Toothy Maintenance

We needed to find a dentist in our new home town so we asked our new friends for recommendations. Only one of those recommended dentists was scheduling appointments within 90 days so that made the decision easy. Alison is in charge of being logical and decisive so she scheduled a cleaning for herself and saw the new dentist within two weeks. Good job Alison! But when it was time for me to schedule my own appointment I delayed, because that’s what I’m in charge of!

Now that we’re retired we no longer have access to employer provided dental insurance so we pay out of pocket for all dental services. Yay! And since we started early retirement as international nomads before the Covid pandemic, we haven’t had to pay American dental prices since 2018.

Among the things we’ll miss most from our nomad days are medical and dental care, literally anywhere outside of the USA! We love insurance for other things but the numbers don’t add up with dental insurance, regardless of whether that’s employer subsidized insurance or self insuring for dental care. If you live in the USA, whether you have employer-provided dental insurance or private dental insurance, you’ll still pay big numbers out of pocket if you need extensive dental work. But I’m not trying to turn this post into a rant on dental insurance, as fun as that might be. So let me just end that brief rant with this: I miss my favorite dentist in Mexico!

Now look at these two cuties!

Try Something Different! 

Alison was really happy with how things went during her visit to the new dentist. She liked the team and she was sure I’d like them as well, and she knows how very picky I am about dentists and hygienists. Despite Alison’s 5 star review and encouragement I wanted to keep stalling so I dove into a nerdy research hole instead. I started reading about the latest in dental equipment and treatment costs, and then I stumbled into a new idea by accident!

Have you ever had your teeth cleaned at a dental hygiene school?

The dental hygiene school in our new home town is always looking for people to come in as patients since students are required to work with real patients in order to graduate.

Our local dental hygiene school provides preventative services including:

  • Blood pressure screening
  • Oral cancer screening
  • Dental examination
  • Periodontal assessment (evaluation for gum disease)
  • Education related to oral health
  • X-rays
  • Dental hygiene therapy (prophylaxis)
  • Periodontal therapy (scaling and root planing and periodontal maintenance)
  • Fluoride application
  • Sealants
  • Teeth whitening

All of that for just $65! And less if you’re a senior, veteran, student or faculty. And even less if you’re a kid. And if I understood the pitch correctly, they would also provide nitrous oxide at no extra charge.

That’s me, back in the chair again!

A very different experience

When I scheduled my appointment I learned the school had been struggling to find enough patients for their students ever since the beginning of the Covid pandemic, and as we all know the pandemic is ongoing so they are still struggling. It’s funny how just the idea of being slightly helpful to someone else can make getting your teeth cleaned sound more fun!

When I arrived for my appointment I was excited to learn about their process and it certainly did not disappoint. They had space for 16 students to see patients simultaneously, all in walled-off pods, plus a separate area with three X-ray rooms. And there were instructors in each area to answer questions, teach, and participate in the appointments.

On a related note, this was my first dental experience since the start of the Covid pandemic. I’ll admit I’ve been nervous about being in a dental office again. But I felt very safe there because all of the students, faculty, and reception staff wore double masks plus face shields, and all patients were kept isolated from each other.

To be honest it was a very lengthy process, and though I’m more impatient than I’d like to admit I was enjoying myself enough that I didn’t mind how long it took. I just kept reminding myself that since I’m retired there’s no need to hurry!

First my student hygienist checked my blood pressure and made note of my general health and active prescriptions in the digital chart she was building. Then she did an oral inspection and built a complete record of my teeth showing every past filling and crown. An instructor came by several times to check on us and QC the digital records, and at one point she asked the student to correct the classification of one of my old fillings.

The interesting part was when they reviewed my new digital file and described each and every filling and crown back to me, including details like the age and condition of older dental work and what will need replacing over time and why. The instructor pointed out details for each of my old fillings and described the relatively good condition of my three porcelain-fused-to-metal crowns since they are more prone to chipping or cracking. [Foreshadowing!!😆🤣]

I really appreciated all of the explanation because I have a goal to replace all of the old dental work I got during my teens and 20’s. They are reminders of my youth since my mom didn’t provide us kids with a tooth brush or any reminders to brush our teeth. Yup, I was raised by wolves until age 12 when I moved in with Grandma!

After my dental records were complete the student hygienist and her instructor gave me an oral exam together, looking for cancer and gum disease and that sort of thing. The instructor hygienist also explained why my mouth is so small and what’s unique about the shape of the roof of my mouth. I’ve never had any dentist or hygienist talk to me about that before, and I’ve had more than a few dentists and hygienists! 

