>choice of dentists instead
Absolute truth.
I would rather sit on my kiester and not get paid than
work my tail off for nothing.
--
W_B
wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
| |
|
| On Fri, 11 Feb 2005 17:00:29 -0500, Joel M. Eichen
<joeleichen@yahoo.com> wrote:
>Get the SRP and skip the squirting thing.
>You can do that yourself later.
>
>
>Joel
>
>
Keep it 'G' rated Joel.
--
W_B
wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
| |
|
| On 11 Feb 2005 14:41:30 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Thanks! The funny thing is that the dentist (at least the front desk
>person from that dental office) said that they do NOT do SRP/irrigation
>seperately. They told me that it is NOT grocery store that you can
>choose product!
Exactly.
This is not Burger King.
You don't get it your way.
You take it my way or you don't
get the damn thing.
>
>I think I'd better switch to OTHER insurance plan :-)
The cost of indemnity dental insurance, and the imposed
waiting periods, far outweigh the cost of just paying for it
yourself.
>
>Sanshi
--
W_B
wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
| |
|
| On Fri, 11 Feb 2005 18:55:54 -0500, Joel M. Eichen
<joeleichen@yahoo.com> wrote:
>They told me that it is NOT grocery store that you can
>
>Oh you woulda known it!
>
>Too funny!
Yeah, and one of my pet peeves...
People don't show up at the grocery store
with no means to pay.
--
W_B
wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
| |
|
| On 11 Feb 2005 10:15:07 -0800, "sanshi" <sanshisd@yahoo.com> wrote:
>Scaling and root planning, 100% covered by my DMO insurance.
>Irrigation, no cover at all because there is no code for it (according
>to the dental office).
>$84 per quadrant.
There is a code for irrigation.
$84 is cheap.
My fee is $250/quadrant.
--
W_B
wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE
| |
| kite@execpc.com 2005-02-12, 1:32 pm |
|
Bill wrote:
> With regard to a DMO, every dentist I know recommends REAL dental
> insurance instead. I've been in San Diego for thirty years, but I
have
> never yet seen a DMO worth joining. Your DMO will restrict you to
> choosing a dentist from a limited list of dentists who were willing
to
> work under the conditions imposed by the DMO structure. It would be
> very difficult to recommend a dentist to you because all the better
> dentists I know refuse to have anything to do with the DMO schemes,
for
> the reasons outlined above.
Sorry to divert this thread, but I happen to be in San Diego too, and
I'm not limited by a DMO. Know anyone who does good crowns? I've
asked people I know, but not a lot of them have crowns to begin with,
and patient satisfaction doesn't necessarily tell the whole story. I
had a crown done elsewhere, and later I was told it was a seriously
poor fit and needed replacement. Up till then, I was perfectly happy
with it. Hey, I'm a layperson, I don't know a good crown from a bad
one. How do I pick a dentist?
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On Sat, 12 Feb 2005 01:12:01 GMT, W_B <no_one@nowhere.net> wrote:
>On Fri, 11 Feb 2005 18:55:54 -0500, Joel M. Eichen
><joeleichen@yahoo.com> wrote:
>
>
>
>Yeah, and one of my pet peeves...
>People don't show up at the grocery store
>with no means to pay.
Yeah but really. 95% of the dentists would never insist on BUYING the
expensive rinse with the 100% covered service.
Joel
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On Sat, 12 Feb 2005 00:58:03 GMT, W_B <no_one@nowhere.net> wrote:
>Exactly.
>This is not Burger King.
>You don't get it your way.
>You take it my way or you don't
>get the damn thing.
As long as its all disclosed up front, that is fair.
Joel
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On Sat, 12 Feb 2005 00:52:55 GMT, W_B <no_one@nowhere.net> wrote:
>On 11 Feb 2005 13:19:47 -0800, "Bill" <dentaldoc@hotmail.com> wrote:
>
>
>
>Absolute truth.
>
>I would rather sit on my kiester and not get paid than
>work my tail off for nothing.
About your kiester discussion, I went back and the patient did not say
how much (at 100%) the DMO was paying to the dentist.
It could be zero,. of course!
You could be right.
