Has anyone questioned the need to remove wisdom teeth?

Parent Cafe
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<p>cartera–we were told that the braces were to keep teeth straight/correct the bite. Wouldn’t having those wisdom teeth gone before braces make for more room in the mouth/alignment of bite? I am not a dentist; however, we could never get a straight answer from dentist or orthodontist about why wisdom teeth needed to come out AFTER braces.</p>

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<p>I am someone who did not have wisdom teeth removed. They are impacted, partially out. Every so often, they move or get an infection (not the teeth but the tissue around them) and I am in excrutiating pain. Never the right time to remove them. Always happens at the worst possible times, like Christmas eve, in the middle of a vacation, etc.</p>

<p>The big problem is if I should get a major illness or problem, the impacted teeth with their high risk of infection can be a huge problem. For example, bone marrow transplant prospects often have to get all of their teeth problems fixed before undergoing the process, as it can be their death warrent. As I get older, it has become a pressing concern.</p>

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<p>teri,
Thank you so much. As I said, my older D had this done in Vermont four years ago before she headed to college. So, when the younger one had the consultation in NYC today and told me the prices of her procedure, it sounded very high to me compared to what we paid here in VT four years ago even if I can’t recall the exact total…this seemed like twice as much. Also, I called our medical insurance and they do not cover any oral surgery (and we do not have dental insurance). Now I am not sure what to do. </p>

<p>First, my D had researched oral surgeons in NYC and picked one with a very high rating. But my husband made her cancel it since it was not a personal referral and just found online. He preferred to ask a family we know who lives in Manhattan (my oldest went to college with one of their kids) who they recommended and they gave us a name and my D made an appointment that she had today there and was able to get the exact surgery date she wants (and truly needs) next month as well. I have no idea if the high price is merely due to it being in Manhattan or if this is a high end person or just what (the family who recommended this oral surgeon is a wealthy family and we are not). </p>

<p>Here is the price we have to pay:</p>

<p>Today’s consultation: $310
Extraction per tooth (she is having all four taken and I believe they have not yet emerged or at least not fully): $625-$950
IV sedation: $450</p>

<p>Therefore, this is going to cost me between $3260 to $4560. That sounds like an awful lot to me compared to average fees I have googled online and compared to what I recall spending for my oldest D. But my husband doesn’t want her to go to someone who is not personally recommended.</p>

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<p>I am 69 years old. Until a few years ago, I had always been told that I had no wisdom teeth. However, they finally found one - far removed from it’s standard location - up near the top of my ear. My dentist said not to even think about removal unless it caused problems. My uncle had the same thing and his “far removed” tooth abcessed - I don’t know whether they dug it out or just tried to get rid of the infection.</p>

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<p>^^ UGGHH.</p>

<p>We do have dental insurance but part of the cost of my kids’ wisdom teeth extractions was covered under our Major Medical, apparently since it was surgery for impacted teeth. Then the dental plan (under a different carrier) picked up most of the rest.</p>

<p>I suggest you check with your MM carrier to see if this procedure is ever, in any circumstances, given *any *coverage under the plan.</p>

<p>Also, most insurance carriers have different schedules for “Reasonable and Customary” allowances by area. So it is possible that the higher NYC charges will get higher allowances. Again, it depends on the plan, as some may just provide a fixed schedule of benefits.</p>

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<p>JEM, I called our insurance carrier…medical…(we don’t have dental) today and asked if oral surgery was covered and they said no. Was there any other thing I could have asked?</p>

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<p>I think the reason why wisdom teeth removal comes after orthodontia is because they are rarely ready to come out prior to the age when most kids get their braces.</p>

<p>Our oral surgeon has told us (with both girls) that wisdom tooth removal needs to be timed appropriately to minimize any risks to the surgery. Evidently, if you do it too soon, before the roots have fully developed, there can be risks, and if you do it too late, you risk nerve damage along the jaw line from the roots.</p>

<p>So it needs to be a personal decision based on the development of the person’s mouth, not before or after braces. My older daughter’s wisdom teeth all developed and came down at a relatively comparable rate, so she had all four out at once. Younger daughter’s lower ones are not developed enough; in fact the oral surgeon said it might be at least two years before they need to come out ( and her uppers were taken out last summer).</p>

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<p>soozie - I’m assuming her consultation fee was so high because they wanted recent x-rays there?</p>

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<p>soozie, my D had all 4 extracted last August in White Plains, Westchester County, north of the city. Cost was as follows:</p>

<p>Initial consult - $85
Pano x-ray - $150
2 lower impact.complete bony - $600 each ($1200)
2 upper impact.partial bony - $475 each ($950)
IV sedation/analgesia (1st 30 minutes) - $300
IV sedation/analgesia (additional) - $175</p>

<p>TOTAL (including 2 post-op visits) - $2865</p>

50

<p>teri…
I spoke to her VERY briefly as she was leaving his office and she was just reporting in about the surgery date and I asked the fees. All the while she was getting her bearings on where she was walking, asking someone which way to Lexington Ave. and telling me she had to get going to get to her job in the city. I don’t know if she got X Rays but I am assuming she likely had to as this guy was not referred through our local dentist where she has X rays (though not taken REAL recently). I imagine they had to take them to see what was going on as the teeth aren’t yet emerged I don’t think (just started hurting very recently). Still, the extraction fees sound higher than averages I am reading online and higher than I recall them being four years ago for my other D here at home (though passage of time and the geographical location may mean the difference). That’s why I asked what others paid. I’m going to have to use money meant for college for it.</p>

