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My first big-time dental procedure

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  • #16
    Originally posted by Zaphod View Post

    I think its entirely unnecessary, I mean its super easy to get the jaws numb, deeply for a long time. Anxiety, etc...could be an issue, but its def not a problem for the procedure side of things. Just did step one myself with a nasty extraction under local and it was downright pleasant.
    Check back in after you have the implant placed, I can all but guarantee you will find that procedure, as well as the healing, to be even easier than the EXT. Obviously every person and procedure is different and some may have a different experience, but that is what we typically find.

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    • #17
      The guy laid out anesthesia options including gas, and I said whatever you think is reasonable. He said I don't look like the nervous type and I confirmed, so we agreed on his first suggestion which is halcion. I didn't remember what it was then but sounds reasonable to me - local + benzo. I'm totally alcohol/benzo (and opioid) naive.

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      • #18
        Originally posted by Zaphod View Post

        I think its entirely unnecessary, I mean its super easy to get the jaws numb, deeply for a long time. Anxiety, etc...could be an issue, but its def not a problem for the procedure side of things. Just did step one myself with a nasty extraction under local and it was downright pleasant.
        Yes, usually super easy to get the jaws numb... until it's not, and sometimes I wonder if I'm part of some sick RCT where half of my anesthetic cartridges are filled with water.
        Or when a super anxious patient chews through your deep profound anesthesia in 15 minutes, in mid-procedure, and is impossible to renumb.
        Those are great fun...

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        • #19
          Originally posted by legobikes View Post
          ...Although maybe it doesn't qualify as a major procedure. I've had a few fillings, but now my baby tooth is giving out and it's due for extraction. I was originally entertaining the idea of just having it taken out, no implant, but everyone acted like I'm crazy and I've been convinced otherwise due to possibility of migration and changes in bite (although I wonder what is the likelihood). It's in the 2nd premolar position so barely affects my smile.

          So I guess I'll be ponying up some cash. The OMFS told me they'll need to do a sinus lift because there's not enough bone for the implant to grab otherwise, using cadaver bone. Gross!

          I know there are some dentists on the forum, just wondering if these charges seem reasonable, and what I might be in for, for the crown?

          Click image for larger version

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          as others said, a pretty good deal, especially at OMFS. I am a higher than that, and as a GP I do both surgery and restorative, so I have greater pricing power. If for whatever reason I want the surgery done by an OS, I would expect their fee to be higher.

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          • #20
            This is very cheap... I'm an OS and I charge significantly more than this.

            Take it and run with it buddy

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            • #21
              this is making my teeth hurt!

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              • #22
                Looks like a great deal, we charge almost twice that for an implant. We also charge a PPE fee (nitrile glove vendors have listed wholesale price increases of over 600%). I do local for implants all of the time, usually well-tolerated. Usually the patient will know based on past experiences with that tooth (filling, then extraction) whether or not they will want nitrous or sedation. The biggest complaint I get is from the osteotome and mallet needed for the indirect sinus lift, but this is just unpleasant, not painful.

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                • #23
                  Just build PPE in to your fees. This is foolish billing for IC that is mandatory for every procedure

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                  • #24
                    We don't charge PPE. Clinical supplies are less than 4% of the revenue, from gauze and cotton rolls to biologics and bonding agents (that go for $100,000/gallon, if you do the math).
                    Even at current surge pricing, gloves hardly affect the cost of doing business.

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                    • #25
                      Originally posted by legobikes View Post
                      ...Although maybe it doesn't qualify as a major procedure. I've had a few fillings, but now my baby tooth is giving out and it's due for extraction. I was originally entertaining the idea of just having it taken out, no implant, but everyone acted like I'm crazy and I've been convinced otherwise due to possibility of migration and changes in bite (although I wonder what is the likelihood). It's in the 2nd premolar position so barely affects my smile.

                      So I guess I'll be ponying up some cash. The OMFS told me they'll need to do a sinus lift because there's not enough bone for the implant to grab otherwise, using cadaver bone. Gross!