Joel
| |
| Joel M. Eichen 2005-02-12, 1:32 pm |
| On 11 Feb 2005 20:45:50 -0800, kite@execpc.com wrote:
>
>Bill wrote:
>
>have
>to
>for
>
>Sorry to divert this thread, but I happen to be in San Diego too, and
>I'm not limited by a DMO. Know anyone who does good crowns? I've
>asked people I know, but not a lot of them have crowns to begin with,
>and patient satisfaction doesn't necessarily tell the whole story. I
>had a crown done elsewhere, and later I was told it was a seriously
>poor fit and needed replacement. Up till then, I was perfectly happy
>with it. Hey, I'm a layperson, I don't know a good crown from a bad
>one. How do I pick a dentist?
There are a number of excellent practitioners in San Diego, maybe
SoCal Sam or Rod Kurthy or one of those guys.
If you end up there, tell them Hi from Joely.
Joel
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| Alexander Vasserman DDS 2005-02-15, 8:21 am |
|
sanshi wrote:
> Scaling and root planning, 100% covered by my DMO insurance.
> Irrigation, no cover at all because there is no code for it
(according
> to the dental office).
> $84 per quadrant.
There is an ADA code for irrigation but your DMO does not have a fee
agreed upon with your dentist.
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|
|
"Fawks" <tuthjockey@earthlink.net> wrote in message
news:1108131646.771769.237430@g14g2000cwa.googlegroups.com...
>
> While irrigation with Chlorhexadine sounds like a good idea, charging
> a hefty fee may be a little suspect. Some research suggests that
> the Chlorhexadine is no more beneficial than water when scaling and
> root planing. It is not effective in the presence of blood (which is
> usually
> all over the place if you really needed scaling and root planing in the
> first place) hence it's use for this purpose is dubious.
>
> Chlorhexadine is helpful as a daily rinse after scaling and root
> planing.
>
> Fawks
>
Yeah - this is my understanding of the irrigation story. I agree with Dr.
Fawks.
Linda (hygienist)
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| Joel M. Eichen 2005-02-15, 8:21 am |
| On Sun, 13 Feb 2005 20:31:10 GMT, "Linda"
<lindaphillipsbong@hotmail.com> wrote:
>
>"Fawks" <tuthjockey@earthlink.net> wrote in message
>news:1108131646.771769.237430@g14g2000cwa.googlegroups.com...
>
>Yeah - this is my understanding of the irrigation story. I agree with Dr.
>Fawks.
>Linda (hygienist)
Chlorhexidine ...........
Brand Names
In the U.S.—
Peridex
PerioGard
In Canada—
Oro-Clense
Peridex
Category
Antibacterial, dental
Description
Chlorhexidine (klor-HEX-i-deen) is used to treat gingivitis. It helps
to reduce the inflammation (redness) and swelling of your gums and to
reduce gum bleeding.
Gingivitis is caused by the bacteria that grow in the coating (plaque)
that forms on your teeth between tooth brushings. Chlorhexidine
destroys the bacteria, thereby preventing the gingivitis from
occurring. However, chlorhexidine does not prevent plaque and tartar
from forming; proper tooth brushing and flossing are still necessary
and important.
Chlorhexidine is available only with your dentist's or medical
doctor's prescription, in the following dosage form:
Dental
Oral rinse (U.S.)
Before Using This Medicine
In deciding to use a medicine, the risks of using the medicine must be
weighed against the good it will do. This is a decision you and your
dentist or medical doctor will make. For chlorhexidine, the following
should be considered:
Allergies—Tell your dentist or medical doctor if you have ever had any
unusual or allergic reaction to this medicine or to skin disinfectants
containing chlorhexidine. Also tell your dentist or medical health
care professional if you are allergic to any other substances, such as
foods, preservatives, or dyes.
Pregnancy—Chlorhexidine has not been studied in pregnant women.
However, chlorhexidine has not been shown to cause birth defects or
other problems in animal studies.
Breast-feeding—It is not known whether chlorhexidine passes into the
breast milk. Although most medicines pass into breast milk in small
amounts, many of them may be used safely while breast-feeding. Mothers
who are taking this medicine and who wish to breast-feed should
discuss this with their dentist or medical doctor.
Children—Studies on this medicine have been done only in adult
patients, and there is no specific information comparing use of this
medicine in children with use in other age groups.
Older adults—Many medicines have not been studied specifically in
older people. Therefore, it may not be known whether they work exactly
the same way they do in younger adults or if they cause different side
effects or problems in older people. There is no specific information
comparing use of this medicine in the elderly with use in other age
groups.