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<p>runnersmom…thanks very much. We cross posted. Maybe the rates in Manhattan are not that out of line afterall? It still costs more than you paid in Westchester and surely more than I paid in Vermont.</p>

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<p>I was just going to say that you are paying the price of using a Manhattan oral surgeon. Everything is more expensive in the City.</p>

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<p>That’s what I am now gathering. I am not sure the alternative. I don’t think she wants to come home that week and even if I brought her home, she would not have had the consultation here and they likely want to do their own and she won’t be home twice to do that and then the surgery…I am sure the next time home will be at Thanksgiving (even if that). And they bothered her and she wants them out. I also would have to fly her back to NYC. It is a done deal that she is doing this in NYC. I don’t know if this person’s rates are higher or not than others but this was a recommended person from a friend and my husband won’t let her do it with someone who is randomly selected.</p>

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<p>Soozie, our oral surgeon dealt directly with the insurance companies - took copies of both cards (medical and dental group plans through spouse’s employer); we did not pay a thing upfront. When both carriers had paid their parts we had a small bill for the remaining coinsurance/deductible. If I can locate the records of son’s (done last summer) I will let you know the cost, etc.</p>

<p>I found the following by googling:
"Generally (unless its a simple extraction) wisdom teeth are covered under major medical plan not under dental-insurance, as its extraction needs to operate the gum & a part of jaw which is performed by an oral-surgeon not by a dentist. "

<p>and, in a file of plan provisions for a group MM plan I found online, “Surgical Expense: The expense actually incurred is allowed not to exceed $100 times the unit value of the MDR allowance, or $2,500 in total for all surgical operations performed for any one Sickness. (Note: Treatment of impacted wisdom teeth is covered on the same basis as any other medical condition.)”</p>

<p>and another
"What is covered of wisdom-teeth removal (oral surgery)?
Depending upon your plan’s benefits, Oral surgery can fall under the Preventive, Basic, or Major category. Please refer to your certificate booklet. A pre-operative x-ray film is required in order to review a surgical extraction because benefits are subject to our consultant’s review. Obtaining a pretreatment estimate is recommended for all dental work that you consider to be expensive. The estimate helps to eliminate misunderstandings by letting you know beforehand how much the plan can cover. We do suggest submitting your oral surgery claim to your medical plan first as some medical plans have benefits for surgical extractions as well as general anesthesia or IV sedation. "

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<p>JEM, that was so sweet of you to look that up. In the one quick call I had with my D today, she said she presented her insurance card and they gave her some forms to submit to insurance. But my husband didn’t think we had coverage and so I called the insurance company and asked and they said that oral surgery is not covered. I do recall having to pay out of pocket entirely for my other D as well (but not as much as this NYC surgeon charges). This is CIGNA. Medical only (we do not have dental insurance). I gather that not everyone’s plan covers this. I understand it falls under medical insurance and not dental but it appears my plan doesn’t cover it. I am not sure what else to ask other than my asking today with Cigna if oral surgery is covered under my plan.</p>

<p>D paid for the consultation with a debit card of her own for which I will reimburse her.</p>

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<p>Soozie, I found some of the numbers from son’s process last summer: </p>

<p>$420 per tooth for two teeth, $368 per tooth for the other two;
anesthesia was another $420;
Total $1,996 just for the actual extractions and anesthesia.
MM Insurance (BC/BS “preferred provider” group medical plan) paid $1,108.80 of that. The balance went to our dental carrier (Met Life group dental plan).
There was about $500 of other charges (I guess x-rays & consult - I just am working from the insurance claims records available online and not the original bills). Again, BC/BS paid a portion and the balance went to the dental carrier.</p>

<p>So the total billed was roughly $2,500 for the whole process. The share we eventually paid after both insurance plans was, I believe, under $100.</p>

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<p>Soozie,</p>

<p>Dd had all 4 wisdom teeth removed on long Island, 30 minutes to NYC, and paid similar rates to runnersmom in Westchester. Cigna paid for most of it. I think we were left with a $200-$300 balance. They were all impacted.</p>

<p>In my experience consults in the city are always more.</p>

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<p>I know I live outside the U.S. and I don’t know if this is even worth writing but my medical plan doesn’t include teeth per se unless one is lost in an accident but when my son had his “wisdoms” out 3 years ago they were impacted and the dental surgeon said the insurance would pay for the surgery and sure enough they did, all of it. I was shocked and pleased. It was his bottom teeth. The top are still there and have not come down.</p>

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<p>My S had his two upper wisdom teeth removed yesterday afternoon, using Novocaine only at S’s request. He ate a big dinner last night after the Novocaine wore off. He slept well and did his usual 14 mile run this morning (slower than usual because of the bouncing when you run).</p>

<p>He said it was interesting being awake for the surgery, because he heard the oral surgeon’s assistant actually gasp when she saw the first tooth come out because it was so large. The surgeon said that my S “had some man-sized wisdom teeth.” S said the worst part was the mouth and tongue numbness from the Novocaine.</p>

<p>The cost is $450 per tooth, plus $80 for the new patient exam and $117 for the panoramic x-ray. Our health insurance will pay for most of it.</p>

<p>My S had his bottom wisdom teeth removed 4 years ago, with general anesthetic that time, and he had a harder time with them. There was much more swelling and bleeding.</p>

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<p>D is having all 4 out tomorrow morning. She has already made for plans for Sunday so she is being very optimistic.</p>