Q & A

Questions & Answers about Root Canal Treatment

Treatment Questions

arrowHow Long Does It Take?
arrowReturning To Your Dentist
arrowAre My Teeth Worth Saving?
arrowAre Root Canals Successful?

Appointment Scheduling

arrowHow Are Appointments Scheduled?

Cost, Fees and Insurance

arrowWhat Does Root Canal Therapy Cost?
arrowWhat Fees Are Involved?
arrowHow Is Insurance Handled?
arrowBilling Policy

Treatment Expectations

arrowRealistic Treatment Expectations!
arrowYour Referral To An Endodontist!
arrowRoot Canal Retreatment And Endodontic Surgery!

More Questions

arrow More Commonly Asked Questions
arrow Do Root Canals Hurt?
arrow What Makes Doing A Root Canal Difficult?
arrow Will Antibiotics Cure A Root Canal Infection?
arrow Are Root Canals Commonly Needed After Crowns Are Placed?
arrow What Signs Or Symptoms May Exist That Suggest A Tooth May Need A Root Canal?
arrow My Tooth Had A Root Canal. Why Does It Still Hurt?
arrow How Long Can I Delay Having A Root Canal?
arrow A dentist started a root canal on me, but the file broke during the procedure. Evidently, he intends to leave it lodged in the canal. Will this cause problems for me?
arrow You And Your Dental Insurance
arrow What Is The Value Of A Root Canal?

HOW LONG DOES IT TAKE?

Root canal therapy is usually done in one to two visits depending on the complexity of the case. Each visit generally lasts between forty five minutes to an hour. Being prepared to begin treatment at your first scheduled appointment will help eliminate delays.

RETURNING TO YOUR DENTIST

When root canal therapy is complete, you must return to your dentist for the permanent restoration of your tooth. Your dentist will decide what type of restoration is required. Usually a cap or crown is required to protect the remaining tooth structure. At times, all that is needed after root canal therapy is a small filling.

ARE MY TEETH WORTH SAVING?

YES! The only real alternative to having root canal therapy, is to have the tooth extracted. To have a tooth extracted without replacement can result in a loss of chewing ability, speech may be affected, and other teeth adjacent to the missing tooth might drift changing your "bite". A false tooth to replace the missing tooth is weaker than a natural tooth. Adjacent teeth may be affected if a bridge is constructed, and a bridge is more difficult to keep clean than natural teeth. In addition, a replacement bridge would probably cost more than endodontic treatment and a permanent restoration.

ARE ROOT CANALS SUCCESSFUL?

We will recommend treatment only when we believe it will be successful. More than 93% of routine cases respond to the treatment methods used in this office. Due to complications, some teeth pose a greater than normal chance of not responding to treatment, even though endodontic therapy is still required. These cases may require more than one procedure. In a few cases, no amount of treatment will produce satisfactory results. We can usually inform you before treatment if your tooth is of the high risk type.


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HOW ARE APPOINTMENTS SCHEDULED?

IF YOU ARE IN ACUTE PAIN: Patients who are in acute pain will be worked into our schedule as an emergency patient and will be seen as soon as possible.

IF YOU ARE NOT IN PAIN: All you need to do is call and arrange a convenient appointment time.

For your convenience, we see patients by appointment only and strive to remain as close to on time as possible. We realize that your time is just as valuable as ours and feel that mutual respect for everyone's time is in both your and our best interest. Please call us at (201)-569-5500 to schedule an appointment. We encourage that your initial appointment be made by your referring dentist who best knows your dental needs. He can usually provide information as well as his x-ray that can benefit us in providing your treatment. Due to the unforeseen need to manage emergency situations and our commitment to quality care, we may at times fall behind schedule. Should this occur, we ask that you be patient. We assure you that complete care will be extended to you during your treatment and if you must experience a slight delay please remember that the patient you are waiting for might just as soon be you if circumstances were reversed. We will be sure to give you the very same attention and TLC. Please note, that should you be seen for emergency care, we may require additional visits to complete treatment.

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WHAT DOES ROOT CANAL THERAPY COST?