Other medicines—Although certain medicines should not be used together
at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your dentist or
medical doctor may want to change the dose, or other precautions may
be necessary. Tell your dentist or health care professional if you are
using any other prescription or nonprescription (over-the-counter
[OTC]) medicine that is to be used in the mouth.
Other medical problems—The presence of other medical problems may
affect the use of chlorhexidine. Make sure you tell your dentist or
medical doctor if you have any other medical problems, especially:
Front-tooth fillings (especially those having rough
surfaces)—Chlorhexidine may cause staining that, in some cases, may be
impossible to remove and may require replacement of the filling
Gum problems (other)—Use of chlorhexidine may make other gum problems,
such as periodontitis, worse
Proper Use of This Medicine
Chlorhexidine oral rinse should be used after you have brushed and
flossed your teeth. Rinse the toothpaste completely from your mouth
with water before using the oral rinse. Do not eat or drink for
several hours after using the oral rinse.
The cap on the original container of chlorhexidine can be used to
measure the 15 mL (½ fluid ounce) dose of this medicine. Fill the cap
to the ``fill line.'' If you do not receive the dental rinse in its
original container, make sure you have a measuring device to measure
out the correct dose. Your pharmacist can help you with this.
Swish chlorhexidine around in the mouth for 30 seconds. Then spit out.
Use the medicine full strength. Do not mix with water before using. Do
not swallow the medicine.
Dosing—
The dose of chlorhexidine oral rinse will be different for different
patients. Follow your dentist's or medical doctor's orders or the
directions on the label. The following information includes only the
average doses of chlorhexidine oral rinse. If your dose is different,
do not change it unless your dentist or medical doctor tells you to do
so.
For oral rinse dosage form:
For gingivitis:
Adults—Use 15 milliliters (mL) as a mouth wash for 30 seconds two
times a day.
Children up to 18 years of age—Use and dose must be determined by your
dentist or medical doctor.
Missed dose—
If you miss a dose of this medicine, use it as soon as possible.
However, if it is almost time for your next dose, skip the missed dose
and go back to your regular dosing schedule. Do not double doses.
Storage—
To store this medicine:
Keep out of the reach of children.
Store away from heat and direct light.
Keep the medicine from freezing.
Do not keep outdated medicine or medicine that is no longer needed. Be
sure any discarded medicine is out of the reach of children.
Precautions While Using This Medicine
Chlorhexidine may have a bitter aftertaste. Do not rinse your mouth
with water immediately after using chlorhexidine, since doing so will
increase the bitterness. Rinsing may also decrease the effect of the
medicine.
Chlorhexidine may change the way foods taste to you. Sometimes this
effect may last up to 4 hours after you use the oral rinse. In most
cases, this effect will become less noticeable as you continue to use
the medicine. When you stop using chlorhexidine, your taste should
return to normal.
Chlorhexidine may cause staining and an increase in tartar (calculus)
on your teeth. Brushing with a tartar-control toothpaste and flossing
your teeth daily may help reduce this tartar build-up and staining. In
addition, you should visit your dentist at least every 6 months to
have your teeth cleaned and your gums examined.
If you think that a child weighing 22 pounds (10 kilograms) or less
has swallowed more than 4 ounces of the dental rinse, get emergency
help at once. In addition, if a child of any age drinks the dental
rinse and has symptoms of alcohol intoxication, such as slurred
speech, sleepiness, or a staggering or stumbling walk, get emergency
help at once.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted
effects. Although not all of these side effects may occur, if they do
occur they may need medical attention.
Check with your doctor immediately if any of the following side
effects occur:
Rare
Signs of allergic reaction (nasal congestion; shortness of breath or
troubled breathing; skin rash, hives, or itching; or swelling of face
Other side effects may occur that usually do not need medical
attention. These side effects may go away during treatment as your
body adjusts to the medicine. However, check with your dentist or
medical doctor if any of the following side effects continue or are
bothersome:
More common
Change in taste; increase in tartar (calculus) on teeth; staining of
teeth, mouth, tooth fillings, and dentures or other mouth appliances
Less common or rare
Mouth irritation; swollen glands on side of face or neck; tongue tip
irritation
Other side effects not listed above may also occur in some patients.
If you notice any other effects, check with your dentist or medical
doctor.
Revised: 08/14/1998
>
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