                      I know there are some dentists on the forum, just wondering if these charges seem reasonable, and what I might be in for, for the crown?

                      Click image for larger version  Name:	Clipboard01.jpg Views:	586 Size:	42.6 KB ID:	235415
                      Feels low, given some of the oral surgery we've had this year. Different procedures, so I can't really say.


                      ... Is anesthesia included? Some options might cost more, but may be more to your liking.
                      Last edited by adventure; 11-18-2020, 04:29 AM. Reason: added 2nd thought

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                      • #26
                        So I had this done three days ago. It was so satisfying to hear the crunch of the tooth giving way and being wiggled free with whatever wrench tool you guys use. The mallet was a surprise but there was only pressure, no pain. Seemed a little concussive... Halcion probably helped a little but I think I might have been fine without it as well.

                        The first day I took a couple of the opioid pills they gave me because as the anesthetic wore off the pain was pretty bad, but I felt much better later that evening. I've got sutures that I keep messing with with my tongue, and lots of edema at gum of the the adjacent teeth. I don't feel any sinus pain from the lift. Doing hot saline rinses around the clock. Wonder how long the swelling lasts?

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                        • #27
                          Originally posted by legobikes View Post
                          So I had this done three days ago. It was so satisfying to hear the crunch of the tooth giving way and being wiggled free with whatever wrench tool you guys use. The mallet was a surprise but there was only pressure, no pain. Seemed a little concussive... Halcion probably helped a little but I think I might have been fine without it as well.

                          The first day I took a couple of the opioid pills they gave me because as the anesthetic wore off the pain was pretty bad, but I felt much better later that evening. I've got sutures that I keep messing with with my tongue, and lots of edema at gum of the the adjacent teeth. I don't feel any sinus pain from the lift. Doing hot saline rinses around the clock. Wonder how long the swelling lasts?
                          I've been on a receiving end of the mallet. No Halcion, was supposed to have lunch with my peridontist friend but we decided to do that instead. Lovely feeling. I do my own lifts hammerless for that reason.

                          There is usually minimal discomfort after the first day. If there wasn't much horizontal grafting the swelling should be minimal. Not sure what hot saline rinses are supposed to accomplish, but I guess they won't hurt.

                          Returning to the cost question - seeing that the lift was no charge, I suspected it wasn't really being done... because that happens sometimes. But if they actually used a mallet, that's a real lift. You got a great deal.

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                          • #28
                            There's no visible swelling but my gums FEEL swollen and painful when I press on them. The dental infection had flared ~5d prior to the procedure and I started quaffing clindamycin to get it under control (regular dentist had said go with clinda next time cause I'd already self-medicated with amox a few weeks back). Anyway the pain had subsided by the morning of the procedure, and I then forgot to mention it to the OMFS while benzo'd. I discontinued the clinda the day of, but did take the keflex premed that was prescribed. However the next day I started feeling similar gum pain so I re-started the clinda. I'm pretty sure I should have kept going with the clinda. Not sure if he would have changed how and when he did the procedure if I'd remembered to mention the infection. I'm not totally sure if this is residual infection or just pain and swelling from the procedure, since the sutures go all the way up the vestibule.

                            Saline rinses - figure they'll help with healing and keeping things clean - it was recommended on the post-op sheet. Also chlorhexidine rinse twice a day.

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                            • #29
                              Originally posted by molar roller View Post
                              We don't charge PPE. Clinical supplies are less than 4% of the revenue, from gauze and cotton rolls to biologics and bonding agents (that go for $100,000/gallon, if you do the math).
                              Even at current surge pricing, gloves hardly affect the cost of doing business.
                              $100,000 per gallon? You're using the cheap stuff. We figured Scotchbond Universal closer to $200,000 per gallon, at least retail. I'm not sure what we actually pay for it. (we need a laughing/crying emoticon for this one)

                              Glad the sinus lift is healing well!

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