Mouth Math

I stopped for coffee in a rural town and couldn’t take my eyes off my young barista’s teeth. He appeared to be in his early 20s, but his teeth were only half there, peeking out of his gums like tiny baby teeth. It was distracting. I’d never seen anything like it, couldn’t stop staring, very rude, I know, and I had the thoughtless insta-thought, Why doesn’t this guy get his teeth fixed? Ha! Now I have my own nightmare mouth math, and I can tell you why some people don’t get their teeth fixed. Because a mouthful of new teeth can cost as much as a new car. Modern dentistry is a luxury. Most people can’t afford it. But still, we often judge people by their teeth.

Billie Best talks about the cost of modern dentistry.

I admit that I didn’t go to the dentist for 15 years. My bad. My gene pool has good teeth, and I gambled on my grandma’s gold fillings. But problems accrued, and I was simply postponing the inevitable. After the covid hiatus, I got a new dentist and a new hygienist. I really like them both, and I feel like I’m getting high quality care. It’s the price that’s blowing my mind. 

As you probably know, but I never really thought about until now, oral healthcare services are divided into specialties like dentist, endodontist, periodontist, etc. Each wants their own set of images of my mouth, taken at their office by their people on their equipment, which works with their software and hardware. After the initial exam, each specialist gives me a treatment plan with prices. Then I must integrate multiple treatment plans and do my own math to come up with the total cost of fixing a problem. So, I’ve decided to consider a per tooth cost of care. 

Now I’m sorting out the costs of a root canal and crown, gum surgery, and possible extractions followed by bone grafts and implants. These procedures range in price from $2500 to $5000. One molar has been recommended for gum surgery, including root cleaning and a bone graft for about $4000. But the periodontist said the problem would return in 5 to 10 years and eventually the tooth would have to be replaced with an implant priced at about $5000. Am I really going to commit to spending $9,000 on a single tooth? No. 

So, next week I’m having that tooth extracted in preparation for an implant. But truthfully, the thing that bothers me most is the empty space between my teeth that will be visible when I smile. Of course, they’re giving me something to hide it, a spacer to keep the other teeth in place while we wait for my new bone to grow. 

This has got me thinking about my lifetime cost of oral care. I’m almost 68 years old. Most humans have 32 teeth. Let’s say I spend an average of $2000 per tooth on my remaining 30 teeth over the next 20 years. Some teeth will require zero care. Some will require root canals, bone grafts and crowns, others implants, plus continuous fillings and cleanings. That’s $60,000 total oral care between now and when I’m 88, or an average of $3000 per year —  that’s $250 a month for the rest of my life — which doesn’t sound like much compared to what I’ll spend this year. And I’ll be okay.

For me managing the cost is easier than seeing myself with missing teeth. But my heart goes out to that young barista and the millions of other people who face social prejudice because they have bad teeth and can’t afford oral healthcare. Such a common problem should have more affordable solutions, right?

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7 thoughts on “Mouth Math

  1. What really irks me about the dental industry and those who can’t afford it is that they regularly opt to pull teeth of the less fortunate rather than fix them! Who’s idea was that? How are poor people supposed to pull themselves up in society, get a job, find some respect, if the welfare system has this terrible policy and they have a mouth with gaping holes?

    1. I know what you mean about the issues facing less fortunate people when it comes to their teeth. There is such a strong connection between unhealthy teeth and systemic disease. I suspect it would save money on healthcare if we just helped people take care of their oral hygiene.

  2. Hi, I have spent $21,000 over the last few years over exactly what you have described. My periodontist said to me that the one thing we enjoy as we age is eating. I get it , but spending all thus on oral maintenance really dips into money that I could have spent on mire enjoyable activities

  3. So are life saving medicines for millions of people. Healthcare is Big Business! No longer “healthcare”
    What happened to humanity and compassion.? Isn’t the Hypocratic Oath still honored….apparently and sadly not:(

  4. I had an extraction. $400 bucks in New Jersey. A friend of a friend. My Brookline dentist wanted min 7K for extraction, post, endo, crown. I asked my friend (in NYC) who turned me onto the Jersey dude, if I should get the post/implant, etc. ‘How long do you think Y’ll live?’ he asked. I figured another 10 plus. I actually LIKE the gap. But then had another problem with another tooth. NYC said, try Harvard or BU or Tufts grad school of dentistry. So that’s where I landed. Insanely long hours but super pro and meticulous and less that 1/10the cost. So I’d always rec a school like that anywhere over the force feed of a typical dentist. Plus it was no question the best teeth clean ever.

    1. To Rick Berlin, When I lived in the Simmons dorm I found out the Forsyth Dental School, (also on The Fenway, just east of the mfa) did studies on gum disease and I got free cleanings for 9 months.
      That was calendar years of 98&99. All kinds of stuff has rearranged since then. Good luck to you and Billie

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