Fees for root canal therapy are generally determined by the number of canals involved as well as the complexity of the situation. Pre-existing dental conditions which increase treatment complexity and cost can often be predicted. You will be informed of the fee range before treatment is started.

CONSULTATIONS AND LIMITED EXAMS

Some patients prefer to have a consultation prior to treatment to have a chance to meet us and discuss their concerns. Sometimes, diagnostic procedures are needed simply to advise patients if root canal therapy is needed at all, or if their specific tooth will respond to therapy. Some procedures such as endodontic retreatment and periapical surgery require a thorough discussion of the treatment options and prognosis before therapy can be initiated. The best patient is an educated one. We are always happy to answer all your patient questions prior to starting any procedure.

WHAT FEES ARE INVOLVED?

The fee for root canal therapy includes:

  • Local anesthetics
  • All necessary treatment x-rays
  • Instrumentation and cleaning of root canal(s)
  • Filling of root canal(s)
  • Placement of a temporary restoration
  • Filling in dental insurance forms
  • Reports to your general dentist
  • Prescriptions (not dispensing of medications)

Some procedures which are charged separately:

  • Diagnostic tests and diagnostic X-rays when necessary
  • Emergency treatment
  • Endodontic consultation
  • Post or Separated Instrument Removal
  • Surgical procedures

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HOW IS INSURANCE HANDLED?

Most dental insurance policies provide the same coverage for root canal procedures whether they are performed by an endodontist or a general dentist. Endodontists do not determine their fees in cooperation with insurance companies. Because of this, the endodontist's fee and the insurance plan's benefit may not always match. The insurance contract is between the patient and the insurance company. Therefore, we have no control over what a policy will pay. A pre-determination of benefits can be filed if you need to know the specific benefits and limitations of your policy concerning a specific procedure. Remember however, that waiting for it to be returned will only delay the therapy you need, and predeterminations usually DO NOT address policy deductible or yearly maximum benefits. Disputes over coverage, benefits, payments, etc., are strictly between you and your insurance company. Your account with us is strictly your responsibility.

BILLING POLICY

Payment for services is expected at the time of treatment. Our treatment is provided on a fee for services basis, and fees are the same for all patients, whether or not they have dental insurance. For your convenience, we accept American Express, MasterCard, Visa, Discover, cash, or personal checks.


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REALISTIC TREATMENT EXPECTATIONS!

1. Treatment success depends on an accurate diagnosis. Allow the dentist, and especially the endodontist to whom you are referred sufficient time to do a diagnostic work-up. Work with him if the diagnosis seems difficult, especially if the x-ray does not show an obvious problem. You do not want the wrong tooth treated. If the dentist is not sure which tooth needs the root canal or he/she can't see a problem on the x-ray, seek a second opinion or wait until the symptoms are more localized (if you can).

2. Seek a care provider appropriate for your needs. One appointment, molar (multi rooted) root canal is more demanding than an anterior (single rooted) root canal. Endodontic surgery is extremely difficult and requires special instruments and techniques not often taught in dental school and rarely found in general dentist or oral surgeons' offices. An endodontist dedicates 100% of his time and efforts to treating root canal problems, and enjoys the work he has chosen. It is logical that with this dedication to treating specific endodontic dental problems he should be able to provide therapy in fewer appointments, more proficiently in difficult cases, and provide a better treatment outcome. This is the advantage of seeing a specialist who has restricted and limited his practice to endodontics.

3. Know and like the person doing your dental treatment. Two words are essential in a dentist- patient relationship; trust and rapport. Neither word suggests anything about the quality of your care, but both are essential to the dental relationship.

4. When the root canal is completed, expect to see the final x-ray showing that the root canal is completed and have the dentist explain what is seen on the x-ray. All canals should be prepared and filled close to the tips of the roots. In reality, this is the only way to check on the work performed. There is no mechanism in dentistry to routinely check on the quality of work performed by licensed dentists. Furthermore, if he feels good about his work, he will be glad to show you the results.