Next the student hygienist took me over to the X-ray area for a full set of images. The instructor who was managing the X-ray area came over to QC each image and helped the student retake one. The instructor explained that some of the tools they use during imaging are one-size-fits-all but some come in different sizes, so they should use the right size for each patient instead of assuming everyone is the same. Yes!!!

Getting X-rays is usually really uncomfortable for me and now I know that’s because the standard tools for positioning the film are too big for my mouth (if you aren’t sure what I’m referring to check this out). So now I know I can ask for smaller sizes of those positioning tools when I need X-rays, and I can also ask dental staff to add adhesive pads to the edges of their tools so they won’t feel as sharp in my mouth when I have to clamp down for an X-ray. More new information!

Time Flies at Dental Hygiene School!

After the X-rays were finished I realized almost three hours had passed. Wow! On my way out I booked another appointment for the following week to finish the process.

When I arrived a week later for my second appointment the same student hygienist got right into the process of cleaning my teeth. At one point she stopped and asked an instructor for help because she was nervous. She explained there was one spot where a bit of plaque had hardened over a filling. That’s wasn’t shocking since we didn’t get our teeth cleaned last year (we had appointments in early March of 2020 but our dentist in Mexico canceled them and closed her office temporarily when Covid was declared a pandemic).

The student hygienist let me know she was nervous about applying extra pressure to that one spot of plaque because she’d never done that before. So her instructor took over and explained exactly what she was doing and feeling, teaching while she worked. I was totally impressed! Then the instructor QC’d the rest of the student’s work and called the faculty dentist over to review everything as a last step. The dentist had a look, declared there were no cavities, and then moved on to the next patient. We wrapped things up with a fluoride application and sealants, and I was done after a little less than two hours that day.

The only thing I skipped during my visit to the dental hygiene school was the teeth whitening. I declined the whitening when the hygienist instructor that finished my cleaning said she wouldn’t recommend it for me because I have a filling on a front tooth. Did you know that crowns and fillings don’t react to whitening? Apparently fillings and crowns remain the same shade even if you have the rest of your teeth whitened. Something I didn’t know, even though my previous dentist in Seattle had talked me into a very expensive whitening at one point years ago. There’s so much to learn at a dental hygiene school!

Ironic dental surprise

A few weeks after I got my teeth cleaned an old crown randomly came loose and fell out. I’ve never even dreamed of my teeth falling out and I can’t remember having any tooth fairy moments as a kid, so that was a bizarre experience. That was my very first crown and I’ve had it for more than 25 years. The hygienist instructor had mentioned it was way past it’s life expectancy since the average crown lasts 10-15 years. I have to admit I thought it was kind of funny when it fell out. I figured that was an opportunity to replace an old porcelain-fused-to-metal crown with a new solid porcelain crown just like I did in Thailand in 2019. And I admit I was weirdly excited to have that done.

It’s no fun to loose a crown! 😆

The next morning I called the same dentist Alison had seen a couple of months earlier and asked for an appointment. I was disappointed when they said it would be a couple of weeks before they could fit me in, even if it was an emergency. It felt weird to eat with a missing molar but I didn’t have any pain or discomfort so it really wasn’t that hard to wait.

That same day I also called the dental hygiene school and asked them to email my X-rays and digital records to the dental office, and I could tell they did that immediately because I also got a copy. Then I called the dental office to make sure they received them and I was pleased to find out they had the files ready for the dentist to review.

When I finally had my appointment I liked the dentist right away. He pulled up my X-rays and records and then had a look at the crown to make sure it wasn’t damaged. He mentioned that his wife gets her teeth cleaned at the dental hygiene school I went to for my cleaning, and then confirmed there was no chip or crack in the crown. He explained that the cement was old and had fallen apart so my old crown just fell out. I launched right into my plan and said I wanted an upgrade to a new porcelain crown, but the dentist said as long as it wasn’t uncomfortable the old crown was just fine. On top of that he didn’t have time to do more than put the old metal crown back in. So the dental assistant cleaned the old cement out of the crown and the dentist cemented it back into my mouth. I was out the door and back in the car after only 20 minutes. Yay?

So what did those 20 minutes cost? The cost to have my old crown re-cemented was $106, after the 5% discount for paying by check. Not bad I guess? Meanwhile, Alison’s cleaning and X-rays by that same dental team cost $337, again that’s after the 5% discount for paying by check. Quite a bit more expensive than my cleaning and X-rays which only cost $65. I also asked the dentist to give me an estimate for a new porcelain crown, and a few days later I got an email with a cost estimate for a new crown at $1,135. Ugh.

