The $50 Week : Nothing but the Tooth

It was around 4:00 a.m. on Christmas when the pain erased any visions of sugarplums from my head. Shooting up the left side of my face, I soon realized that whatever lingering toothache I had been nursing over the last couple of years had finally come to—pardon the pun—a head.

Fortunately, I had some prescription-strength ibuprofen in my medicine cabinet, enough to get me through to January 1 when my dental insurance finally kicked in. The severe pain that came from even opening my mouth also meant that I was able to detox a bit from all of the pre-holiday dinners and treats that I had tucked away since Thanksgiving. I spent hours on December 25 poring over the dentists available in my new plan, comparing their names to corresponding reviews on the Internet, from Yelp.com to Wellness.com to Vitals.com. After seeing enough horror stories of botched fillings and threats of legal action for less-than-stellar reviews, I wondered if using my cast-iron skillet to knock out the offending tooth would be a better course.

That idea seemed even more palatable the next day, when many offices reopened for business and I was able to call to schedule appointments. Turns out, of the 20 dentists that seemed on the up-and-up and within my network that I called, only one took Solstice, my new dental plan, despite being named in their provider directory.

And even that one dentist proved to be a bust when it turned out that he took the PPO version of Solstice but not the DMO. I found this out after he novocained me up to begin work on a much-needed root canal on January 2. If you haven’t had half of your face numb while juggling phone calls between your husband, your mother, and your insurance provider while you’re in a dentist’s chair, I envy you. Ultimately, my husband and I wound up dropping Solstice in favor of Careington, which is not insurance but rather a discount program. But unlike a DMO, more reputable dentists accept it, and unlike a PPO you don’t have to worry about spending limits.

While only 50 percent of Americans have dental insurance (according to an ADA study) and 60 percent of those Americans who don’t go to the dentist don’t go because of the cost of insurance, it’s an investment worth making. Had I had my cavity filled a couple of years ago, I would have paid 10 percent of my total root canal costs (which included a post and a crown). But whether you merely need a routine cleaning or have impacted wisdom teeth you need extracted, there are ways of defraying the costs of keeping your canines in top form.

Get Schooled

A while back, I wrote of an experience I had at NYU dental school that took all of six hours, involved little more than a shy student examining my teeth with basic tools, and a co-pay that nearly set me back three figures. I was told to come back when they were less busy and informed that I would have to pay once again even though my appointment for X-rays and a teeth cleaning was incomplete—and had I the stamina to argue I probably could have solved that problem.

It’s not worth sugarcoating this news: dental schools run by local universities and colleges are, especially in New York, painful on a multitude of levels. Supervision is hard to come by when you’re one of hundreds sitting in a series of cubes, counting the number of indentations in the ceiling panels. There is a lack of expertise and a pervasive attitude, especially among the non-student staff, that you’re getting a huge favor out of a cheap and comprehensive checkup.

But the thing is, it is a favor. For preventative care, and for those short on pocket change, the inconveniences that are part and parcel with submitting to the university system can also be worth it. Most university-run clinics don’t offer restorative or surgical options, but a standard cleaning is probably all you want to risk with someone still in training. And these kinds of appointments are the baseline for your overall oral care.

Read Up

Ultimately, my teeth are on their way toward being back to normal thanks to an emergency credit card that I keep just for these sorts of situations. My dentist was worth every penny (and, to all of you New York readers, I can’t recommend Dr. Mehrdad Noorani on Madison Avenue highly enough). But I knew what I was getting into with Dr. Noorani when I Googled him. Vitals.com is a great resource as it aggregates reviews from a number of platforms—Yelp, CitySearch, and the like.

In reading reviews, it’s best to take both the positives and negatives into context. A one-star review complaining about the aesthetics of the office or the lack of warmth in your potential dentist’s personality aren’t automatic deal breakers. Likewise, a glowing review that doesn’t go into detail shouldn’t equal an automatic sell (in fact, if a dentist’s office has nothing but glowing reviews full of generic platitudes, it could very well be that the practice’s own employees or friends wrote those reviews to boost their competitive advantage).