5. There is always a period of post operative discomfort. The degree and type of pain you experience after root canal therapy depends upon a number of factors. They include the original diagnosis, your unique reaction to dental trauma, the amount of pain you had prior to treatment, and the amount of manipulation necessary to work on the tooth. Appropriate analgesics and antibiotics may be required and should be taken as directed. The tooth is expected to be sore to chew for several days to a week. To help diminish this discomfort, the 'bite' on the tooth is often relieved from occlusion, and you are asked to avoid the side while eating until it is again comfortable.

6. There is usually a need for the tooth to be permanently restored following root canal therapy. For nearly all back teeth, the final permanent restoration should be a crown. A crown covers the entire tooth, protects the tooth from breaking and chipping, restores the tooth to its original strength, and protects the root canal from becoming contaminated (leading to early failure). For teeth with crowns, and for some front teeth that do not have fillings or decay, a permanent filling in the access opening may be all that is needed. If your general dentist has not discussed the permanent restoration, ask her or him.

7. As fillings and crowns need to be replaced from time to time, root canals may need retreatment. Root canals ARE NOT always forever. Once thought of as a once in a lifetime treatment to a tooth, it is now accepted that root canals may fail over time when the pulp space inside the tooth becomes contaminated or reinfected. The need for regular dental check ups must be emphasized, because a tooth with a root canal will no longer be sensitive to hot, colds or sweets (the typical warning signs of dental decay and potential dental problems). Periodic x-rays are needed to make sure the tooth has not developed new decay or an abscess. Failure of a previous root canal is very often a painless chronic process, yet a problem that needs to be corrected.

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YOUR REFERRAL TO AN ENDODONTIST!

A dentist at times has a duty to refer to a specialist, but most referrals are suggested because of a sincere care for your dental health and the recognition that your special dental problem is more suitably treated by a specialist.

A referral can be done in several ways, but is generally initiated by your family dentist. Normally patients are referred for a specific treatment or for an evaluation and treatment. The reasons a referral is needed may include unusual difficulty of the endodontic case, the recognized need for special case management (e.g., health problems, difficult diagnosis), or because the procedures are not normally performed by your general dentist.

Be prepared for your appointment to an endodontic specialist. First and foremost, realize you were referred for a root canal and your accepting a 'treatment' appointment means you are prepared to proceed with root canal therapy. If however, you have questions concerning endodontic therapy, feel special issues (medical history, insurance coverage) need to be discussed, or you simply want to meet and get to know the specialist before treatment is started, then a short appointment for 'evaluation and consultation' should be made prior to treatment. All of your questions should be answered prior to accepting root canal therapy (informed consent) to save your tooth.

ROOT CANAL RETREATMENT AND ENDODONTIC SURGERY!

The procedure of doing a root canal is largely mechanical manipulation inside the tooth. The response to it is a biological response of healing. Even though the success rates for routine cases are very high, (93%), and success only decreases slightly in difficult cases if the objectives of treatment can be achieved, there is no guarantee for root canal procedures because of the biological response of healing. Even successful root canals may someday develop a problem. Two important factors are usually not considered to have a direct effect on the success of a root canal procedure, but ultimately help determine success and failure. One is the skill level of the dentist providing therapy, and the other is quality of the permanent restoration placed after the root canal is completed. Either of these two factors may result in the development, recurrence, or nonresolution of non-vital pathology associated with a tooth previously treated with root canal therapy. The decision to keep the tooth and avoid extraction must again be made. Once you have decided that you want to keep the tooth your dentist will advise you of the appropriate treatment decision for the tooth. The alternatives of root canal retreatment or endodontic root end surgery need to be considered.

Root canal retreatment should generally be the first consideration to save a tooth with a failed previous root canal. Retreatment may require removal of the existing post within the tooth, removal of the crown, and then the removal of the old root filling material(s), cleaning and shaping all the canals in all of the roots, identifying and correcting the problems encountered from the old root canal if possible . The canals are then refilled and sealed. There are circumstances that are not correctable by root canal retreatment and in which case endodontic surgery is indicated.

