I have about 5 dentists in my immediate family (grandfather, dad, dad's wife, aunt and uncle). My dad is the head of the Perio department in the Hadassah Dental School in Jerusalem. Naturally, I had my teeth checked twice a year like clockwork all my life. I have some gum issues, but never needed a filling.
6 month after moving to the bay area, I went to a local dentist for general checkup. He used the "laser thingy" to find cavities and found no less than eight cavities that required filling. He also took XRays that showed no issues at all. I asked him for copies of the records and XRays so I can send to my father for second opinion. He immediately agreed, but despite weekly reminders, he never sent me the films.
On my first visit back home, I got my teeth checked by my aunt again. I need one filling.
Lessons learned:
* US diet accounts for one cavity.
* Dentist greed accounts for seven more.
* Always ask your dentist for copies of XRay and files and don't return if he will not supply them. It is your right to have those copies of your dental history.
* If the XRays don't show the cavities, there are not at a level where you need to treat them yet. You can safely wait until they show up. If you maintain high level of dental hygiene they may never get to the point where they need filling.
Since you have so many dentists in your family, can you (or anyone else here) comment on the cost of dental care?
Every time I go, I am absolutely floored by the prices. I haven't been for several years now as I've had no pain requiring immediate attention.
My last experience with dentists was getting a tooth that had cracked in half examined. At that point I had some pain, but I use sensodyne toothpaste so it seems to have healed over the crack. I can't recall the exact numbers, but I first had my regular dentist look at it, who then sent me to a specialist (oral surgeon I believe). I seem to recall the combined charge of these two visits was almost $1000 (this is in Canada, fwiw). Total time in chair was far less than 30 minutes....I recall calculating the hourly cost was >$2000/hour. The estimate on "building the tooth back up" (not pulling and replacing with ceramic) was around $3000-$3500 (for I think around 45 minutes work).
Teeth cleaning is less, but on an hourly basis, it is just ridiculous. And of course it seems to always come with the unrequested inspection by the dentist, < 5 minutes for $75 (likely much more now).
I just can't fathom how working class families without insurance can afford this....even for the parents, let alone their kids!
I know they have some expensive machinery to pay for, but I just can't see how these prices are justified in any way. Yes, I know prices are "set by the market", but I have never encountered any dentists that vary much in price, style of delivery, or services offered. I have also never encountered a profession so secretive about its prices. Receptionists never have a clue about what the price range would be to cap a tooth for example, it always "depends".
It would seem to me that doctors would likely have to take much more schooling, and they certainly have more advancements in their industry to keep up with, but in Canada at least, it is fairly common for a family doctor to make $150 to $200k per year. I reckon a dentist could easily make that in 3 months: $500/hour * 160 hrs/month * 3 months = $240,000. Yes, this is a simplistic calculation, ignoring the 4 dental hygienists working for him earning him $50/hr profit, possibly not 160 hrs/month billable (but equally possible billing equivalent of 260 hrs/month if he structures his staff right), must rent office and lease equipment, receptionist, etc etc....but you get the idea.
To me, something about the whole industry just doesn't seem right. It smells to me of collusion to some degree, but this is just pure speculation.
One other related thing I have noticed (anecdotally)....whenever you go to a dentist or doctor/clinic in Canada, there is always a big lineup, usually with at least a half hour wait, even with an appointment. The times I have visited a dental or medical office overseas (Thailand and Japan), there were either very short wait times, or I was literally the only person there....which makes me suspect the medical and dental associations here may be restricting the number of new applicants into schools, in order to control the supply of their services, and therefore the price.
Anyways, can anyone with some actual knowledge of the field could comment on my pure speculation?
It has to be determined by specific market conditions. I don't think anyone practicing dentistry in Israel earns anything even close to the sums you mention. As you said, there could be an artificial shortage in dentists. When my father lived in the US, he worked as a researcher, but didn't bother getting a dentist license because the process was too complicated and time consuming.
Dentists don't like to quote prices because they want you to choose them based on their skills and reputation. Letting you shop around would turn this into commodity market. They do know (at least in countries without strange insurance habits) how much each procedure should cost and how much each of their friends asks for. This is not exactly collusion, but can contribute to price similarity. The same way that you can't find a decent DBA in the bay area for less than 100k. People usually know how much their skills are worth.
The answer to your question about working families is that they simply wouldn't go because of the cost. The last time I had any dental work done (root canal + crown) I paid over $1k total, and that was WITH dental insurance. Teeth or rent - choose one.
6 month after moving to the bay area, I went to a local dentist for general checkup. He used the "laser thingy" to find cavities and found no less than eight cavities that required filling. He also took XRays that showed no issues at all. I asked him for copies of the records and XRays so I can send to my father for second opinion. He immediately agreed, but despite weekly reminders, he never sent me the films.
On my first visit back home, I got my teeth checked by my aunt again. I need one filling.
Lessons learned: * US diet accounts for one cavity. * Dentist greed accounts for seven more. * Always ask your dentist for copies of XRay and files and don't return if he will not supply them. It is your right to have those copies of your dental history. * If the XRays don't show the cavities, there are not at a level where you need to treat them yet. You can safely wait until they show up. If you maintain high level of dental hygiene they may never get to the point where they need filling.