Look for reviews that discuss what you believe your specific problem to be. For me, I was 95 percent certain that I needed a root canal, so I was especially wary of dentists who were faulted for insufficient root canal work. Another quality I gravitate toward is loyalty, and the number of people who mentioned seeing my dentist for five or 10 years indicates not only a sense of lasting reliability in his practice but also a consistent quality.

Speak Out

When I was in the chair and told that my insurance was not, in fact, accepted by my dentist, I immediately said that wouldn’t work for my arts-industry salary. Maybe it was the fact that we were both Arabic Jews, the fact that we both liked classical music, or the fact that I was an overall pleasant person even under the pressure, but Dr. Noorani sat down with me and went over, in writing, the financial breakdown of my work and then proceeded to tell me what kind of discount he could offer me (prior to my husband and I deciding to join Careington).

Sometimes just simply leveling with your oral care provider can mean the difference between debt and dental health. Most dentists agree that the majority of dental insurance is more trouble than it’s worth—indeed, you’re better off taking whatever money you’d pay out of pocket for a dental plan and setting it aside each month to cover your annual expenses out-of-pocket—and so they’re willing to shave a little off the top in order to keep your business.

In some cases, they’re also amenable to the occasional barter. Remember what I said about threats of legal action over Yelp reviews? That’s a testament to the competitive nature of the dental industry. And unlike a restaurant or tailor, one bad review can carry substantial weight in an industry where you’re putting your well-being into a veritable, albeit qualified, stranger’s hands.

As such, a dentist with strong reviews and who runs their own practice may be in a position to give you an additional discount in exchange for some coaching on social media, website design, or perhaps even music lessons. Be sure to lay out your agreement in writing and be specific as to the terms of the barter (and check out the October 2012 installment of this column for more on effective bartering tactics).

Plug In

We found Careington on DentalPlans.com—which, if you do find having some sort of coverage necessary, is a great place to find a plan to suit your individual needs (you can even tailor your search to a specific dentist if you already have one in mind).

Beyond that, however, the Internet can be a wellspring of financial aid if you commit the time. While I’ve taken websites like Groupon and LivingSocial to task for encouraging unnecessary spending, occasionally their offers include half-priced teeth cleanings and X-rays. Just be sure to check out the offering company on a third-party website to make sure you’re not throwing money down the drain. (Chances are, if a dental practice is on a Groupon or LivingSocial type of website, they’ve been there before and often you’ll see a review from someone who has gone on a similar discount, which is an experience that has the potential to differ markedly from someone who paid full price.)

Social networks like Yelp and Facebook also offer the potential for discount hunting. As I write this, I’m staring at a Yelp Deal that offers $75 for $100 worth of care at my dentist’s office, and other larger practices often co-opt their Facebook and Twitter accounts to offer discounts to fans.

Get Out

There are differing schools of thought on the notion of dental tourism, or the act of seeking dental care out of your country in order to take advantage of a more navigable system. The prevailing argument against this practice is that you end up spending more in travel costs than you would to simply be treated domestically.

But as a singer, you have the advantage of being in a profession that often requires travel—particularly to Europe. The standards to become a dentist in the European Union are consistent from country-to-country, which also means that a dentist in Hungary is as qualified to practice dentistry as one in France. In fact, Budapest is one of the more popular cities to go to for steeply discounted dental care, especially for those in neighboring Germany and Austria. They even boast the Association of Leading Hungarian Dental Clinics, which caters to finding dental tourists the highest quality care. Members of this association handle tens of thousands of appointments each year, and over half of those patients come from abroad. Likewise, the Czech Republic is establishing itself as another popular destination for dental tourism.

If your work keeps you on the continent, an EasyJet flight over to the former Eastern Bloc and a budget hotel could still end up saving you big when it comes to getting a crown or bonding—prices are roughly 10 percent of the cost in America. Just avoid the sugary strudels once you’re out of the chair.

Olivia Giovetti

Olivia Giovetti has written and hosted for WQXR and its sister station, Q2 Music. In addition to Classical Singer, she also contributes frequently to Time Out New York, Gramophone, Playbill, and more.