Endodontic surgery is indicated when there is a problem, such as an endodontic abscess, that cannot be corrected by a retreatment. The problem, usually seen on an x-ray, is that a blockage exists in the canal that prevents access, treatment, and correction of the root end area of the canal. Instead of treating the problem through the tooth, the problem can only be accessed and treated by treating the root tips directly. During surgery, a surgical operating microscope is utilized to identify the root end and the infection in the bone and a small amount of the root (about 3mm) is shaved off and the infection is scraped away. This is called an apicoectomy. Usually the root end is then prepared and a filling is placed. This root end filling is intended to seal the canal and prevent leakage of possible contamination out of it.

Surgery may also be a more appropriate treatment choice if the doctor and patient wish to avoid the time, trouble, and expense of removing and subsequently replacing the existing post and crown, or if the Specialist feels that clinical experience indicates a very low possibility of success through retreatment alone, thereby requiring the subsequent need for the additional surgical procedure as well, or if there is a need for replacement of the diseased bone through a regenerative procedure to help with the repair process by adding new bone and a protective healing membrane barrier.


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MORE COMMONLY ASKED QUESTIONS

Specific questions concerning your case cannot be answered without a current set of x-rays, a chief complaint, and a hands on dental examination. Generic endodontic questions will be answered however. Send your questions to info@rootcanaldentist.com

DO ROOT CANALS HURT?

In reality the process of doing a root canal should never hurt. You should be profoundly numb and the tooth should have no feeling (to hot, cold or pressure) during the procedure. For some teeth, profound local anesthesia may be difficult for dentists to achieve, but it is usually possible. What really hurts is the reason a root canal is needed in the first place. The probability is that the root canal was started when a toothache emergency occurred. The person was already in pain before the root canal was started. Post operative discomfort is another potential pain problem, but mostly should be within some degree of soreness manageable with pain medications.

WHAT MAKES DOING A ROOT CANAL DIFFICULT?

The reasons are too numerous to discuss in detail. The following are some of the more common reasons root canals are referred to an endodontist when difficulty of the case is discussed:

    • Difficulty in achieving profound local anesthesia.
    • Difficulty in diagnosis or being sure the correct tooth is treated.
    • Difficult tooth location for root canal treatment. Two things make back teeth more difficult to treat. One is that molars are far back in the mouth making it harder to get to and harder for you to stay open. The second is that molars have at least three canals and often four canals that need to be treated.
    • Calcification of the root canal chamber (in the crown of the tooth) or root canal system (in the roots of the tooth). Calcification means that the space needing to be treated has been partially or mostly closed down by trauma or nature and is more difficult to find, more difficult to enlarge, and more difficult to fill.
    • Root canal curvature. Observed on x-rays, the roots of teeth are rarely straight, but are most often curved. Often not seen on x-rays is that root canals have even more severe curves than those seen. The more severe the angle of curvature and the abruptness of curvature, the more difficult the case.

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WILL ANTIBIOTICS CURE A ROOT CANAL INFECTION?


Absolutely not! If this was the case all that would ever need to be done would be to take some pills and presto!, you would be cured! Unfortunately, this is not so. But, antibiotics are often useful in aiding in the treatment of root canal infections because they help relieve symptoms associated with teeth that have diseased nerves. Antibiotics are indicated when there is swelling, a temperature, or other systemic signs of infection. Antibiotics may be useful to diminish symptoms such as biting pain before the root canal can be started, and may help prevent some types of post treatment pain involved with having the root canal performed. Antibiotics cannot cure a root canal infection because the source of the infection is inside the tooth where there is no blood supply and where antibiotics cannot get to. The cure is the complete cleaning, shaping and obturation of the contaminated root canal space. In other words, the root canal therapy!

ARE ROOT CANALS COMMONLY NEEDED AFTER CROWNS ARE PLACED?

Dentists will nearly always suggest that crowns be placed on teeth that have had root canals. There are times when a recently crowned tooth, as well as teeth that have had crowns on them for a considerable length of time, will need root canals. The percentage of teeth that have crowns that will eventually need a root canal ranges from 19% to 25%. This is not common, but it does occur with some regularity. It is common enough that a dentist should advise that every tooth which needs a crown may require root canal therapy in the future. A risk of any involved restorative procedure is that the dental pulp may become diseased and a root canal may be required on the tooth.