It was amazing to compare costs between our local dental office and the dental hygiene school, and then for reference to compare those prices to what we paid in other countries. And it’s amazing that I was able to get my teeth cleaned at a dental hygiene school in the USA at rates that looked similar to what we saw from dentists (not hygienists) in other countries!

The Dental Hygiene School Wins!

I’m so glad I had some nerdy research fun along with getting my teeth cleaned. I learned so much about my own mouth and about dental hygiene in general from this experience, which really satisfied the data nerd in me. The teaching process was obviously very important for the student but it was also a benefit for me, and I really enjoyed it!

Would I recommend visiting a dental hygiene school to others who need to get their teeth cleaned? Yes! Would I do it again myself? Yes! In fact I have my next cleaning scheduled with the same student hygienist for six months after the last one. And I’m actually looking forward to it. I’ve already gotten our housemate an appointment there with the same student hygienist for his cleaning, and I’m pretty sure Alison will decide to have her next cleaning there as well.

In the end I got about 5 hours of excellent quality care for just $65 at the dental hygiene school. Not exactly a spa treatment but satisfying nonetheless! Clearly everything took more time than it would have in a private dental office because they’re focused on teaching instead of churning through patients quickly. And I loved that! So there you have it.



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15 comments

    • Yes I went to the one in Northern AZ and I think there are three dental hygiene schools in the Phoenix area. This experience made me wonder where schools like this are located more generally. I wish I had known about this option when I lived in California, and when we lived in Seattle, etc.!

      Like

      • I consider the savings on premiums as part of the whole compensation package. Don’t most dental insurance plans cover preventative and then some percentage of everything else?

        Liked by 1 person

        • Yeah I think the savings on premiums and copyas are the elements of dental coverage that fit nicely in your overall compensation package. But I think our premiums were like $30 and we didn’t go to the dentist often when we were working. And for sure the percentage of savings for things like getting a crown or root canal through our employer dental insurance was not impressive for either of us with our two different plans. Hopefully you’ve got insurance that really makes a difference in dental costs and a much better plan than we did!

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  1. Hi Ali,

    Very timely post!!

    Myself and Deb are firing ours once the work on my front tooth is completed. (Temporary crown resembles Cletus from the Simpsons….looking forward to wishing people a happy new year with this awkward self-conscious smile)

    Ours is basically a money-making machine type of dentist who wants to just use both our mouths as insurance claim cash machines, unfortunately we only discovered this after we got on the conveyor belt. They are all like that around here in Savannah but the work needed to be done 🤷‍♂️

    My work colleagues basically quit going to the dentist at all, how sad.

    Seem to remember also my old dentist here used to give you a sugar cookie on your way out..seriously.

    Truly miss our old pre-Covid UK dentist, really nice human who wouldn’t dream of performing a single unnecessary procedure.

    Ho-hum, maybe the students would be a better option? might be onto something.

    Happy New Year!

    DD4L

    Liked by 1 person

    • Ho-hum, now I want a sugar cookie. I wonder how all of the costs and processes you’ve had with dentists here in the US compare to what you experienced in the UK. I almost got us appointments with a dentist on the IOW there last December but sadly we couldn’t go the one day we could get appointments. Next time!

      Good luck with that front tooth, and Happy New Year Dave!

      Like

    • It was a pretty cool experience! I felt like I was on a research mission the entire time which made it super entertaining. And I know I’m more sensitive than Alison which probably means I’m more sensitive than most people. I’m so used to spending most of my dental office time in the USA with hygienists who don’t seem to be paying attention while they poke and scrape, so having such a focused team was actually very refreshing for me!

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  2. Great post and I’m glad you had such a good experience!
    I’ve done something similar with haircuts. When I moved to Washington, DC I was astounded to see that a simple cut, even at your standard salon like Great Clips, was so expensive. I tried going to Aveda’s salon school (once in DC and once in another city) and both times had a bad experience. But I’ve since started going to a local hair school that I love. It’s a great way to give the students an opportunity to learn more about your hair type/different styles, and I’m able to pay less than $20 for a wash, cut, and tip – for a great experience!
    At my job I work with uninsured and under-insured individuals and we oftentimes send them to the dental school in town, especially for more extensive work like root canals. Sounds similar to what you wound up doing.

    Liked by 1 person

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