Why Is the Dentist so Darn Expensive ?

I see people who have little money to afford what they really need in terms of dental treatment. I see teeth getting pulled instead of getting a needed crown (which is almost always a mistake). And I hear this question more than any: "Just WHY is going to the dentist so expensive?"
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Okay, let's be frank -- the economy just isn't what it used to be, is it? The mid '80s and late '90s booms are in the distant past and today, more often than not, people are struggling to make ends meet.

As an NYC Cosmetic Dentist, I see this type of thing a lot. I see people who have little money to afford what they really need in terms of dental treatment. I see teeth getting pulled instead of getting a needed crown (which is almost always a mistake). I see people going years without checkups and cleanings. I hear complains about insurance, and the like.

And I hear this question more than any: "Just WHY is going to the dentist so expensive?"

Well, I'm going to answer that question today.

Now, before I even start, I have to state two things. First: I, as a dentist, am not looking for any sympathy. I "get" that no matter how I explain it, people getting a crown, etc. are still going to think I pocketed $1,000+ for an hour's work. And it's their right to think that.

And second: I fully realize the reality of things. I will explain that I do not think it's a smart economic move to forgo a checkup, but I also realize that if it's a choice between that or food, well, sorry Mr. Dentist.

Okay, are we clear? Good, let's move on. Here's why going to the dentist costs what it does:

• Equipment is expensive -- The next time you visit your dentist, look at the amount of equipment he or she has in their office / treatment rooms. It's far more equipment than most medical physicians have. We have X-ray machines onsite, and every examination room has a drill (with all manner of attachments), water, and suction. It's all obscenely expensive. Heck, the chair alone costs as much as some cars do. Not to mention that overhead light. My "equipment bill" never, ever goes away.

• Changing Technology -- Once the above equipment is paid off, it's generally at the end of its useful life. A good, competent dentist will always invest in the best equipment. Have you noticed how much X-ray technology has changed (your dentist does use digital X-rays, right?) That stuff is shockingly expensive, but I cannot do my job without it. Again, my equipment bill is immense, and it never goes away.

• Schooling -- We have the equivalent of a Ph.D. The education / college costs in becoming a dentist (much like the costs of becoming a medical physician or a lawyer) are astronomical. That's partially why your doctor or lawyer or accountant charges the hourly fee they charge as we all have advanced degrees. A big difference in the lawyer/accountant, though, is the above-mentioned equipment that medical facilities have. Sometimes I wish I made what my lawyer makes.

• Materials -- If you read here regularly, you know we send out for crowns and such (or, there are machines that make them in-house... at a price that will make one choke). That's expensive -- the material cost of your crown is probably more than half the total fee. More than half the total fee, for that little tiny thing.

• Personnel -- Almost all dentists have a hygienist on staff. And, unlike many other medical professions, there are almost always TWO people working on you at all times -- your dentist, and his or her assistant. We have a busy office, to say the least.

• Insurance (mine) -- Like physicians, I am required to have a large amount of malpractice insurance. And it's really, really expensive.

• Insurance (yours) -- I discussed this in another post (and I'm going to revisit it again soon), but dental insurance is awful. It just doesn't adequately address the costs involved. Again, I've discussed the "why"s of this previously, and we'll talk about it in the future as well, because it's a hot button issue, and one I'd love to see addressed.

In all of the above, I haven't mentioned the normal expenses that any office has, like rent, heat, lights, advertising, etc. There's also continued schooling (again, very expensive).

Add the entire thing up, and you have an overhead number that is simply amazing in how large it is. I know most people won't believe me, but nobody becomes a dentist to get rich. Especially a general dentist. (I will admit my specialty, cosmetic dentistry, pays more up front, but also has even higher material expenses.) I go to work every day, just like you do, and trust me, I'm not retiring anytime soon. I grumble at the price of gas as well. When I charge $1,500-$2,000 for a root canal/crown combo that I spend an hour and a half on, I'm making less than my account or lawyer does. I'm also probably making less than the general contractor who redid my bathroom, and my auto mechanic who fixed my Audi (nope, no Porsche here).

Again, I am not looking for any sympathy. I love my profession, and it does afford me a solid middle-class lifestyle, and allows me to put something away for later as well. But us dentists are hardly getting rich here. I've also done my share of free work (with free meaning I don't get paid), and I'll always try and make myself affordable to anyone who wants to visit me.

I hope this post was at least informative to you in regards to high dental costs.

Until next time, keep smiling.

For more by Thomas P. Connelly, D.D.S., click here.

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