Teeth may develop symptoms indicating a root canal is needed years or immediately after a crown is performed. What happened and was this preventable? All decay and dental work are insults that injure the dental pulp. By themselves, many such insults are not a problem, but cumulatively they take an additive toll on the health of the dental pulp (the nerve). In fact, teeth often have dental pulps that are already compromised either by poor blood circulation or by painless chronic inflammation before a crown is placed. There is virtually no way to evaluate for the problem or to tell if a problem exists at all. Remember, the restorative procedures needed for the crown are usually the last of many insults the dental pulp has endured over the lifetime of the tooth. Before the crown, there have been several fillings that have become larger and larger over time. Then the tooth is prepared yet again for the crown. An impression is taken, a temporary crown is made, and ultimately the permanent crown is cemented. This additive preparation trauma is normal, but may be the insult to the dental pulp from which it cannot recover. The tooth dental pulp therefore either begins to hurt and becomes symptomatic or it may undergo a slow painless death. The dentist did nothing wrong. Elective endodontics or preventive root canal therapy may be considered for teeth that need crowns when concerns exist about the health of the dental pulp before the procedure is started.

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WHAT SIGNS OR SYMPTOMS MAY EXIST THAT SUGGEST A TOOTH MAY NEED A ROOT CANAL?

  • During a restorative procedure, a tooth may be difficult to numb, or a small area of the prepared dentin hurts when touched, even though the rest of the tooth does not have any feeling to the drill. Such a condition may suggest localized inflammation in the dental pulp that is irreversible and that the tooth/pulp cannot heal from.

  • After restorative procedures are completed, teeth may demonstrate a variety of symptoms. Symptoms may include sensitivity to thermal changes (hots and/or colds) that do not improve or disappear within a couple weeks. Sensitivity symptoms may continue to worsen after having the filling or crown done. Generally, the more severe the sensitivity and the longer it continues to bother, the more likely a root canal is needed. Some teeth start to become and remain uncomfortable to chewing, but adjusting the bite does not seem to help. Some teeth experience a poorly localized diffuse chronic aching in the general area of the tooth (or side), frequently described as a soreness but not a toothache. At times it may not be noticeable, while at other times it is noticeable. This type of pain can actually persist for months or years without developing a severe toothache. Yet, the dental pulp is diseased and a root canal is indicated. X-rays will usually continue to look normal, and will be of little benefit in diagnosing these problems.

When a root canal is needed on a tooth with a crown, the crown can generally be saved. Sometimes a practitioner may decide to try and remove the crown to do the root canal. Many times there is a consideration that taking the crown off could break or damage the tooth underneath it. Therefore, root canals are commonly performed through the crown without removing them. After the root canal treatment is complete, a temporary filling may be placed, but a permanent filling into the access opening will be needed.

MY TOOTH HAD A ROOT CANAL. WHY DOES IT STILL HURT?

This is a false statement I hear from dentists and patients quite frequently." He told me the tooth was dead, so why does the tooth still hurt?" The answer has several parts. First, we must be absolutely sure what is meant by the word hurt.

  • Let us make sure that by hurt, we all mean that the tooth is sore and tender to bite on, touch, or otherwise manipulate. This is a tooth which you will generally be able to point to or touch, and be very specific as to which tooth is hurting. "This tooth right here hurts, when I put my finger on it."

  • If you mean the tooth with a previous root canal is still sensitive to thermal changes, or if you have a toothache in an area but you cannot tell which tooth it is, then an entirely different problem is posed. The answer is not here. The most likely problem is that you need another root canal on an adjacent or nearby tooth.

The part of the nerve and feeling to the tooth that is removed with a root canal is the part that responds to temperature changes (hots and colds) and sweets. The tooth has another set of nerves that are never changed, removed or altered during root canal therapy. That part feels pressure and touch.

The tooth is surrounded by bone and tissue. The roots are embedded in the bony socket and the tooth is held in place by small ligaments. The gums surrounding the tooth are attached and sealed to it as the tooth protrudes from the bone and tissue. The feeling to these two elements (bone and gums) are never changed with root canal therapy. You still can feel the pressures of biting on the root canal treated tooth, and still feel the soreness of the tooth being bumped. The bone and gums surrounding the tooth still have a blood supply and a nerve supply. Therefore, the tooth with a root canal is not dead but is a continued viable and live component of the dentition.

If the bone and gums are not healthy, then periodontal (gum) disease may cause you pain. If the bone at the root tip is abscessed, then an endodontic problem may cause you pain. Your dentist must diagnose and treat the many potential variations that exist.

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HOW LONG CAN I DELAY HAVING A ROOT CANAL?

The basis for this question is generally that your dentist saw something on the x-rays taken at a routine dental examination. That 'something' was most likely a dark area at the tip of the root indicating that (root apex) pathology commonly called abscesses or infections, are present. You need a root canal to cure the problem. However, the problem has never bothered you, and the only reason you are aware of needing a root canal is because of the evidence on the x-ray.

First, consider yourself lucky. Your dentist has performed a thorough examination and has found a potentially painful problem that is treatable and curable. When treated, it is probable that this therapy will prevent you from experiencing a severe toothache. Many times root canal problems quietly develop, and because of the slow chronic nature of the developing problem, they are not painful.

How long can you delay therapy? How lucky do you feel? Delaying therapy is like rolling dice; sometimes you win, eventually you will lose. Teeth needing root canals are best treated when they are not hurting. The experience of having the root canal performed can then be thought of as having a long filling appointment, and does not need to be dreaded (when performed by a caring and knowledgeable dentist). When the tooth begins to hurt, the scenario for having to work on the tooth is entirely different. You are in pain before the procedure is started!! Possibly you have developed a facial swelling or are running a temperature because of the more severe infection developing. The tooth gets very sore to touch and bite on. You still need the root canal (or extraction of the tooth).

Delaying root canal therapy may result in an emergency. It is unlikely the tooth can be treated completely in one appointment, but will require two or more (one for the emergency, and one for the root canal completion). Post-operative discomfort is going to be greater. In the very worst cases (thankfully occurring very rarely), hospitalization for management of the infection is necessary.

Delaying root canal therapy may result is a situation where the tooth become non-salvageable or non-restorable. Delaying therapy for years may lead to a situation that root canal therapy does not offer a predictable way of resolving the infection; your delaying of endodontic therapy has greatly reduced the probability of success. Now you are left with the decision of extraction or the possibility the root not only requires a root canal but also endodontic surgery.

Our advice is simple; You have the opportunity to save your tooth and prevent future problems through root canal therapy. A short delay is unlikely to result in any serious problems, but you are pushing your luck if you think you can delay treatment indefinitely.

A DENTIST STARTED A ROOT CANAL ON ME, BUT THE FILE BROKE DURING THE PROCEDURE. EVIDENTLY, HE INTENDS TO LEAVE IT LODGED IN THE CANAL. WILL THIS CAUSE PROBLEMS FOR ME?

It is unfortunate that separation (breakage) of an instrument occurred during your root canal therapy. This should not occur often but does happen, especially in more challenging teeth, even when root canals are performed by a competent dentist, as it is an inherent risk of doing root canals. It is more likely to occur in cases of canal calcification and curvature. . The breakage of an instrument is not an indication of therapy below the standard of care, nor does it suggest any negligence on the part of the dentist. The single thing that is considered negligence and below the standard of care is if the dentist had not informed you of this mishap. If he/she told you, your dentist should be commended for being forthright and honest.

Your question about 'will the broken file cause a problem' does not have a straightforward answer however. Depending on the type of instrument and the location within the canal it broke at, some are actually able to be removed. There is no doubt that the best solution is to remove the broken file. The second best solution is to bypass it, clean around it, and ultimately incorporate it into the filling by entombing it in the root canal filling material. When these two things cannot be achieved, the third solution is to complete the case as well as possible and observe for future healing and resolution. Endodontic specialists are becoming more highly skilled in removing objects that should not be there (including broken files) from root canals. A variety of techniques to remove objects (such as broken files, posts and old filling material) are available. Many of the techniques require special training and instruments your general dentist may not be aware of or does not have.

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YOU AND YOUR DENTAL INSURANCE

Do you determine the quality of your dental therapy by how much your insurance will pay? Have you had to search for a new dentist because your old one does not participate in a new dental plan? If so, you are a victim of the insurance system. Our consumer hint to you is that you should never allow your insurance to dictate dental treatment on the basis of coverage. You should understand your insurance, not depend on your dentist to know this information. Insurance should and must be considered an adjunct, that helps you with your financial responsibility towards the dental treatment that you accept as being in your best interest. Any questions or disputes involving insurance should remain between the subscriber, that is you, and the insurance company. Ultimately the fees involved in dental (or medical) treatment are the patient's responsibility to pay to their dentist or doctor.

It should be no surprise to you that insurance companies exist solely to make money, not to pay your medical or dental bills. Increasingly patients and dentists are suffering (reduced or refused benefits on major procedures, reduced compensation and administrative headaches) while the profits of insurance companies increase. Insurance companies are not solely to blame. Employers must continuously negotiate for better (lower) prices for employee benefit packages, usually resulting in reduced benefits. Realize that insurance benefits are a contract between you, your employer, and the insurance company. Your dentist has no input into this process.

Dentists accept insurance as payment as a courtesy to you and because they do not want to offend you, their patients. The reality is that figuring individual contract limitations, deductibles and percentages for potentially hundreds of insurance contracts is overwhelming not to mention time consuming. So the insurance is submitted to 'see what comes back'. There are layers of confusion built into the insurance industry. Fee for service, PPO, DMO, networks, and flat schedule reimbursement are just a few types of insurance contracts provided in employer benefits packages. Many require participating dentists to sign a contract that reduces their collectable fee income by accepting an insurance fee schedule for the promise of new (or maintaining existing) patients. This contract dentist requirement also limits your selection of dentist to those few dentists who have signed up.

Another layer of confusion involves what are called 'usual and customary' fee schedules. With this there is little hope of accurately figuring your benefit information. Usual and customary fees are schedules that each company has determined to reflect what dentistry 'should' cost in your region (zip code area). Many companies to do not readily divulge the usual and customary fee information and cannot tell you precisely how they were derived. This leaves their payment a surprise on the benefits printout and leaves the impression the dentist has overcharged you because it states 'the fee exceeds the contract limitations'. Subscribers should be aware that insurance companies with 80% coverage for a "Basic" dental service, will pay 80% of what they consider usual and customary, but it is rarely 80% of the ACTUAL fee. The actual fee is the fee the dentist charges for his services.

Do not blame your dentist for restrictions your insurance company imposes because of your coverage contract!

Basically, dentists who accept "assignment of benefits" from their patients do so as a courtesy and are under no obligation to do so. The dentist does not really know what the insurance will or will not cover, and it usually takes about six weeks for a dentist to hear anything from an insurance company, whether they pay or deny benefits. Dental offices may not accept assignment of benefits for a number of reasons, one being the financial loss it represents. The dentist is not a bank or credit institution. He deserves his fee when treatment is rendered. When you have your car repaired, does your mechanic let you have your car back before you pay him? Does your beauty or nail salon do your hair and then let you take six or seven weeks before paying them?

WHAT IS THE VALUE OF A ROOT CANAL?

It has been stated that the value of an extracted tooth can reach well over $140,000 in dollars spent over time. The value of root canal therapy is not what it costs. Value is the importance of the service to you the dental consumer. It is the importance of knowing you have done everything possible to save your natural teeth, a non-replaceable commodity. Your selection of a care provider should correlate with the value you place on your own well being (especially if a treatment is expected to last a life time, which few dental therapies do). You deserve the best and saving your teeth is the best dental treatment you can provide yourself.

No one expects to get the performance and quality of a luxury car for the price of a compact. No one should expect the highest quality of dental care if the main criteria for selecting a dental provider was the cheapest price. Root canals are no different, you generally get what you pay for!

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